Global Issue
When a medical condition affects a large portion of the population, it becomes a burden on the economy. That can mean a concentrated effort to understand the disease in an effort toward finding a cure. That’s what’s happening with polycystic ovarian syndrome (PCOS), which now affects every one in 15 women, all over the world. Since the disease is linked to obesity, experts believe that the rate of obesity is liable to increase at a rate similar to PCOS, which affects a woman’s endocrine system. This is the conclusion of Dr. Theresa Hickey and Prof. Robert Norman of the University of Adelaide in Australia.
PCOS affects multiple body systems, resulting in varied health issues such as acne, obesity, excessive body hair growth, infertility, metabolic syndrome, and menstrual problems. The main symptoms of PCOS, however, are ovarian cysts, the overproduction of male hormones, and unpredictable ovulation. Type 2 diabetes is often found in women with PCOS.
Two Definitions
However, the very definition of PCOS is still under discussion, with two different perceptions of how the disease should be seen. One definition was created in 1990, the other in 2003. The two definitions make for two sets of statistics. This leads to money being diverted to very different study tracts, which may muddy the waters of medical understanding for this complicated disease process.
While the exact causes of PCOS are still a mystery, both genetic and environmental factors are shown to be players in the contraction of this ailment. Researchers have concentrated their efforts on the determination of the primary cause of PCOS which may be due to defects in the ovaries, abnormal insulin activity, or problems with the hypothalamic-pituitary axis. Another apparent cause of PCOS is obesity itself, and sometimes weight loss is enough to help regulate ovulation and better the chances of conception in women with the disorder.
As Dr. Hickey and Prof. Norman comment, “Skin and hair disorders can be substantial in women with PCOS, and are physically and psychologically very damaging.”
Doctors address these problems by prescribing oral contraceptives which are efficient in healing acne and hirsutism as well as serving to regulate the menstrual cycle.
The seminar provides an in depth look at the link between PCOS and infertility and the standard treatment of the syndrome with clomifene, which helps in stimulating the growth of follicles and ovulation. Clomifene is not without its risks and women with PCOS who are being treated with the drug are at risk for the life-threatening condition known as ovarian hyperstimulation syndrome, as well as for multiple pregnancies, and the cancellation of in vitro fertilization cycles.
Pregnant women with PCOS risk early miscarriage, preeclampsia, caesarean section deliveries, gestational diabetes, and high blood pressure.
The authors believe that the number of women with PCOS will increase in the coming years, and comment that, “Future priorities in relation to PCOS include the development of evidence-based criteria for diagnosis and treatment, and determination of the natural history, cause, long-term consequences and prevention of the disorder.