Early treatment for PCOS

February 4, 2008 9:18:27 AM PST
Polycystic ovary syndrome, or PCOS, is a disease characterized by enlarged ovaries with multiple small cysts -- also an abnormally high number of follicles at various states of maturation -- and a thick, scarred capsule surrounding each ovary. It is also known as polyfollicular ovarian disease and Stein-Leventhal syndrome, so named because it was originally reported by doctors Stein and Leventhal in 1935 when they described a group of women with amenorrea -- the absence of menstrual period -- infertility, unwanted hair growth and enlarged polycystic ovaries. Today, it's known that those with polycystic ovaries may have some, but not necessarily every one of the symptoms included in Stein-Leventhal syndrome.

According to the National Institutes of Health, polycystic ovary disease is a disorder of the endocrine system. This means that normal hormone cycles in the patient are interrupted, though it is not immediately understood why this occurs. Hormones direct many functions in the body; for example, they regulate reproductive functions, including normal egg development in the ovaries. In polycystic ovary disease, underdeveloped follicles -- the sacs within the ovaries that contain eggs -- accumulate in the ovaries. The eggs in these follicles do not mature, and can't be released, accumulating instead as cysts. This can contribute to infertility. The likely cause of maturation of the follicles, and the inability to ovulate are believed to be caused by low levels of follicle stimulating hormone, also, higher-than-normal levels of male hormones, or androgens, produced in the ovary. A key feature in PCOS seems to be that in this disease, cells throughout the body fail to readily respond to the insulin circulating in the blood, so the amount of insulin in the blood remains high -- high insulin levels can contribute to high male hormone levels, lack of ovulation, infertility and early pregnancy loss.

Insulin resistance also seems to be a key feature in polycystic ovarian syndrome. In addition to other hormones, insulin helps regulate ovarian function. When someone is insulin resistant, this means that cells throughout the body do not readily respond to the insulin circulating in the blood. For this reason, the amount of insulin remains high in the blood (hyperinsulinemia). High levels of insulin can contribute to lack of ovulation, high androgen levels, infertility, and early pregnancy loss.

Many women with polycystic ovary disease have irregular periods and may have very little menstruation (oligomenorrhea) or no period at all (amenorrhea). Frequently, women diagnosed with this disorder have a mother or sister with similar symptoms commonly associated with polycystic ovarian syndrome (PCOS).

EARLY DETECTION: Though symptoms of PCOS can show up in the teenage years, reproductive endocrinologist Kathy Hoeger says women with PCOS often aren't diagnosed until they're in their 20's. "There is a definite risk of ignoring the symptoms and making the disease worse over the long term." In her study, Dr. Hoeger's aim is to diagnose PCOS early, and teach teenage girls the importance of exercise and healthy eating while they get hormonal treatment. The goal of her study -- to reduce the risk factors for these patients and improve their long term health.


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