Polycystic
ovarian syndrome (PCOS), also
known as the Stein-Leventhal syndrome, is a condition
associated with multiple cysts in the ovaries. It is a
common complex hormonal disorder, affecting up to 10% of
women of reproductive age worldwide.
Women
with PCOS may complain of abnormal
bleeding, extreme weight gain, depression,
tiredness,
thyroid problems, headaches, sleeping disorders,
high cholesterol, poor memory, panic attacks, constant
thirst, dizzy spells, insulin resistance, extreme
cravings, cystic ovaries, cystic acne, anovulatory
menstrual cycles, irregular periods, mood swings, high
levels of testosterone, infertility, extreme hair growth
on face and body.
To treat
PCOS, it is essential to diagnose it and diagnosing is
one of the main problems as it is a heterogeneous
condition with varied manifestations. Many women have
polycystic ovaries but only 50% of these exhibit the
constellation of symptoms associated with PCOS. Left
untreated it can lead to various life-threatening
conditions including hypertension, kidney problems,
cardiovascular disease, and heart diseases. Endometrial
cancer can occur due to anovulatory menstrual cycles.
The three treatable features of PCOS include the
clinical symptoms, hormonal abnormalities and metabolic
problems.
Treatment
of polycystic
ovarian syndrome has two distinct directions.
Patients not desiring pregnancy at the time of treatment
receive different management than patients actively
wanting to get pregnant.
For
patients desiring pregnancy there are several
approaches. The first and foremost is weight reduction.
Exercises and dietary modifications works wonders for
ovarian function and even a loss of few pounds can
reduce insulin resistance, stimulate ovulation, and
improve fertility rates. Another approach in younger
patients involves the use of insulin-sensitizing agents
which allow for a better response to the insulin in the
circulation. Many women begin to ovulate and have a
return of normal menses. These medications are
discontinued after achieving pregnancy. In some
patients, ovulation is induced using Clomid, and later
gonadotropins may be required but carries the risk of
ovarian hyperstimulation and multiple
gestation.
Patients
not seeking pregnancy are generally treated with oral
contraceptive pills which allow the endometrium to cycle
normally thus reducing the risks of endometrial cancer
and hyperplasia. It also helps in reducing acne as well
as hair growth. To decrease the androgenic effects of
PCOS medications such as finasteride, Reglan, and
spironolactone may also be used.
Since
the cause of PCOS is not properly understood, there is
no way of preventing it. Though PCOS tends to run in
families, genetics researchers believe that the
environment has a significant influence on how genes
behave. Hence diet, lifestyle and physical environment
can influence the expression of genes. To optimize
genetic expression and provide health building options,
a visit to a holistic medicine practitioner is an
absolute must. He will treat you as a person and not
just the
disease.
