Polycystic Ovary Syndrome

Polycystic Ovary Syndrome Diagnosis and Treatment at Lee Gynecology in Portland, OR

PCOS is very common, affecting about one in eleven women. Caught early, the consequences can be greatly improved. Counseling, lifestyle changes and safe medications are the keys to effective treatment.
– Michael J. Lee

What is Polycystic Ovary Syndrome (PCOS)?

This appears to be a genetically determined imbalance of hormones and proteins coming from many organs of the body.  These include the ovaries, pancreas, liver, fat tissues, muscles, brain (pituitary and hypothalamus glands) and adrenal glands. Often, several members of a family will have the condition.

PCOS is called a “syndrome” because the exact cause is not known but it is related to many factors, including insulin resistance, increased levels of hormones called androgens and an irregular menstrual cycle, which can lead to infertility. PCOS affects all areas of the body, not just the reproductive system. It increases a woman’s risk for serious conditions that may have lifelong consequences, such as diabetes, heart disease, breast cancer and depression.

Common Symptoms and Findings Associated with PCOS

  • Irregular menstrual periods
  • Infertility
  • Obesity
  • Excess hair growth on the face, chest, abdomen or upper thighs
  • Severe acne or acne that occurs after adolescence and does not respond to usual treatments
  • Oily skin
  • Patches of thickened, velvety, darkened skin
  • Multiple small cysts on the ovaries

Treatments

  • Hormonal birth control pills: Used for treatment of women who do not wish to become pregnant at the current time, these birth control pills decrease androgen levels. This regulates the menstrual cycle and reduces excess hair growth and acne. It also decreases the risk of endometrial cancer.
  • Weight loss: For overweight women, weight loss alone often regulates the menstrual cycle. Losing weight has also been found to improve cholesterol and insulin levels and relieve symptoms such as excess hair growth and acne.
  • Insulin-sensitizing drugs, such as metformin: These drugs help the body to respond to insulin and are frequently used to treat PCOS. They can help to decrease androgen levels and improve ovulation, with the goal of menstrual periods that are more regular and predictable.
  • Androgen blocker (spironolactone): This medication safely reduces hair growth and acne by simply blocking the effect of circulating testosterone on hair follicles and oil glands.

Role of Surgery for PCOS

For women with PCOS who have not been able to become pregnant with the use of medications (metformin and ovulation induction with clomiphene) and lifestyle changes, Dr. Lee may perform surgery on the ovaries.  This technique reduces the hormonal imbalances interfering with normal ovulation.  Most women with PCOS will not require surgery.

Long-Term Aspects to Consider with PCOS

No matter what a woman’s immediate goals are regarding PCOS, Dr. Lee will address the long-term effects through counseling on the risks for diabetes, heart disease, depression and cancers of the breast and uterus. These risks can be greatly mitigated with safe medications such as progesterone.  Less serious, long-term consequences such as hair growth and acne can also be controlled with medications.


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