Polycystic
ovaries is a
condition where instead of one or two dominant
follicles developing each month, the ovaries
become filled with many small cysts which over time
enlarge, and stretch the capsule of the ovary. The
cystic areas indicate improper activity in the ovary and
is often associated with low circulating levels of
estrogen, often a slightly raised level of testosterone,
and a lower than usual level of progesterone. This
hormonal imbalance can lead to many symptoms and are
often associated with other symptoms due to high
circulating insulin levels. Most commonly polycystic
ovaries are a sign of the polycystic ovary syndrome,
PCOS, which is characterized by absence of ovulation, a
variety of menstrual irregularities, and androgenic
hyperactivity comprising of hirsutism, acne and obesity.

The exact
cause of polycystic
ovaries still remains a mystery, but both genetic
and environmental factors are shown to be causative
factors of this disorder. Primary causes may be
dysfunction of the ovaries, abnormal insulin activity,
or problems with the hypothalamic-pituitary axis.
Another important cause is obesity itself, and sometimes
weight loss is enough to help regulate ovulation and
control other symptoms.
The
polycystic ovaries have a thickened outer layer and
about twice the area of normal ovaries. The increased
area is due to both an increased stromal area as well as
an increased number of follicles. Polycystic ovaries on
ultrasound are characterized by 10 or more 2-8 mm
follicles and an increased, echodense stromal area. This
is generally associated with specific metabolic and
endocrine abnormalities. Also, women with polycystic
ovaries have associated risk factors for coronary
artery disease. Polycystic ovaries may also be found in
postmenopausal women. Often women with polycystic
ovaries seen on ultrasonography often do not have the
clinical symptoms of the polycystic ovarian disease. The
disorder probably exists as a band ranging from no
clinical symptoms to fully developed
syndrome.
Young
women with polycystic ovaries often present with a gamut
of signs and symptoms from acne, hirsutism, and
menstrual irregularities to infertility issues. Pregnant
women with polycystic ovaries too run the risk of early
miscarriage, preeclampsia, caesarean section deliveries,
gestational diabetes, and high blood pressure.
Conventional treatment includes oral contraceptive
pills, anti-androgens, ovulation stimulators, or ovarian
drilling. Most of the drugs need to be taken over a long
period of time and have many serious side
effects.
Since polycystic ovaries are often associated with cardiovascular risk, lifestyle modifications are highly indicated. A holistic medical practitioner will outline a personal program by taking into consideration physical, mental as well as emotional factors. This will help not only in controlling the symptoms but also reducing future risks.