Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) is the most common endocrine problem in women. Around one in every six women probably has the tendency to develop polycystic ovaries. The condition has a strong genetic tendency. PCOS is a jumble of conditions and symptoms making it a difficult condition to pinpoint the cause of. How it manifests itself is very complex – it has no one cause or trigger.
The understanding of this syndrome by the medical fraternity is still in its infancy and until recently it was thought to be a specifically gynecological problem. However, doctors now recognize that the disorder is associated with insulin resistance in 30 – 60% of cases. There is variation in different racial groups. African Americans, indigenous groups, Islanders and people of Indian sub continental or Chinese origin are at a higher risk.
The term polycystic ovarian syndrome is derived from the presence of small fluid-filled sacs or cysts which accumulate in the ovaries from trapped eggs, which were never released from the ovaries. In a normal ovary, a single egg develops and is released each month. In PCOS, normal ovulation or release of the eggs at the middle of the menstrual cycle is inhibited. A woman may have PCOS without actually having the ovarian cysts. It is partly due to a hormonal imbalance.
These three hormones are produced in the ovaries: estrogen, androgens and progesterone.
Because ovulation does not occur very often, these women do not produce adequate amounts of the hormone progesterone, but do produce estrogen. This results in infertility and very infrequent menstrual bleeding. This lack of progesterone can also result in heavy, irregular menstrual bleeding.
As a result, the follicle, the fluid-filled sac that develops around the egg before it ovulates, never develops. Instead, it turns into a cyst on the ovary.
It is the abnormal progesterone level that prevents the follicle from developing. Two more hormones -follicle stimulating hormone (FSH), and luteinizing hormone (LH) – are produced in the pituitary gland in the brain. The hormones produced in the brain regulate the production of the hormones produced in the ovaries. For whatever reason, production of FSH and LH is irregular, so problems develop with the other three hormones as well.
Women with PCOS usually have higher levels of male hormones or androgens, which are produced in their ovaries, adrenal glands and also in their upper level body fat. Therefore, it is desirable for women with this condition to avoid carrying too much body fat. Weight excess will aggravate the hormonal imbalances of PCOS, and is often associated with Syndrome X (see “I can’t lose weight! …and I don’t know why”). Women with PCOS have a much higher risk of Syndrome X and a seven-fold increa