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Features of Polycystic Ovaries

 

A typical presentation of polycystic ovarian syndrome is:

• Obesity: There is a tendency to be overweight or obese but this is by no means universal. Some women with polycystic ovaries will be of normal weight.
• Irregular menstruation: This is very common in polycystic ovaries. Periods tend to be erratic, typically going for several weeks, even months without one. This is caused by the derangement of the hormone profile in the body.
• Hirsutism: There is a tendency to increased body hair, including the very distressing facial hair.
• Skin changes: Acne and greasy skin can be quite prominent; again, that is an effect of high androgen activity.
• Sub-fertility: Because of erratic ovulation, a woman with polycystic ovaries may have a great deal of difficulty conceiving. There is also a slightly higher tendency to miscarry.

 

Underlying problems in polycystic ovaries

So what are the hormone problems in Polycystic Ovarian Syndrome (PCOS)? For one, the ovaries, for some obscure reasons, produce excessive amounts of the so-called male sex hormones. These are more appropriately called ‘androgens’. It is important to understand that ovaries do normally produce these androgens, alongside the other ‘female sex hormones’ such as estrogen and progesterone. The difference is that, in polycystic ovaries, the production is higher. This, apart from the masculinising effect, tends to mess up the balance of other hormones. This is one of the main causes of the features mentioned above including hirsutism, skin problems, erratic menstruation and sub-fertility.

 

The other major problem in polycystic ovaries is insulin resistance. Insulin is a crucial hormone for metabolism of carbohydrates. While production of insulin is normal in polycystic ovaries, there is resistance to the effect of the hormone. In fact, women with polycystic ovaries are at a significantly higher risk of Type 2 diabetes in middle age and later.

 

Long term issues with polycystic ovaries

Most women affected by polycystic ovaries will present seeking help with regard to the early features which tend to be menstrual irregularities, body hair issues, sub-fertility and excessive body weight. However, polycystic ovarian syndrome can and often does cast a shadow on the woman’s long term health. We have already mentioned Type 2 diabetes. In addition to that there is increased risk of:

§ Cardiovascular disease: This is partly due to high cholesterol (and other lipids) levels prevalent in this condition

§ Increased risk of stroke

§ Higher rates of depression

§ Increased risk of cancer of the lining of the womb (endometrial cancer)

 

 

 

 

 

 

Next page: Treatment for polycystic ovaries