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Polycystic ovary syndrome (PCOS)
What is polycystic ovary disease?
Polycystic ovary syndrome is a common disorder that afflicts females of reproductive age. More commonly associated with older women, teens and young adults may also have PCOS.
The ovaries produce "female" (progesterone and estrogen) and "male" (androgen) sex hormones. Higher amounts of any of these hormones are responsible for female or male secondary traits. Both boys and girls produce both kinds in differing amounts.
In PCOS, the ovaries make too much of the male sex hormone androgen, which is considered the sign of the disease. When this happens, sometimes the cells that produce eggs within the ovaries fill up with fluid (cysts) instead. Over time, these cysts build up. When this happens, the ovaries become enlarged and young women miss periods because no eggs are released, causing serious consequences.
Some warning signs of PCOS
- Skin symptoms of hyperandrogenism (too much androgen): acne, abnormal hair growth, or baldness/thinning of head hair
- Menstrual dysfunction - irregular or absent periods
- Abnormal amounts of hormones that control egg development/maturity and release are produced
- Polycystic ovaries detected by ultrasound - a build-up of cysts in the ovaries appears on a sonogram
- A family history of PCOS
Increased risks associated with PCOSThough doctors are not certain what causes polycystic ovary syndrome, it runs in families and some signs can show up in early childhood. Both of these circumstances suggest that children are born with PCOS. Symptoms usually appear within the first year of life.
If your daughter has PCOS, she is also at increased risk for a number of other serious conditions, including:
- Infertility - unable to have children
- Uterine carcinoma - cancer of the uterus
- Dysfunctional uterine bleeding - bleeding of the uterus outside of periods
- Endometrial carcinoma - cancer of the lining of the uterus
- Depression - a mental illness that is more than just sadness
- Diabetes (type 2) - a lifelong condition with too much sugar in the blood
- Hypertension - high blood pressure
- Dyslipidemia - too much (more common in the US) or too little fat in the blood
- Metabolic syndrome - a combination of problems like increased blood pressure and abnormal cholesterol levels, but independent of a high blood sugar level and obesity
Diagnosis & TreatmentAfter we evaluate your daughter’s medical history we conduct a general and pelvic exam. We may also perform a blood test to evaluate hormone levels and do an ultrasound of her ovaries to look for cysts.
Treatment depends on the specifics of the case and the severity of symptoms. Specific treatments can include insulin-sensitizing drugs or oral contraceptives to regulate periods and control acne and unwanted hair growth. Combination oral contraceptives can also decrease endometrial cancer risk in teens.
Teen girls with PCOS are also encouraged to develop a healthy lifestyle and lose weight, as excess weight affects insulin levels, which may be a contributing factor in PCOS
Our Adolescent Health and Medicine Program addresses the unique health challenges of children ages 10 through 21. When combined with our endocrine program’s staff and volunteers, your daughter has a powerful ally in the treatment of PCOS.