Polycystic Ovary Syndrome

Polycystic ovary syndrome PCOS often begins to appear at the time of puberty, and in some women only in adulthood. Women often have less than 6-8 periods per year, and variously expressed signs of excess male hormones. Increased hairiness of the male type, hair on the cheeks, chin, chest or abdomen, is common. The picture varies from woman to woman, some have acne, some have increased hair growth, some have irregular periods.

• Excessive body hair (hirsutism)
• Acne
• Increased skin pigmentation in the groin or armpit
• Obesity
• Irregular cycles or absence of menstruation
• Difficulty getting pregnant
• Vaginal yeast infections
• Hair loss

Polycystic ovary syndrome in women often causes obesity and/or infertility. Infertility is caused by irregular ovulation, i.e. failure to release an egg at the time when ovulation should occur. A problem that cannot be seen, and is most often the cause of polycystic ovaries, is the so-called insulin resistance, i.e. weak effect of insulin produced by the patient in an increased amount.

Polycystic ovary syndrome in women increases the risk of diabetes, high blood pressure, endometrial cancer and sleep apnea in later life.

• weight gain and obesity – about half of women with PCOS will gain weight over time.

Problems with blood sugar regulation that may include:

• Hyperinsulinemia (excessive insulin production)
• insulin resistance (weak response of tissues in the body to insulin)
• Glucose intolerance (prediabetes)
• Non-insulin dependent diabetes mellitus (NIDDM)

Insulin resistance and hyperinsulinemia can occur in obese, but also in women of normal weight who have PCOS. By age 40, up to 35% of obese women with PCOS develop glucose intolerance, and up to 10% develop NIDDM. Glucose intolerance and diabetes are proven by blood tests.

In case of a more serious disorder, sometimes it is enough to draw blood on an empty stomach, but sometimes it is necessary to do the so-called OGTT (oral glucose tolerance test), i.e. measure blood sugar after a sugar load. Insulin resistance, hyperinsulinemia, and even glucose intolerance can be controlled with diet and regular exercise.

• heart disease – insulin resistance and obesity raise the risk of coronary heart disease, which is a narrowing of the arteries that supply blood to the heart itself. Again, weight loss and exercise reduce the risk.
• cancer of the lining of the uterus – women with PCOS do not have regular ovulation, so neither do they have regular periods. The lining of the uterus is constantly stimulated to grow without regular “cleaning” in the form of menstruation. Over time, this increases the risk of uterine lining cancer. That’s why women with irregular periods caused by PCOS should use contraceptive pills or progesterone pills (Dabroston, Utrogestan, Provera) for 10 days a month, because they reduce the risk of this cancer.
• sleep apnea – sleep apnea is a complete cessation of breathing for a short period of time, and is thought to occur during sleep in about 30% of women with PCOS. It is characterized by extremely loud snoring with short periods in which breathing stops (apnea). Patients with this problem are excessively tired and sleepy.