Diagnose and Treat Poly Cystic Ovarian Syndrome (PCOS)

imagesPoly cystic ovarian syndrome (PCOS) is an endocrine disorder that causes women to have a variety of symptoms. Women with this condition have a number of small cysts in the ovaries which the most common cause of infertility in women.

Symptoms of Poly Cystic Ovarian Syndrome (PCOS) 1. Menstrual Disturbances: The principal signs and symptoms of PCOS are related to menstrual disturbances and elevated levels of male hormones (androgens). Menstrual disturbances can include: a) Delay of normal menstruation (primary amenorrhea) b) Oligomenorrhea c) Absence of menstruation for more than three months (secondary amenorrhea). Menstrual cycles may not be associated with ovulation (anovulatory cycles) and may result in heavy bleeding.

2. Symptoms related to elevated androgen levels include acne, excess hair growth on the body (hirsutism), and male-pattern hair loss.

3. Other Signs and Symptoms of PCOS include: A) Obesity and weight gain B) Elevated insulin levels and insulin resistance C) Oily skin D) Dandruff E) Infertility F) High Lipid levels G) Elevated blood pressure, and H) Multiple, small cysts in the ovaries. Women who have PCOS do not regularly ovulate; that is, they do not release an egg every month. This is why they do not have regular periods and typically have difficulty conceiving.

Causes: The certain cause of PCOS is yet not known but it is believed that an imbalance of the endocrine system is responsible for many of the changes associated with PCOS. However, it is still not known exactly what causes those changes. 1. The Hypothalamic-Pituitary-Ovarian Axis: In women with polycystic ovaries, the pituitary produces FSH, or Follicle Stimulating Hormone, and high levels of LH, or Leutenizing Hormone. That travels to the ovary where it stimulates the production of androgens. It has been hypothesized that persistently high levels of LH and androgens, namely testosterone, causes PCOS. However, this does not explain why many women with PCOS do not have high levels of LH.

2. The Insulin-Androgen Connection: Insulin has been thought to have a role in the development of PCOS. It is believed that high levels of insulin can increase the amount of androgens that the ovary produces. This also does not fully explain PCOS, as many women with PCOS do not have insulin resistance, a change in how body cells react to insulin, and a common issue seen in PCOS.

3. Genetic Factors: This is made difficult to identify whether genetic abnormalities can be a cause of PCOS due to the lack of a single diagnostic test as well as the role that external factors (such as obesity, diet and exercise habits) may play in the development of the disease.

Diagnosis: During diagnosis, it is necessary to exclude other illnesses that have similar features, such as:

1. Low thyroid hormone blood levels (hypothyroidism)

2. Elevated levels of a milk-producing hormone (prolactin)

3. Ovarian Tumors 4. Elevated male hormone (androgen)

5. DHEA and testosterone may be elevated. However, levels of testosterone that are highly elevated are not unusual with PCOS and call for additional evaluation. Additionally, levels of a hormone released by the pituitary gland in the brain (LH) that is involved in ovarian hormone production are elevated. 6. Ultrasound images of pelvis can be done to rule out ovarian cysts, and because ovarian cysts are not part of the definition of PCOS, ultrasound is not routinely ordered to diagnose PCOS. The diagnosis is usually a clinical one based on the signs and symptoms..

Complications: Women with PCOS are at a higher risk for a number of illnesses such as 1. High Blood Pressure Problems 2. Diabetes especially development of type 2 diabetes. 3. Endometrial cancer 4. Heart Problems i.e. elevated levels of triglycerides. 5. Infertility due to absence of ovulation. 6. Obesity 7. Changes in skin pigmentation can also occur with PCOS. Acanthosis nigricans refers to the presence of velvety, brown to black pigmentation often seen on the neck, under the arms, or in the groin. This condition is associated with obesity and insulin resistance and occurs in some women with PCOS.

Treatment: Usually, treatment is prescribed depending on the age and stage in woman’s life. For example, younger women who is ready to take oral contraceptives, especially those with low androgenic (male hormone-like) side effects can cause regular periods and prevent the risk of uterine cancer. Another option is intermittent therapy with the hormone progesterone. Progesterone therapy will induce menstrual periods and reduce the risk of uterine cancer, but will not provide contraceptive protection.

Mostly Symptomatic treatment is provided such as: 1. For acne or excess hair growth, cream medication can be used that slows facial hair growth in women. Electrolysis and over-the-counter depilatory creams are other options for controlling excess hair growth.

2. For women who desire pregnancy, they can be given some fertility agents which can In addition; weight loss can normalize menstrual cycles and often increases the possibility of pregnancy in women with PCOS.

3. Ant diabetes drugs are given to treat type 2 diabetes. These drugs affect the action of insulin and are useful in reducing a number of the symptoms and complications of PCOS.

4. Finally, a surgical procedure known as ovarian drilling can help induce ovulation in some women who have not responded to other treatments for PCOS. In this procedure a small portion of ovarian tissue is destroyed by an electric current delivered through a needle inserted into the ovary.

Natural remedies for PCOS: 1. Weight Control: Cutting out fatty foods and exercising may help. Sometimes PCOS sufferers have an elevated level of insulin in their body which results in higher androgens. Excessive sugar intake can contribute to this, so reducing sugar intake can help in losing weight.

2. Stress Management: During stress, our body produces a substance called cortisol which can cause an over-production of androgens. Counselling, massage, and plenty of rest may help.

3. Nutrition: There are several nutritional supplements known to reduce androgens, regulate the ovaries and therefore PCOS. These are zinc, magnesium, B vitamins and omega 3′s, which are found in fish and in seeds such as flaxseed and linseed.

4. Herbal Medicine: A qualified herbal practitioner can also prescribe medicines which drain or reduce ovarian. So, it is clear that with proper treatment, risks can be minimized. Ideal treatment is directed to each of the manifestations of PCOS.

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