5 things to know about Polycystic Ovary Syndrome

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By Stephanie Bowens
 |  StarNews Correspondent

Polycystic Ovary Syndrome is one of the most common, yet treatable, causes of infertility in women. PCOS affects 1 in 10 women of childbearing age, according to the Office On Women’s Health, and women who have the condition experience hormonal imbalance and metabolism problems that may affect their appearance and overall health.

Dr. Nicholas Bodenheimer, DO, an obstetrician-gynecologist with Novant Health OB/GYN – Bolivia, said he’s treated many women who have PCOS. He said the condition is typically characterized by hyperandrogenism, or elevated levels of androgens, such as testosterone, irregular or no menstrual periods and polycystic ovaries revealed on an ultrasound. Bodenheimer said despite the name, you don’t have to have polycystic ovaries or small cysts on your ovaries to be diagnosed with PCOS. He recommends women discuss their concerns with a gynecologist.

1. Imbalances of hormones, including insulin and testosterone, play key role in PCOS symptoms.

The exact cause of PCOS is unknown. However, PCOS is associated with insulin resistance, obesity and high levels of androgens.

Androgens, often called male hormones, are hormones, such as testosterone, that are important for normal male sexual development, but women also make small amounts of androgens. Androgens control development of male traits, and women with PCOS have more androgens than normal.

Normally, in healthy women testosterone is largely bound by a protein called sex hormone binding globulin, leaving just a very small amount of freely circulating bioactive “free testosterone.” However, insulin resistance can disrupt this, and Bodenheimer said many women with PCOS have insulin resistance. “Insulin resistance can cause a low level of sex hormone bind globulins,” Bodenheimer said. “So, if you have a low level of that you have an increase of testosterone in the body which can lead to hyperandrogenism.”

Insulin resistance refers to when the body’s cells do not respond normally to insulin, a vital hormone that regulates blood sugar (glucose) in the body.

2. Irregular menstrual cycles are common symptoms of PCOS.

Higher than normal androgen levels in women can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle.

Bodenheimer said PCOS symptoms that often bring patients in to see him include excessive facial hair growth, absence of a menstrual period, irregular menstrual bleeding, or unsuccessfully trying to get pregnant for over a year. “We see a lot of different types of clinical manifestations from PCOS, but probably the most common we see are menstrual disorders,” Bodenheimer said. “That can range from irregular menstrual periods to heavy menstrual periods to someone who is not having any menstrual periods. If we see women who are anovulatory, meaning they aren’t having regular menstrual cycles, that can lead to infertility.”

Bodenheimer said usually in a 28-day cycle around cycle day 14 a woman ovulates so an egg is released. “If someone is not ovulating, the egg is not released,” he said. “That’s how that leads to infertility.”

Bodenheimer said there are various treatment options for infertility caused by PCOS.

3. PCOS often causes abnormal hair growth.

Bodenheimer said, for women with PCOS, increased levels of testosterone in the body can lead to excessive hair growth on their arms and face as well as acne. According to OWH, the excessive hair growth is called hirsutism and affects up to 70 percent of women with PCOS, causing them to have too much hair on the face, chin, or parts of the body where men usually have hair, and acne can appear on the face, chest, and upper back.

According to the OWH, other symptoms of PCOS include thinning hair, hair loss on the scalp or male-pattern baldness, weight gain or difficulty losing weight and darkening of skin, particularly along neck creases, in the groin, and underneath breasts.

4. Research has linked PCOS to other health problems, such as hypertension and sleep apnea.

According to OWH, studies have found links between PCOS and diabetes, high blood pressure and unhealthy cholesterol, sleep apnea, depression and anxiety and endometrial cancer. OWH indicates more than half of women with PCOS will have diabetes or prediabetes before age 40, and women with PCOS are at higher risk for high blood pressure compared with women of the same age without PCOS.

Problems with ovulation, obesity, insulin resistance, and diabetes, which are all common issues in women with PCOS, increase the risk of developing endometrial cancer, according to OWH.

Additionally, Bodenheimer said, “For women with PCOS who do get pregnant we see increased risk of gestational diabetes as well as hypertensive disorders such as preeclampsia.”

5. PCOS treatment focuses on managing symptoms.

Bodenheimer said treatment for PCOS focuses on treating and managing patients’ symptoms. When developing a treatment plan, the physician typically considers the patient’s symptoms, their plans for having children, and the patient’s risk of long-term health problems such as diabetes and heart disease.

“If patients desire future fertility and are planning to become pregnant, then we see if they are ovulating or not, and we can usually do that by checking lab work,” he said. “If we are treating someone with PCOS who is not ovulating, we can treat them with medicine to help them ovulate,” he said.

But Bodenheimer said one of the risks of using fertility drugs include pregnancy with multiples, such as twins.

“If they are not desiring fertility in the immediate future, then we try things like birth control pills to help regulate those menstrual periods,” Bodenheimer said.

He said he also sometimes discusses lifestyle modifications, including diet and weight loss. “Some studies show losing five to 10 percent of their current body weight may induce spontaneous ovulation again,” he said.



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