POLYCYSTIC OVARIAN SYNDROME

General Information

DEFINITION--Ovary enlargement from many small cysts. The surface of the ovaries becomes too thick to allow ovulation (the monthly release of the egg from the ovary). Women with this problem cannot become pregnant without treatment.

BODY PARTS INVOLVED--Ovaries.

SEX OR AGE MOST AFFECTED--Females.

SIGNS & SYMPTOMS

• Irregular menstrual bleeding, usually a lighter flow.
• Increased time between periods, often up to several months.
• Increased hair growth on the face, arms, legs and from pubic area to navel.
• Enlarged clitoris.
• Increased sex drive.
• Higher energy level.
• Obesity.
• Acne.

CAUSES--An imbalance between the pituitary gonadotropin luteinizing hormone (LH) and follicle-stimulating hormone (FSH), resulting in a lack of ovulation and an increased testosterone production.

RISK INCREASES WITH

• Endometrial hypoplasia or carcinoma.
• Obesity.
• High-blood pressure.
• Diabetes mellitus.
• Breast cancer.

HOW TO PREVENT--Cannot be prevented at present. Get appropriate cancer screening tests to reduce risk factors.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of blood hormone levels and pelvic ultrasound; endometrial biopsy (See Glossary for both) to rule out hyperplasia or cancer.

APPROPRIATE HEALTH CARE

• No ideal medical treatment exists; drugs prescribed for the disorder will be determined by severity of symptoms and whether there is a desire for pregnancy.
• Surgery to remove a small section from each ovary may be recommended in patients not helped by drugs.

POSSIBLE COMPLICATIONS

• Permanent hormone imbalance.
• Infertility.
• Increased likelihood of uterine cancer and breast cancer.

PROBABLE OUTCOME--Hormone therapy and surgery usually decrease masculine characteristics and often restore fertility. Some signs and symptoms may never disappear completely.

How To Treat

GENERAL MEASURES----You may need professional help if you want to remove excess hair from your face, arms and legs (techniques can include bleaching, electrolysis, plucking, waxing and depilation).

MEDICATION--Your doctor may prescribe:

• Progestin or oral contraceptives for patients not desiring pregnancy.
• Clomiphene citrate or other hormones for patients who desire pregnancy.
• Drugs for excess hair (hirsutism). A few drugs have been tried, but the success rate is not high, and side-effects are numerous.

ACTIVITY--No restrictions on activity, including sexual intercourse.

DIET--No special diet. Weight loss recommended if you are overweight.

Call Your Doctor If

• You have symptoms of polycystic ovarian syndrome.
• Your periods become profuse or more frequent than usual.
• You develop a lump or swelling in the breast.
• Symptoms recur after treatment or surgery.
• You want a referral to remove excess body hair.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.