Polycystic ovaries (also called Stein-Leventhal syndrome or PCOS) is a condition associated with multiple cysts on or in the ovaries. Every month, during a normal menstrual cycle, the ovaries will produce follicles that contain the eggs which are released.
Normally only one follicle will mature fully and go on to release an egg, however in polycystic ovaries many follicles are produced but none of them mature sufficiently to release an egg. This means that ovulation doesn’t take place and therefore the normal hormonal cycle is interrupted and hormone levels become unbalanced, creating a ongoing problem. As a result PCOS is now known to be the most common cause of infertility and ovarian failure.
It is believed that 10% of women in the UK may be affected by PCOS to some extent and according to the NHS, almost 25% of women referred for an ultrasound exam are found to have PCOS.
The classic symptoms of polycystic ovarian syndrome are:
- irregular or light periods, or no periods at all
- excessive hair growth
- weight gain
However, it should be borne in mind that if you suffer from PCOS, you may not have all the symptoms all of the time. Every symptom can also be experienced in mild or severe forms and they usually start to develop in the early years after puberty.
The exact cause of PCOS is unknown, but it is known that it runs in families and that insulin resistance, particularly in those who are overweight, seems to be a factor as well. This is probably because an excess of insulin and of testosterone interferes with the body’s ability to develop the follicles fully to allow ovulation. As a result of this, being overweight has a profound impact on PCOS, as additional fat in the body encourages it to produce greater amounts of insulin. But this can be a bit chicken and egg, as having insulin resistance is also known to increase weight. One point to bear in mind though, is that losing weight is often very helpful in reducing the symptoms and severity of the symptoms of polycystic ovaries. Reducing the amount of insulin that the body produces, also reduces the amount of testosterone as well thereby having an increased effect on the PCOS symptoms.
Most women with PCOS, will also run an increased risk of developing diabetes, experiencing high blood pressure and high cholesterol. All of these conditions can lead to heart disease. In addition a lack of periods or experiencing lighter periods may mean that women risk developing endometrial cancer as well.
The main treatments for PCOS are drug based and emphasise a normalising of the hormone levels to try to ensure that ovulation takes place. Therefore drugs that block testosterone production may be used, as well as those to stimulate ovulation such as clomiphene.
Finally, Metformin which is normally used to reduce insulin resistance in diabetes sufferers seems to offer some treatment possibilities – however this research is in it’s early stages and has yet to be completed.