PCOS - Polycystic ovarian syndrome

I want to take this time to highlight something that is close to my heart, and that's PCOS (Polycystic ovarian syndrome). I've posted about it before because I was going through some tests to see if my problems were caused by PCOS. My next doctors appointment will most likely have the outcome for being told I 100% have PCOS. I'm making this post so that other women might recognise some of the symptoms and then seek help and tests. So here goes. Please read carefully and if anything in this post rings true to you, then please seek help from the doctor.

Polycystic ovarian syndrome (PCOS), also known by the name Stein-Leventhal syndrome, is a hormonal problem that causes women to have a variety of symptoms. Some of the symptoms include:

* absent or infrequent periods (oligomenorrhoea): a common symptom of PCOS. Periods can be as frequent as every five to six weeks, but might only occur once or twice a year, if at all.

* increased facial and body hair (hirsutism): usually found under the chin, on the upper lip, forearms, lower legs and on the abdomen (usually a vertical line of hair up to the umbilicus).

* acne: usually found only on the face.

* infertility: infrequent or absent periods are linked with very occasional ovulation, which significantly reduces the likelihood of conceiving.

* overweight/obesity: a common finding in women with PCOS because their body cells are resistant to the sugar-control hormone insulin. This insulin resistance prevents cells using sugar in the blood normally and the sugar is stored as fat instead.

* miscarriage (sometimes recurrent): one of the hormonal abnormalities in PCOS, a raised level of luteinising hormone (LH - a hormone produced by the brain that affects ovary function), seems to be linked with miscarriage. Women with raised LH have a higher miscarriage rate (65 per cent of pregnancies end in miscarriage) compared with those who have normal LH values (around 12 per cent miscarriage rate).

Any of the above symptoms and signs may be absent with the exception of irregular or no periods. All women with PCOS will have irregular or no menses. Women who have PCOS do not regularly ovulate; that is, they do not release an egg every month. This is why they do not have regular periods. No one is quite sure what causes PCOS. However, the ovaries of women with PCOS frequently contain a number of small cysts, hence the name poly (many) cystic ovarian syndrome. A similar number of cysts may occur in women without PCOS. Therefore, the cysts themselves do not seem to be the cause of the problem. A malfunction of the body's blood sugar control system (insulin system) is frequent in women with PCOS. The result is an inadequate response to insulin (insulin resistance) that can lead to abnormally elevated blood sugar (glucose) levels. The insuliin disturbance is thought to also be the trigger for the development of symptoms such as acne and excess hair growth that is seen with PCOS.

The diagnosis is based on the patient's symptoms and physical appearance. If the diagnosis seems likely because the patient's history contains many of the symptoms described already, certain investigations are done to provide confirmatory evidence or to indicate another cause for the symptoms. These include:

* Blood tests such as
- Female Sex Hormones (at a certain point in the cycle if possible)
- Male Sex Hormones
- Glucose
- Thyroid Function Tests
- Other Hormones, eg Prolactin
* Ultrasound Examination

Your own GP can do the initial blood investigations, ensuring they are carried out at the correct time of the cycle if appropriate. Your GP may be able to arrange an ultrasound scan. Once the diagnosis is made, nothing more needs to be done for some women, eg if their fertility is not an issue, if their weight is within normal limits, and if they do not have excess body hair. If any of the symptoms are an issue, then further advice and treatment, and possibly specialist referral is needed.

PCOS often comes to light during puberty due to period problems, which affects around 75% of those with the disease. Infrequent, irregular or absent periods are all common variations, many finding their periods particularly heavy when they do arrive. The period disturbance is a sign that there is a problem with regular monthly ovulation. So just why do your periods go out of whack when you suffer from PCOS? The main culprit is hormonal imbalance

If you recognise two or more of these symptoms in yourself, make an appointment with your health care provider to investigate whether you may have PCOS. While a cure for PCOS has yet to be found, effective treatment for these symptoms is available.