Polycystic ovary syndrome (PCOS) is the most common reproductive disorder worldwide affecting up to 20% of women of reproductive age as well as the most common endocrine disorder in premenopausal women.
It has been considered a disease process for the last century although was described as early as 300 B.C. by Hippocrates who described “ women….. a masculine appearance; yet are not concerned about bearing children nor do they become pregnant.”
The name itself, PCOS, is a misnomer. The name suggests that it is a gynecologic problem with ovarian cysts being the issue. The real defect is hyperinsulinemia (too much insulin) caused by insulin resistance. This makes PCOS, in reality, an endocrine disorder, and therefore makes the target of treatment: reversing insulin resistance.
A better name may be metabolic reproductive syndrome. A myriad of other names have also been suggested.
PCOS is a syndrome with a varying spectrum of symptoms that has made it challenging to come to a consensus on diagnostic criteria.
– 50% are obese, 50% are not obese
– 50% have hirsutism (facial hair), 50% do not
These stark variations in presenting symptoms means that the diagnosis is often missed, in some estimates up to 90% of the time.
It is generally accepted that one has PCOS if they have 2 of the 3 of the following:
– Hyperandrogenism – excess male hormone causing acne, facial hair, changes in body shape
– Menstrual irregularities
– polycystic ovaries
PCOS in the short term can cause the above mentioned symptoms as well as infertility. Long term, PCOS puts women at increased risk for Type 2 Diabetes, heart attacks, strokes, and cancer.
Therefore it is imperative for PCOS to be recognized by clinicians and aggressively treated. Short term treatment goals are reduction or elimination of hyper-androgenic symptoms such as facial hair, acne, and hair loss as well as restoration of fertility (if desired).
Long term treatment goals should be to reverse insulin resistance that puts patients at risk for multiple chronic disease processes.
If you or someone you know have more questions about PCOS and are wondering whether or not you may have it, please call our office at 910-399-6661 or visit our website at www.biosymmetrywilmington.com/polycystic-ovarian-syndrome/ and schedule a consult.