Polycystic Ovarian Syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is a prevalent hormonal condition that affects around 10% of women.
Women with PCOS typically experience both anovulation (lack of ovulation) and hyperandrogenism (chronic high testosterone levels).
• ovaries with numerous follicles (more than 20).
PCOS is diagnosed by taking a patient’s history and performing an examination, pelvic ultrasound, and blood tests.
Symptoms of PCOS
- Irregular or skipped menstrual cycles.
- Difficulty maintaining a healthy weight (50% of women with PCOS are overweight)
- Enhanced hair growth (hirsutism).
- Acne
- Infertility
- Thick endometrial lining (not shed regularly, leading to irregular bleeding)
- Metabolic syndrome, which causes high blood pressure, diabetes, an increased risk of heart disease, and obesity with abdominal weight gain.
Investigations
- Evaluation of male hormones (e.g., testosterone)
- Full blood examination with LFT (risk of fatty liver)
- Lipid profile analysis (often abnormal).
- Glucose testing
Treatment
- If pregnancy is not wanted, the oral contraceptive pill with an antiandrogen is the best way of treatment and prevention.
- If pregnancy is desired, oral treatments such as clomid or letrozole can be administered (although, there is a 10% greater risk of a multiple pregnancy).
- Lifestyle adjustments are crucial, and a reduced carbohydrate diet should be adopted.
- Metabolic problems should be treated with metformin
- When there is resistance to the usage of clomid, ovarian drilling may be explored, which is a surgical operation to burn the follicles. This comes with the risk of scarring and harm to the ovary and its function.
- Low-dose gonadotropins if oral medicines do not promote ovulation (there is an increased risk of multiple pregnancy of 20-30%)
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