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Polycystic ovary syndrome

Polycystic ovary syndrome is a very common hormonal problem in women, causing menstrual irregularity, inability to get pregnant, acne (pimple), excessive male pattern hair growth (over lips chin, cheeks, chest, abdomen, arms & legs). It is one of the most common cause of menstrual irregularities in overweight girls. In PCOS ovary is larger than the normal and contains many small cysts (follicles) due to arrest in the maturation of developing ovum. 0ne out of 10 women is affected by PCOS.

The symptoms of PCOS include:

  • Irregular periods or no periods at all
  • Inability to get pregnant
  • Acne (pimple), oily skin
  • Excessive hair growth over body and face
  • Weight gain
  • Depression and mood swing
  • Symptoms of PCOS vary in women.Some women have mild symptoms while others have very severe symptoms.

    Diagnosis of PCOS is based on symptom complex and solography feature. Diagnosis is made when you have any 2 of the followings,

  • Irregular periods or no periods
  • Acne, Hair growth and/or high level male hormones (Testosterone, Androstenedion , DHEA)
  • Sonography of ovaries shows enlarge ovaries with or without multiple cysts
  • Yes, PCOS have various long term health issues.Women with PCOS are at High risk of developing Type 2 Diabetes mellitus, Hypertension (High blood Pressure), Heart disease. They are also at high risk of developing Cancer (Endometrial cancer). PCOS and overweight can lead to snoring and daytime drowsiness.

    There is no cure of PCOS, but it can be treated with various available medical options Most important aspects of management is lifestyle modification which includes Healthy diet, exercise and weight reduction.Weight gain can cause menstrual irregularity with or without PCOS. In obese women with PCOS, weight loss is the first line of therapy1. Menstrual irregularities are improved in some women with as little as 5–10% reduction in body weight.Other benefit of weight loss are, it improves ovulation, increase pregnancy rates, also decrease the requirement of other treatment for fertility management.

    Available option for management of various symptoms are as below

    Control of irregular periods:

  • Lifestyle modification (Healthy diet, exercise and weight reduction)
  • Metformin: Insulin sensitizing agent
  • Oral contraceptive pills like Ysamin, ovral, femilon, novelon
  • Treatment of hair growth:

  • Lifestyle modification (Healthy diet, exercise and weight reduction)
  • Metformin
  • Ant androgenicmedications: Spironolactone, Fenasteride, Cyproterone acetate
  • Laser treatment
  • Fertility management:

  • Lifestyle modification (Healthy diet, exercise and weight reduction)
  • Metformin
  • Ovulation induction with Clomiphene citrate, FSH (Follicular Stimulating Hormone)
  • Laser ovarian drilling
  • There is no cure of PCOS. The symptoms of PCOS can be managed with medical treatment. With the help of lifestyle modification (healthy eating, exercise, weight reduction) most women can manage symptoms of PCOS without Medical treatment.

  • 1. Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline. J ClinEndocrinolMetab, December 2013, 98(12):4565– 4592.