Polycystic Ovarian Syndrome
What is Polycystic Ovarian Syndrome?
Polycystic ovarian syndrome (also called PCOS, polycystic ovary syndrome, or Stein Leventhal syndrome) is a common problem among teen girls and young women. The exact cause of PCOS is unclear. It is common for sisters or a mother and daughter to have PCOS, but a definite genetic link has not been found.
Multiple cysts on the ovaries produce excess hormones which impair the ability of the ovary to develop and release an egg. When the ovaries do not produce the proper balance of hormones needed for ovulation, they become enlarged and develop many small cysts. Increased levels of hormones can interfere with ovulation, disrupt the normal menstrual cycles, and can also result in relative glucose intolerance.
Many females with PCOS have insulin resistance, in which the body cannot use insulin efficiently. This leads to high circulating blood levels of insulin, called hyperinsulinemia. It is believed that hyperinsulinemia is related to increased hormone levels which may lead to obesity and cause worsening of PCOS. It is estimated that about 8 percent to 15 percent of women experience this disorder.
Untreated PCOS can lead to significant risk of type 2 diabetes mellitus, metabolic syndrome, cardiovascular disease, compromised fertility, and endometrial cancer.
Symptoms of PCOS
The signs and symptoms of PCOS are related to hormonal imbalance, lack of ovulation, and insulin resistance and may include:
- irregular, infrequent, or absent menstrual periods
- hirsutism - excessive growth of body and facial hair, including the chest, stomach and back
- acne or oily skin
- enlarged and/or polycystic ovaries
- infertility - the inability to produce children
- overweight or obesity, especially around the waist (central obesity) and abdomen
- male-pattern baldness or thinning hair
- acanthosis nigricans - darkened skin areas on the back of the neck, in the armpits, and under the breasts
- insulin resistance
Treatment for PCOS
Because of the possible long-term health risks of PCOS, including heart disease and type 2 diabetes, girls with PCOS should consult their physician about appropriate treatment.
During adolescence, treatment is focused on proper diet and physical activity, correcting the abnormal hormone levels, and managing cosmetic concerns. Treatment may include:
- weight reduction - a healthy diet and increased physical activity allow more efficient use of insulin and decrease blood glucose levels
- diabetes medications - metformin, a medication used in the treatment of type 2 diabetes, is often used to decrease insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help ovulation occur more regularly.
- oral contraceptives (birth control pills) to regulate menstrual cycles, decrease androgen levels, and control acne
- treatment for excess hair growth or acne
North Shore-LIJ gynecologists are experienced in the diagnosis and treatment of PCOS. For more information about polycystic ovarian syndrome or to schedule a consultation, please contact the Division of Pediatric and Adolescent Gynecology at Cohen Children’s Medical Center of New York at 516-390-9258. For an emergency call 911 or go to the Cohen Children's Medical Center Emergency Room.