Ask Dr. Hecht
from: NY DAILY NEWS
Q: What can you tell us about polycystic ovarian syndrome (PCOS)? Is it treatable? Is it curable? Why does it cause infertility?
W.W., Hawkinsville, Ga.
A: Polycystic ovarian syndrome (PCOS) is the most common cause of female infertility, affecting up to 10% of all premenopausal women. After over seven decades of study, we're still not sure what causes it to occur. While it's a well-known cause for infertility in women, it can also be responsible for irregular menstrual periods; high blood pressure; acne; borderline-diabetes; excess facial and body hair; male-pattern baldness in a woman, and midsection obesity. A key part of the problem in PCOS is male hormone overproduction. You may be overweight, have diabetes and high blood pressure and unknowingly have had PCOS for years.
During the normal maturation process of a woman's egg, the egg develops within a fluid-filled cyst inside the ovary. Each month in normal ovulation, hormones trigger the release of one mature egg from within the cyst/follicle. In PCOS, a relative excess of male sex hormones inhibit the egg's development. The egg's failure to mature leads to the lack of ovulation and the subsequent infertility. Rather than the normal rises and falls in sex hormones, there's a constant elevated level of estrogen, testosterone and LH hormone. The high LH hormone level suppresses egg release. The high level of estrogen contributes to weight gain. The increased levels of hormones also increase the risk of developing diabetes and high blood pressure which, in turn, increase the risk of heart disease.
What causes a person to develop PCOS? We're not sure, but we believe that it's genetically inherited. If you have it, you may also have a mother or grandmother with some of the symptoms.
How is PCOS diagnosed? It starts with a careful and detailed history and physical exam. A pelvic ultrasound may identify the numerous cysts of PCOS. An elevated testosterone and a persistently elevated LH level will help confirm the diagnosis. This sounds easy enough, but often the symptoms of PCOS are subtle and overlooked.
Once diagnosed with PCOS, the next step should be a consultation with an endocrinologist. To improve fertility, drugs like Clomiphene may be used. If you're looking to control the acne and facial hair, oral contraceptives and/or Spironolactone can be helpful. Weight loss greatly helps control the symptoms of PCOS and has been shown to restore fertility in some women. A diabetic diet is often helpful, especially since many of those with the disorder are diabetic or borderline-diabetic.
from: NY DAILY NEWS
Q: What can you tell us about polycystic ovarian syndrome (PCOS)? Is it treatable? Is it curable? Why does it cause infertility?
W.W., Hawkinsville, Ga.
A: Polycystic ovarian syndrome (PCOS) is the most common cause of female infertility, affecting up to 10% of all premenopausal women. After over seven decades of study, we're still not sure what causes it to occur. While it's a well-known cause for infertility in women, it can also be responsible for irregular menstrual periods; high blood pressure; acne; borderline-diabetes; excess facial and body hair; male-pattern baldness in a woman, and midsection obesity. A key part of the problem in PCOS is male hormone overproduction. You may be overweight, have diabetes and high blood pressure and unknowingly have had PCOS for years.
During the normal maturation process of a woman's egg, the egg develops within a fluid-filled cyst inside the ovary. Each month in normal ovulation, hormones trigger the release of one mature egg from within the cyst/follicle. In PCOS, a relative excess of male sex hormones inhibit the egg's development. The egg's failure to mature leads to the lack of ovulation and the subsequent infertility. Rather than the normal rises and falls in sex hormones, there's a constant elevated level of estrogen, testosterone and LH hormone. The high LH hormone level suppresses egg release. The high level of estrogen contributes to weight gain. The increased levels of hormones also increase the risk of developing diabetes and high blood pressure which, in turn, increase the risk of heart disease.
What causes a person to develop PCOS? We're not sure, but we believe that it's genetically inherited. If you have it, you may also have a mother or grandmother with some of the symptoms.
How is PCOS diagnosed? It starts with a careful and detailed history and physical exam. A pelvic ultrasound may identify the numerous cysts of PCOS. An elevated testosterone and a persistently elevated LH level will help confirm the diagnosis. This sounds easy enough, but often the symptoms of PCOS are subtle and overlooked.
Once diagnosed with PCOS, the next step should be a consultation with an endocrinologist. To improve fertility, drugs like Clomiphene may be used. If you're looking to control the acne and facial hair, oral contraceptives and/or Spironolactone can be helpful. Weight loss greatly helps control the symptoms of PCOS and has been shown to restore fertility in some women. A diabetic diet is often helpful, especially since many of those with the disorder are diabetic or borderline-diabetic.
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