Polycystic ovarian syndrome (PCOS) is a condition in which ovaries have many cysts (fluid-filled sacs). It’s also called Stein-Leventhal syndrome. PCOS is a disorder related to the body’s hormones. For example, the pituitary gland, which is at the base of the brain, makes hormones that tell the body how to work. One of these hormones tells the ovary when to release an egg. When the pituitary gland is overactive and makes too much hormone, ovaries get cysts.
PCOS usually starts in women younger than 30 and affects 5% to 10% of women.
The cause of changes in hormone levels isn’t clear. One possibility is genetic reasons that cause PCOS in overweight or obese women.
The most common symptom is irregular periods. They occur a few times a year, sometimes only once a year, and sometimes not at all. Bleeding can be very light or very heavy. Other symptoms include acne; hair loss on the head; too much hair on the face (can be thick and dark), chest, or stomach; high cholesterol levels; high blood pressure; deep voice; oily skin; dark rash on the neck, underarm, or groin; trouble getting pregnant (infertility); depression; and weight gain.
The health care provider will take a medical history, do a physical and pelvic examination, and order blood tests to measure hormone levels and rule out other illnesses. Blood pressure and blood glucose and cholesterol levels will be measured. The health care provider will also order ultrasonography of the ovaries to see how many cysts they have. The health care provider may suggest a visit to a gynecologist (a health care provider who specializes in female reproductive health) and to an endocrinologist (a specialist in hormone disorders).
Treatment depends on how severe symptoms are and if pregnancy is wanted. Overweight women will need to diet and exercise. Weight loss can help many women with PCOS.
Medicine can be given to make periods more regular, control other symptoms, and help in becoming pregnant. Surgery (laparoscopic ovarian wedge resection) is sometimes performed to decrease hormone release from the ovaries.
High blood pressure, diabetes, and high cholesterol, if present, should also be treated.
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