Polycystic ovarian Syndrom (PCOS) is also known as Stein Leventhal syndrome after Stein and Leventhal who first described the condition. They described an association between the presence of multiple cysts in the ovaries, menstrual disturbances, hirsutism (excess hair growth) and obesity.
It is estimated that upto 10% of pre-menopausal women have PCOS.
It is thought to be due to a hormonal imbalance. The ovaries and adrenal glands of women with PCOS produce more androgens (male hormones) such as testosterone. Cysts develop in the ovarian follicles which produce eggs. These cysts when multiple can cause damage ot the ovaries. It is thought that high levels of insulin (hyperinsulinaemia) stimulate the ovaries to increase production of androgens.
Yes. You can be slim and have PCOS. You can also develop insulin resistance in the absence of obesity.
I have noticed increased hair growth – am I likely to have PCOS?
There are other causes of hirsutism as well. Idiopathic hirsutism (hair growth without an obvious cause) and PCOS together make up over 95% of all cases.
PCOS is associated with insulin resistance and high levels of circulating insulin. Obesity adds to these problems. It is estimated that as many as 10% of women who are obese and have PCOS develop type 2 diabetes by the age of 40 years. A higher proportion have developed impaired glucose tolerance by this age.
What is the significance of finding Polycystic ovaries on ultrasound?
Three key features are necessary:
The treatment of this condition often depends on whether you wish to conceive or not. Your doctor will discuss these issues further with you.
There are two groups of drugs currently used to increase insulin sensitivity
Currently the evidence does not suggest that metformnin has a significant effect on hirsutism and acne. No recomendation can be made for its use.
These drugs have been shown to result in higher ovulation rates.
Dr Nishan Wijenaike, Consultant Physician
West Suffolk Diabetes Service