PCOS and Menstrual Irregularities

Defining PCOS

Polycystic ovarian syndrome (PCOS) is defined by the National Institute of Child Health and Human Development this way, “PCOS is a condition in which a woman’s ovaries and in some cases the adrenal glands, produce more androgens (a type of hormone, similar to testosterone) than normal”. It is normal for women to produce both female and male hormones, but when a woman produces more androgens than normal the results can be devastating, especially if the person is a young woman or teen. Hirsutism (excessive body hair growth), acne, and irregular periods are but a few of the symptoms of this condition. Symptoms can run the gamut from mild to severe, with some women not even knowing they have it until they try to become pregnant.

The Symptoms of PCOS

PCOS is the most common endocrine disorder in women and experts believe that the number of women affected by it could be as high as one in ten. Many cases of this syndrome go undiagnosed because the symptoms vary so much. Consequently, a diagnosis can often be difficult to obtain, unless a reproductive endocrinologist is involved. The symptoms, along with those mentioned above, include infertility (often due to irregular periods and lack of ovulation), male-pattern balding, obesity, high blood pressure, diabetes mellitus, cancer, acanthosis nigricans (darkened, thickened skin around the neck, armpits, or breasts, and sleep apnea. PCOS often has significant, long-term effects which means an early diagnosis and treatment are important.

What Causes It?

PCOS, formerly called Stein-Levanthal syndrome, was first noted in the 1930s, yet even today doctors cannot give an exact cause for the condition. Some research indicates it could be related to increased insulin production in the body. Women with PCOS may produce too much insulin which, in turn, signals the ovaries to release extra male hormones (androgens). The imbalance of hormones affects virtually every system in the body, which is why there are so many differences in the ways women experience the syndrome. Blood sugar issues are typical in women with PCOS and the imbalance of insulin is the cause. PCOS tends to run in families and typically the symptoms begin to appear in adolescence, continuing through adulthood. There are some cases where the symptoms are seen as early as pre-adolescence. They cease at menopause, however, the long-term effects of diabetes and other serious diseases that can result from PCOS may never go away.

It Can Go From Bad to Worse

There are complications that can arise from PCOS, especially since it affects so much of the body. Having PCOS puts a woman at risk for a number of other serious conditions. Endometrial cancer risks increase if a woman has irregular periods with more than 60 days between menstruations. It is necessary for the uterine lining to be shed in order to prevent the growth of abnormal cells so if they are not shed regularly danger increases. It is possible to medically regulate menstruation by using hormonal birth control pills. Type 11 diabetes, cardiac disease; high cholesterol and metabolic syndrome are all additional risks since insulin resistance and difficulty regulating blood sugar are common in PCOS. Often obesity or large weight gain accompanies PCOS.

Diagnosing and Treating PCOS

Although the list of symptoms can be a guide for diagnosing PCOS, the best way to get a sure diagnosis is through an endocrinologist who will do a complete medical history, physical examination and gynecological examination. Blood tests that allow the doctor to measure androgen, insulin, and other hormone levels are necessary to determine the condition as well as treatment. An ultrasound may also be done to look at the ovaries and determine how to treat cysts, if they are visible.

There is no cure for PCOS, but there are treatments that can be effective. Birth control pills or progesterone pills may be used to help regulate periods by reducing androgen levels. Metformin, used to treat diabetes may be used to lower insulin levels which can help with hirsutism and acne. There are a number of ways to deal with the outward signs of PCOS, like depilatory creams for hair growth, and seeing a dermatologist for acne. A healthy diet and exercise can be a good way to deal with weight gain.

There are a number of support groups available for young girls and women struggling with PCOS.

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