Article Medically Reviewed By:
Ricardo Azziz, MD, MPH, MBA
The Helping Hand of Los Angeles Chair in Obstetrics & Gynecology Chair, Department of Ob/Gyn and Director, Center for Androgen Related Disorders at Cedars-Sinai Medical Center Professor and Vice-Chair, Department of Ob/Gyn and Professor, Department of Medicine The David Geffen School of Medicine at UCLA Los Angeles, CA
Overview
What Is It?
Polycystic ovary syndrome (PCOS) is generally characterized by the presence of polycystic ovaries, hyperandrogenism (the condition caused by excess male hormones or male-like traits) and irregular ovulation and menstruation.
Polycystic ovary syndrome (PCOS) is the most common cause of infertility in reproductive-age women. It affects an estimated 5 to 10 percent of females and is associated with an increased risk of diabetes and obesity, and as a result, an increased risk of cardiovascular disease. The syndrome is generally characterized by the presence of polycystic ovaries, hyperandrogenism (the condition caused by excess male hormones or male-like traits) and irregular ovulation and menstruation. The symptoms of PCOS can vary.
The syndrome, previously called Stein-Leventhal Syndrome after the physicians who first characterized it in the 1930s, usually presents when a woman is in her 20s or 30s, with irregular or absent periods. As the term polycystic ovary syndrome suggests, the syndrome often is accompanied by enlarged ovaries containing multiple small painless "cysts" or tiny follicles about 1/8 to 1/4 inch in diameter.
During a normal menstrual cycle in which a woman ovulates (called an ovulatory cycle), a small number of follicles begin to grow. One becomes the biggest, or dominant, follicle. This dominant follicle then ruptures and releases the egg.
In women with PCOS, however, high levels of hormones called androgens (commonly known as "male hormones") halt the normal hormonal process and the egg's development. These halted or arrested follicles—whose appearance (via an ultrasound) is sometimes likened to a "string of pearls" on the outside of the ovary—form the "cysts" observed in PCOS. These cysts are not tumors and do not require removal. Treatment of PCOS, instead, is through the use of lifestyle modifications and medication to treat symptoms.
Many, but not all, women with PCOS will have the polycystic-looking ovaries (which are often two to five times larger than normal ovaries) for which the syndrome is named, but it is possible to be diagnosed with the syndrome without having this symptom. Furthermore, not all women with polycystic-appearing ovaries will have PCOS.
While the biochemical imbalances that cause symptoms are becoming better understood, the trigger for PCOS is unknown. Some researchers believe that abnormal levels of the pituitary hormone LH and high levels of male hormones (androgens) prevent the ovaries from functioning normally.
Some patients with PCOS experience excess insulin prod...
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