Polycystic Ovarian Syndrome Can Be Demoralizing
Polycystic ovarian syndrome (PCOS) is a common hormonal disorder in women of childbearing age. This often seen endocrine disorder is the predominant cause of the inability to conceive. PCOS is defined by ovarian enlargement as a result of multiple, benign cysts seen on the outer edges of each ovary provoked by hormonal imbalance. This condition of unknown origin is medically scribed Stein-Leventhal Syndrome.
Primarily a hormonal imbalance, PCOS, is triggered by increased androgen production that results in an-ovulation and subsequent infertility. This occurs when the pituitary hormone (LH) and follicle-stimulating hormone (FSH) become imbalanced. Typically, the masculine effects of the excess testosterone begin following menarche at normal age. Variance is seen in older patients as a response to significant weight gain and the inability to become pregnant.
The most common characteristic of this condition are irregular menstrual periods in adolescence, expressed as oligomenorrhea and secondary amenorrhea. Profuse bleeding may alternate with failure to menstruate for 3-months or longer. Prolonged periods may vacillate with scant or heavy flow. Obesity, hirsutism, acne, enlarged clitoris, slight deepening of the voice or enlarged, “oyster-like” ovaries may accompany this syndrome.
The absence of menstrual flow, amenorrhea, is classified as primary or secondary. While primary does not begin as expected by 16, secondary amenorrhea begins at an appropriate age, but ceases for three or more months in the absence of physiologic causes such as pregnancy, lactation or menopause. An-ovulation may result from hormonal imbalance, debilitating disease, eating disorders, stress or emotional disturbances, obesity and anatomical abnormalities.
Androgenic excess, particularly elevated testosterone levels, may de-feminize female appearance through excess predominantly typical male facial hair growth, pattern baldness, acne and voice depth. The degree of physiologic change correlates with the level of hormonal imbalance and ethnicity of the female. Northern Europeans and Asians are usually less visibly impacted. Increased androgenic influence may increase energy levels, aggression and sex drive.
Although, ultrasound technology can reveal cystic ovaries, definitive diagnosis of PCOS requires further investigation for confirmation. Physician confirmation of positive physical signs of masculinization and a record of amenorrhea will confirm suspicions of androgen imbalance that necessitates further study.
Beyond the ultrasonic view of ovarian appearance following observance of acquired male predominant characteristics, there is typically blood work performed to determine hormonal levels. Further process of elimination is satisfied through endometrial biopsy, ruling out uterine cancer.
Besides infertility, there are deleterious, long-term, health implications with the diagnosis of PCOS. Innocuous yet psychologically impacting, occasionally there are cases of physical changes in the appearance of the skin called acanthosis nigricans, a darkening, textural effect seen on armpits, thighs, vulva and beneath the breasts. Physically, there is an increased risk obesity at 50% of PCOS suffers, diabetes 2 or varying degrees of glucose intolerance.
Confirmation and appropriate health care can reduce the complications of living with polycystic ovarian syndrome. The chain of cause and affect with obesity, diabetes and high-blood pressure leading to heart disease or stroke can be broken through appropriate lifestyle and medical care. Appropriate monitoring for high-risk uterine or breast cancer inherent with PCOS is advised.
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