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Polycystic Ovary Syndrome

At some time in her life, one in every three or four women develops polycystic ovaries- which means her ovaries become studded with multiple cysts that are bubble-like and up to 8mm across. Normally, several egg follicles start growing in the first half of the menstrual cycle, and then one becomes dominant and ruptures to release an egg. But in a woman with polycystic ovaries this mechanism is upset, so none of her follicles becomes dominant.

The cells of many women with PCOS are relatively insensitive to insulin. This problem is usually associated with a woman being overweight or eating an unhealthy diet with too much high-glycaemic-index (GI) food and not enough low-GI food. Insulin resistance leads to high blood sugar, low cell-sugar levels and, eventually, to a high insulin level. Researchers think this is the key factor in PCOS and one which also increases the risk of diabetes, high blood pressure, and stroke.

Being overweight can cause or worsen insulin resistance, though many women with PCOS aren't overweight, so the underlying cause remains unclear. Some women with PCOS and insulin resistance have 'acanthosis nigricans' - rough, darkened, thickened skin in their armpits and groins and on the nape of the neck.

A high insulin level tends to raise the levels in the blood of free testosterone and other androgens. This is probably because it reduces the level of sex hormone binding globulin (which normally mops up a proportion of male hormone molecules -leaving fewer available to exert their influence by latching on to cell receptors). High testosterone encourages acne, male-pattern hair thinning and excess facial or body hair, though the 'high' level found in some women with pcas is still much lower than that in a man.

There may also be a high level of oestrogen (mostly oestrone, made from androgens in fat cells). However, in spite of this - or perhaps, partly, because of it the egg follicles don't mature properly and instead become cystic, no one follicle ripens fully and ovulation is often irregular, or stops. This causes irregular, infrequent or absent periods and, perhaps, infertility, though the pituitary gland tries to get the cycle back on track by producing a high level of luteinising hormone. Lack of ovulation causes continued stimulation of the womb lining in the second half of the cycle, which thickens the womb lining and may disrupt womb-lining cells, increasing the risk of womb cancer. If periods are absent the risk is higher, since the womb lining continues to be stimulated yet is never shed.

The menopause in a woman with PCOS is likely to be early.

Need to see a doctor

Your doctor can confirm PCOS and suggest a package of home and medical treatments you need to prevent or control your symptoms. In teenagers it may be difficult to distinguish normally irregular periods plus obesity or other PCOS-type symptoms, from PCOS it self, so a doctor will probably recommend watching and waiting to see what happens. Any woman who has adult acne, or whose hair is falling out for no obvious reason before the menopause, should discuss the possibility of PCOS.

Medical treatment for Polycystic Ovary Syndrome

This depends on your weight, age and plans to have children and is secondary to lifestyle factors such as losing excess weight and eating a healthy diet. If you find irregular periods a problem, or your womb lining is particularly thick (over15mm or %in),the Pill can help by causing monthly periods and thereby reducing the raised risk of womb cancer associated with a thickened womb lining. It also, of course, provides contraception.

If you are bothered by excess facial and body hair a contraceptive Pill containing cyproterone acetate plus oestrogen, for 21 days a month, usually reduces hair growth by up to a third over six months. It also makes each hair finer, which makes electrolyis easier and skin damage less likely. Cyproterone is a powerful progestogen that inhibits the production of gonadotrophins (follicle stimulating hormone and luteinising hormone), thus reducing androgen production in the ovaries. It also attaches itself to androgen receptors so it blocks the action of androgens. This therapy also produces regular periods and can help insulin resistance and acne (though it's worth trying over-the-counter or prescribed acne treatments first). One problem is this medication could make it more difficult to lose weight and weight loss is often a vital part of successful treatment. Possible side effects include weight gain, nausea, tiredness, low sex drive, breast tenderness, headaches, depression, irritability.

Home remedies and Precaution for the treatment and cure of Polycystic Ovary Syndrome

Healthy weight maintenance - Losing excess weight and keeping your new, healthy weight stable make your cells more sensitive to insulin, which is the best way of restoring regular periods and reducing hairiness. Losing weight is also the best way of increasing fertility, since you're unlikely to ovulate if you are obese

Do it with a sensible diet, exercise and stress-management plan.

Other dietary changes - Eat a healthy diet to help balance hormones and protect arteries. Have regular small meals with some low-glycaemic-index (GI) food at each meal. Avoid rapid increases in blood sugar by eating high-GI food only in small amounts, and choosing foods rich in chromium (mushrooms, wholegrain foods, and liver), magnesium, manganese, zinc, fibre, and plant oestrogens. Dietary plant oestrogens may help, as they tend to increase the level in the blood of sex hormone binding globulin- a protein that binds testosterone and thereby reduces its action. Also, consider liquidizing and eating a whole orange, (including the peel) each day; researchers say inositol (related to vitamin B) in the peel reduces insulin, testosterone and sugar levels.

Your action plan

Vital: Healthy weight maintenance, Dietary changes, Exercise, Discourage oestrogen dominance, Stress management, Exposure to Light

Could be vital: Acne and excess-hair remedies, Herbal remedies

Medical Conditions

Gynae cancers
Oestrogen dominance
Oestrogen deficiency
Period pain
Mid cycle pain
Heavy periods
Polycystic ovary syndrome
Ovary cancer
Ovarian Cysts
Cervix cancer

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