Polycystic Ovary Syndrome is a reproductive endocrine disorder of chronic anovulation and hyperandrogenism. PCOS affects approximately 4-6% of reproductive age women and is one of the most common endocrine disorders affecting women.
The Etiology of PCOS
There appears to be no specific environmental factors and any genetic contributions remain uncertain. We do know that it can exist within a family and be passed down.
Obesity is often seen in PCOS women and may amplify the effects of PCOS, however 20% of women with PCOS are not obese. Women with PCOS tend to have insulin resistance (the body’s cells don’t respond normally to insulin to control blood sugar). This may be central to the etiology of the syndrome.
PCOS has several diagnostic criteria:
· Clinical and or biochemical evidence of hyperandrogenism
· Polycystic ovaries
· Exclusions of other known etiologies
PCOS affects the body by increasing LH concentrations, which causes excess ovarian androgen production. PCOS patients can also have irregular menstrual cycles and anovulation. As mention above PCOS patients can have excess insulin, which can stimulate androgen production in the ovary.
· Total and free testosterone
· Cycle Day 3 FSH and LH or AMH
· Fasting glucose or glucose tolerance test
· Fasting lipid panel
· Pelvic ultrasound
PCOS women have a high risk for developing type 2 diabetes, cardiovascular disease, endometrial cancer, abnormal uterine bleeding and infertility if their syndrome is not treated and managed.
Lifestyle changes such as diet, exercise and weight loss can help alleviate and reduce risks associated with PCOS.
Treatment should be determined by your doctor and can vary whether you are trying to get pregnant or not. At Dominion Fertility, we recommend Metformin and we often see a return of normal ovulation with this intervention alone. In addition to Metformin if a patient is trying to achieve pregnancy we use Letrozole as our preferred treatment. The Doctors at Dominion Fertility are available to help patients treat their PCOS, as well as guide them to their fertility options.
Hope to see you soon at Dominion Fertility!
Dr. Susan Sarajari