Polycystic ovary syndrome (PCOS) is a health problem that can affect a woman's hormones, menstrual pattern, ability to have children and appearance. Women with PCOS, typically have high levels of androgens (male hormones), which lead to many small fluid-filled sacs in their ovaries.
About 20 % women of childbearing age suffer from PCOS.
The cause of PCOS is unknown. But most experts think that several factors, including genetics, could play a role. Women with PCOS are more likely to have a mother or sister with PCOS.
A main underlying problem with PCOS is a hormonal imbalance. In women with PCOS, the ovaries make more androgens than normal. Androgens are male hormones that females also make. High levels of these hormones affect the development and release of eggs during ovulation.
It is also thought that insulin may be linked to PCOS. Insulin is a hormone that controls the conversion of glucose and other food into energy. Many women with PCOS have too much insulin in their bodies because they have problems using it. Excess insulin appears to increase production of androgen. High androgen levels also lead to acne, excessive hair growth, weight gain and problems with ovulation.
The symptoms of PCOS can vary from woman to woman. PCOS is the most common cause of female infertility. This is because of problems in ovulation. Infrequent, absent, or irregular menstrual periods are also common Hirsutism which is increased hair growth on the face, chest, stomach or back occurs because of increase in male hormones. This is usually treated with Laser hair removal and creams. Acne and oily skin also occur due to the same reason. Women with PCOS generally tend to put on extra weight.
• Lifestyle Modification : Many women with PCOS are overweight or obese, which can cause health problems. You can help manage your PCOS by eating healthy and exercising to keep your weight at a healthy level.
• Supportive medications : The medicine metformin is used to treat type 2 diabetes. It has also been found to help with PCOS symptoms, though it isn’t approved by the U.S Food and Drug Administration (FDA) for this use. Metformin affects the way insulin controls blood glucose and lowers testosterone production. It slows the growth of abnormal hair and, after a few months of use, may help ovulation to return. Recent research has shown metformin to have other positive effects, such as decreased body mass and improved cholesterol levels.
• Fertility medications : Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. Treatment options include :
Clomiphene - the first choice therapy to stimulate ovulation for most patients.
Metformin taken with clomiphene - may be tried if clomiphene alone fails. The combination may help women with PCOS ovulate on lower doses of medication.
Gonadotropins - given as injections if the ovaries do not respond to tablets.
• Laparoscopic Ovarian Drilling : This is a procedure that may increase the chance of ovulation. It's sometimes used when a woman does not respond to fertility medicines. This surgery can lower male hormone levels and help with ovulation. These effects last a few months.
• In-Vitro Fertilization (IVF) : IVF offers the best chance of becoming pregnant in any given cycle. It also gives better control over the chance of multiple births
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