PCOS – Polycystic Ovarian Syndrome

What are the symptoms of PCOS ?


Q. What tests do I have to do to determine whether I have PCOS ?

The diagnostic criteria are not definitive for PCOS. There are a few tests that help confirm insulin resistance such as a fasting insulin blood test and cholesterol panels [specifically triglycerides]. Testosterone, cortisol and DHEA should also be tested.

A pelvic scan of the ovaries should be done for knowing the number of visible cysts. The non-appearance of cysts does not confirm that one does not have PCOS. Treatment is usually ineffective pharmaceutically and lifestyle and reduced insulin strategies are more effective.

Q. Can surgery treat PCOS?

The removal of ovarian cysts is not an effective way to treat PCOS. Cysts on the ovaries are the result of hormone imbalance that begins with the production of too much insulin. This over-abundance of insulin causes an increase in male hormones, which eventually create the cysts. As a result, removing the cyst does not remove the problem, just a symptom.

Q. How is polycystic ovarian syndrome treated?

Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatment goals are based on your symptoms, whether or not you want to become pregnant and to lower your chances of getting heart disease and diabetes. Many women will need a combination of treatments to meet these goals.

  4. Surgery: Ovarian drilling is a surgery that brings on ovulation . it is used on some women who do not respond to fertility medicines. Laparoscopy is also another option.
  6. Does PCOS put women at risk for other health problems?
    Women with PCOS have greater chances of developing several serious, life-threatening diseases, including type 2 diabetes, cardiovascular disease [CVD] and cancer. Getting your symptoms under control at an early stage can help to reduce the above complications.

Q. How are PCOS and infertility related?

PCOS is sometimes associated with infertility. In PCOS, thee is elevated LH reversal of the LH/FSH ration as LH becomes higher than FSH. The low levels of FSH allow many follicles to develop but without ever maturing even one follicle. Thus, numerous follicles are present in ovaries and once they become ataractic they form cysts, hence the ovaries appear as polycystic. Since the follicles do not mature, they do not release the egg. Hence, lack of ovulation is seen. The most likely cause of infertility is anovulation or lack of ovulation. Ovulation can be induced with ovulation drugs [clomid & metformin], by gonadotropins or correction of insulin resistance. The final option for achieving pregnancy in patients with PCOS related infertility is IVF i.e Invitro Fertilization with Gonadotropins.

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