Polycystic Ovarian Syndrome (PCOS) and type-II Diabetes

PCOS (Polycystic Ovarian Syndrome) is a hormone imbalance that occurs in women, and can often be mistaken for something else. Women who have it have high testosterone and high circulating insulin levels. Without diagnosis, women with PCOS risk infertility, persistent weight gain and, if left untreated for a long period of time, Type-II diabetes.

It's estimated that over 50% of women with untreated PCOS contract Type-II diabetes before their fortieth birthday. Women with PCOS have a five to seven times higher incidence of heart attacks than women of childbearing age without the ailment. PCOS therefore poses an important danger to women, and should be diagnosed and treated as early as possible.

What causes PCOS? Simply put, PCOS represents multiple cysts on the ovaries. Cysts originate in follicles which should be producing oocytes (eggs) for reproduction. Because of a higher level of male hormones, these follicles do not fully mature, and instead remain as cysts in the ovaries. Since the follicles don't mature, the ovaries put out less progesterone and are less likely to have their periods. With less estrogen and progesterone, a woman's testosterone secretions increased and PCOS results.

These cysts are sources for testosterone, which counteract a woman's natural estrogen level and lead to other problems. These problems can include excess facial hair, obesity and a diminished number of periods. Although all women secrete some level of male hormones, PCOS-afflicted women's levels are much higher, which stimulates other symptoms. Other symptoms can include:

Acne
High cholesterol
High blood pressure
Thinning hair or male-pattern baldness

In more severe cases, patches of brown spots at the elbows, breasts, knees and other points on the body (note: these are also symptoms of Type-II diabetes

In reviewing the symptoms, it is clear that many women with PCOS are at a heightened risk for heart and other circulatory diseases. Of all the symptoms, high and persistent insulin levels may be the most harmful to a woman's health. This symptom causes blood vessels to constrict, and may lead to insulin-dependent diabetes in some cases if left untreated.

How does one treat PCOS? There is no one perfect therapy. Each woman's case must be treated in a different way. Those women who suffer from severe symptoms should be given steroids to reduce acute problems. Over the longer term, many women are given one or more of the following:

Birth control drugs, in order to regularize their periods and counteract the increased production of male hormones

Anti-diabetes medicines, including glucophage and Avastin, to reduce the effects of higher levels of insulin being circulated in the bloodstream.

Fertility medications, both to stimulate normal female hormone production and, in the case of infertility, to stimulate a pregnancy. The two drugs most often prescribed are Clomid and mettformin if the Clomid is not enough.

In the case of reduced pituitary output, gonadotropins are also administered.

Anti-androgens, such as Minoxidil (topical) are administered in order to counteract the male hormones' influence on hair loss. Their secondary effect is to reduce the overall effect of male hormones on the female body.

If these drugs are not enough, a woman with PCOS can undergo surgery to reduce the number of cysts in the ovaries. By "cyst drilling," the surgeon can reduce the amount of male hormones and insulin secreted by the ovaries and improve the relative output of estrogen and progesterone. Although any surgery is potentially dangerous (particularly with obese patients), this is a relatively non-invasive procedure which can be performed using laparoscopic tools.

It is estimated that five to ten percent of women have PCOS. Women who have a family history, or are obese, are more likely to contract PCOS.