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POLCYSTIC OVARY SYNDROME
Polycystic ovarian syndrome, or PCOS, is a common hormone disorder. It affects women in the reproductive years. The cause is unknown. On ultrasound scan, the ovaries have many small cysts around the outside of the ovary. These cysts are not important. They point to the underlying metabolic disorder. We call this ultrasound appearance “polycystic ovaries”. A woman has polycystic ovary syndrome if she has one or more of the following symptoms as well.
Most common symptoms of polycystic ovaries
Women with polycystic ovaries may have one or more of the associated symptoms or none. If they have no symptoms, they have polycystic ovaries. If they have symptoms they have polycystic ovary syndrome.
Menstrual irregularities
Women with PCOS or polycystic ovarian syndrome may have irregular periods. Irregular periods suggest that the ovaries are not releasing eggs every cycle. Women may have reduced fertility in this situation, but fertility may be normal.
Hirsuitism
This term refers to extra hair growth, in areas that men grow hair. This includes the upper lip, the face, the chest and the lower abdomen below the umbilicus.
Acne
Women with PCOS may develop troublesome acne, on the face, the chest and the back.
PCOS treatment
The best treatment for PCOS in women who are overweight is weight loss. This reverses all the underlying metabolic changes. In women who are thin, the treatment is not so easy.
We treat PCOS, or polycystic ovary syndrome, by treating the symptoms, listed below.
Weight Loss
Polycystic ovary syndrome is often associated with women being overweight. The best and most effective treatment for PCOS in overweight women is weight loss. Often, the symptoms of PCOS will disappear completely with weight loss.
Oral contraception
The pill will regulate the menstrual cycle in women who have PCOS. This has the added benefit of protecting the lining of the uterus for those women who have very few periods.
Anti-testosterone contraception
Some oral contraceptives are very effective at treating acne and hirsuitism. The choice of the best pill is important. Dianette contains an anti-testosterone agent and is very effective. Yasmin is almost as effective.
Laparoscopic Ovarian Drilling
This is an operation under general anaesthetic, where we make 3 or 4 small burns on the surface of each ovary. The repair process often reverses the underlying metabolic process causing polycystic ovary syndrome. This may result in ovulation for about 18 months. The treatment may be useful for women wanting to get pregnant.