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April 21, 2019  
UTERINE NEWS: Feature Story

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  • Living with Polycystic Ovary Syndrome

    Living with Polycystic Ovary Syndrome


    October 31, 2005

    By: Jean Johnson for Uterus1

    Unwanted hair growth on the face and elsewhere, acne, weight gain largely carried around the waist, not to mention the depression and low self-esteem that accompanies these symptoms, along with infertility makes PCOS (polycystic ovary syndrome) a major issue for women who suffer from the condition.
    Learn More
    Know the symptoms of PCOS:

    Infertility

    Miscarriage

    Unwanted hair growth

    Irregular menstruation

    Insulin resistance

    Difficulty losing weight

    Depression

    Low self esteem

    For more information on PCOS, visit PCOStrategies, Inc.

    Five to 10 percent of American women that get PCOS usually begin experiencing symptoms during puberty and the disease is progressive. That means even though PCOS strikes women in their child bearing years, even after menopause, excessive hair growth can continues and male pattern baldness can develop as well.

    Clearly, PCOS is not something to be taken lightly. The National Women’s Health Information Center notes that “no one knows the exact cause of PCOS,” but the center does suggest that researchers are looking at possible genetic links. “Women with PCOS frequently have a mother or sister with PCOS.”

    PCOS is an endocrine disorder with wide systemic effects. Not only do cysts form on the ovaries, insulin levels rise, increasing risk for type 2 diabetes, high blood pressure (hypertension), and heart disease. As if the weight gain from insulin imbalance is not enough for women to deal with, excessive amounts of the male hormone androgen circulate in the blood causing unwanted hair to sprout on the face and body, a condition called hirsutism.

    As PCOS researchers Melissa Hunter, M.D. and James Sterrett, PHARM.D. wrote, “the underlying defect in polycystic ovary syndrome remains unknown, but there is growing consensus that key features include insulin resistance, androgen excess, and abnormal gonadotropin dynamics [hormones related to ovarian activity].” The team further observed that “the principal underlying disorder is one of insulin resistance,” and that the resulting high levels of insulin stimulate “excessive ovarian androgen production.” That said, there’s just no way PCOS is even close to being on the benign, semi-tolerable side.

    Hunter and Sterrett also noted that women usually “present for three primary reasons: Menstrual irregularities, infertility, and symptoms associated with androgen excess (hirsutism and acne). They write that “Approximately 70 percent of affected women manifest growth of coarse hair in androgen-dependent body regions (e.g., sideburn area, chin, upper lip, periareolar area [nipples], chest, lower abdominal midline, and thigh), as well as upper-body obesity.” They also add that obesity is present in 70 percent of cases.

    Researchers interested the debilitating effects of PCOS on quality of life used a questionnaire to compile information from women with the disease. Said Ricardo Azziz, M.D., M.P.H., M.B.A., professor and vice-chair of the department of obstetrics and gynecology and professor in the department of medicine at the David Geffen School of Medicine at the University of California at Los Angeles, “When you look at a larger population of women with the polycystic ovary syndrome, there is a clear reduction in quality of life, driven primarily by hirsutism and excess weight. The good news is that quality of life perception does improve with therapy.”

    Hunter and Sterrett caution that “few treatment approaches improve all aspects of the syndrome, and the patient’s desire for fertility may preclude treatment despite the presence of syndromes.” In other words, although low dose oral contraceptive pills do tend to normalize menstrual cycles and discourage unwanted hair growth and acne, women interested in becoming pregnant might not choose this option, at least over the shorter term while they try to conceive and bear children. Regardless of the patient’s choice of pharmacologic intervention, however, Hunter and Sterrett echo the National Women’s Health Information Center and point out that “weight reduction, diet and exercise are recommended for all women with polycystic ovary syndrome.”

    While professionals across the board recommend weight loss for women with PCOS, the non-profit group, PCOStrategies, Inc. focus on enabling patients to manage symptoms, point out that managing weight is quite difficult. “Recent studies have demonstrated that PCOS is due to an underlying metabolic problem known as insulin resistance. When the body's muscles and fat tissues become resistant to insulin action, the pancreas produces increased amounts insulin, leading to high insulin levels. In a woman with PCOS, these high insulin levels can set into play a vicious cycle that makes weight loss extremely difficult. Because the high insulin levels tend to produce food cravings, particularly in the form of carbohydrates, the woman often finds herself in a state of overnourishment. These high insulin levels also drive the ovary to produce high amounts of male hormones (androgens) leading to ovarian confusion.”

    Hunter and Sterrett state that “because the primary cause of polycystic ovary syndrome is unknown, treatment is presently directed at the symptoms of the disorder.” In sum, the idea is to correct conditions in the ovaries so that normal ovulation occurs, and get the high levels of insulin and androgen under control.

    Last updated: 31-Oct-05

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