Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a virilising syndrome seen in young ladies. They typically have a number of small cysts around the edge of their ovaries (polycystic ovaries).

Causes of polycystic ovarian syndrome

  • Resistance to insulin

As the body’s tissues are resistant to the effects of insulin, extra insulin is produced by the body to compensate. These high levels of insulin cause the ovaries to produce too much testosterone, which interferes with the development of the follicles and prevents normal ovulation.

  • Weight gain

Raised insulin levels lead to weight gain. 

  • Hormone imbalance
  1. Raised LH (luteinizing hormone)
  2. Raised levels of Prolactin
  3. Raised levels of testosterone and other male sex hormones
  4. Decrease in FSH(follicle-stimulating hormone)and progesterone
  5. Dysfunctional thyroid gland

Symptoms and signs

  • Acne
  • Excessive hair growth on the face (hirsutism), nipple area, chest, lower abdomen and thighs
  • Irregular, infrequent or no menstrual periods(secondary amenorrhoea)
  • Overweight and obesity
  • Prone to type 2 diabetes, high blood pressure and high cholesterol
  • Enlarged clitoris (rare) and enlarged ovaries.

Investigations

Blood test

  • 17-ketosteroids
  • Estrogen levels
  • Fasting glucose, glucose intolerance test
  • FSH levels
  • LH levels
  • Lipid levels
  • Prolactin levels
  • Male hormone (testosterone) levels
  • Thyroid function tests

Pelvic laparoscopy

Pregnancy test (serum HCG)

Vaginal ultrasound

Treatment

  • Weight reduction

Lose weight by following a balanced diet and regular exercise

  • Ayurvedic Medicines
  • Surgery

Laparoscopic ovarian drilling (LOD)

Complications

  • Breast cancer  
  • Diabetes 
  • Endometrial cancer
  • Heart diseases 
  • Hypertension 
  • Infertility   

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