5

Polycystic Ovary Syndrome

 

 

Polycystic ovary syndrome (PCOS), also called polycystic ovary disease refers to a combination of conditions that occur together; usually presents in adolescent girls and young women. They consist of some or all of the following: irregular menstrual cycles (due to ill-timed or absent release of ovum from the ovaries), gain in weight, increase of body hair (in androgen-sensitive areas of the face, chest, abdomen, front of thighs and of back), insulin resistance and risk of future metabolic diseases. Ultrasound may show multiple cysts in the ovaries

​

None of these is by itself diagnostic of PCOS. In a way, PCOS is not a ‘diagnosis’ for instance such as hypothyroidism

 

Women may present for some of the conditions: eg, irregular menstrual cycles and failure to conceive; or for cosmetic reasons such as increased facial hair or acne

 

Treatment depends on the primary reason for which a doctor is consulted: for example, diet and exercise are the cornerstones in the management of subjects who are obese, even though lean women also benefit from reducing the degree of insulin resistance.

 

Hormone suppressive medicines alone in combination (oestrogen-progestin,  drugs to block androgen receptor in the hair follicle) may be used. It takes time for improvement in excess hair growth to be seen, typically 4-6 weeks. Meanwhile, the disfiguring hair may be physically removed, not necessarily by laser treatment. These help to regularise menstrual cycle and improve the dark, thick hair (also called male pattern hair growth)

 

To aid in conception, a variety of medicines may be used to improve the cyclic release of the ovum from the ovary. Sometimes if a single drug is not effective, a combination may be given

 

Irregular menstruation, excess hair and inability to conceive are well recognised causes for medical consultation

 

Equally important is to keep in mind that PCOS is often associated with increased risk of hypertension, type 2 diabetes mellitus, coronary artery disease and cancer of the uterus. Therefore lifestyle changes to lower their risk, early identification if they set it, and proper management when they are diagnosed 

​