Polycystic Ovary Syndrome
Polycystic ovary syndrome, also known as PCO, is not a specific condition but rather designates any condition that affects a woman’s ovaries and causes chronic failure to ovulate. Ripe but unreleased eggs accumulate in the ovaries, causing the characteristic “polycystic” appearance. These eggs have surrounding cells which create excessive amounts of the reproductive hormones estradiol and testosterone, aggravating the problem.
The causes of polycystic ovary syndrome include excess insulin levels, excessive Luteinizing Hormone (LH) or Prolactin (PRL) production by the pituitary gland, hypothyroidism and other disorders. As many as percent to 10 percent of the women in the United States are affected by this condition, which is the leading cause of infertility in women.
Polycystic ovary syndrome causes many different symptoms including:
- Irregular or absent menstrual periods
- Excessive body hair, especially on the face (“hirsutism”)
- Skin tags
- Pelvic pain
- Sleep apnea
- Enlarged ovaries
Dr Howe diagnoses PCO using the patient history, a physical exam, ultrasound of the ovaries and blood studies. The blood studies allow one to understand the exact cause of the syndrome and thus to apply specific therapy. Treating PCO without a specific diagnosis is not recommended.
Treatment of PCOS
PCO has many causes and therefore many treatments. Treatment focuses on treating the specific cause while addressing symptoms in order to prevent long-term damage.
- Regulating the menstrual cycle
- Reducing excessive hair growth with medication
- Using diabetic medications
- Stimulating ovulation with fertility medications
- Managing weight gain
- Surgical intervention
If left untreated, PCO can lead to type 2 diabetes, high blood pressure, heart disease or infertility. We believe in aggressively correcting the exact metabolic cause of each patient’s PCO, rather than merely masking symptoms with birth control pills.
When treated, most of the signs of PCO will resolve. Menstruation can be normalized, fertility restored, blood sugar lowered, weight lost. Abnormal facial hair, however, does not revert and requires electrolysis, shaving or laser therapy. For this reason it is important to diagnose the exact cause of a woman’s PCO and apply specific therapy early in the course of the disease, rather than after the skin changes have become permanent.