Irregular, long cycles – it could be PCOS

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. It is estimated to affect between 6 and 15% of them, but most remain undiagnosed due to associated problems. PCOS, also called Stein-Leventhal syndrome (after the doctors who described the hormonal disorder in 1935), is most often manifested by irregular, prolonged cycles and ovulation disturbances. Women also complain of excessive hair and acne and are more likely than average to have weight problems. What is important, problems with getting pregnant may also occur.

Polycystic ovary syndrome occurs in young women all over the world. Until now, it has not been clearly identified as to what causes it. It is suspected to have a genetic cause. It is most often discovered when a woman fails to get pregnant – during the diagnosis of the causes of infertility. This hormonal disorder encompasses a whole range of different ailments.

Due to hypothalamic-pituitary dysfunction the lack of ovulation is common. There is excessive secretion of androgens (male sex hormones), luteinizing hormone (LH) also increases and the LH/FSH ratio is disturbed.The maturing follicles do not rupture but turn into small (2-10 mm) cysts on the ovaries (hence the name). It is also accompanied by metabolic and psychological disorders.

The most common symptoms of PCOS

To diagnose PCOS, doctors use the so-called Rotterdam criteria: excess androgens (male sex hormones), irregular cycles, and polycystic ovaries on ultrasound imaging. It is assumed that the presence of already two of the three parameters indicates the disease.

Among other typical complaints, doctors mention:

– long, irregular cycles or complete absence of menstruation – prolonged PMS symptoms – fertility disorders – acne and skin problems – metabolic problems, insulin resistance – obesity, especially abdominal obesity (but the disease also affects slim women) – elevated glucose levels; – symptoms of male pattern baldness (hair curves, top of head) – hypertension.

If you have any of these symptoms, you should consult your doctor, who will suggest appropriate tests and further steps.

Diagnosis and Treatment

Since PCOS is a disorder that manifests itself with a series of symptoms of varying severity and at different intervals, its diagnosis requires a visit to the doctor and appropriate tests. Most often the basis for the diagnosis is the result of laboratory tests (including androgens, but also AMH) and ultrasound image. It is important to rule out other hormonal abnormalities beforehand.

Treatment is usually planned in relation to the symptoms and the woman’s family plans. Medications that lower androgen levels are used to alleviate acne and excessive hair problems. Oral contraception is used to normalize the cycle if the woman is not planning a pregnancy. Surgery and ovarian cauterization in young women is now strongly discouraged because of the impairment of fertility that such therapy can cause.

When trying to have a baby, ovulation stimulation may be an option in some cases, while in others, in vitro fertilization may be worth considering.

According to recent studies, women with PCOS benefit greatly from lifestyle changes, a low-carbohydrate diet and regular physical activity. Some of them are able not only to reduce weight and keep fit but also return to a regular cycle and ovulation.