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Endocrine glands
Endocrine glands


Pelvic laparoscopy
Pelvic laparoscopy


Female reproductive anatomy
Female reproductive anatomy


Stein-Leventhal syndrome
Stein-Leventhal syndrome


Uterus
Uterus


Follicle development
Follicle development


Definition:

Polycystic ovary disease is a condition in which there are many small cysts in the ovaries , which can affect a woman's ability to get pregnant.



Alternative Names:

Polycystic ovaries; Polycystic ovarian syndrome (PCOS); Stein-Leventhal syndrome; Polyfollicular ovarian disease



Causes, incidence, and risk factors:

Polycystic ovary disease affects hormone cycles. Hormones help regulate the normal development of eggs in the ovaries. It is not completely understood why or how hormone cycles are interrupted, although there are several ideas.

Follicles are sacs within the ovaries that contain eggs. In polycystic ovary disease, there are many poorly developed follicles in the ovaries. The eggs in these follicles do not mature and, therefore, cannot be released from the ovaries. Instead, they form cysts in the ovary.

This can contribute to infertility . The immature follicles and the inability to release an egg (ovulate) are likely caused by low levels of follicle stimulating hormone (FSH), and higher than normal levels of male hormones (androgens) produced in the ovary.

Women are usually diagnosed when in their 20s or 30s. Women with this disorder often have a mother or sister who has symptoms similar to polycystic ovary disease.



Symptoms:

If you have polycystic ovary disease, you are likely to have some of the following symptoms:

  • Abnormal, irregular, or very light or infrequent menstrual periods
  • Absent periods, usually (but not always) after having one or more normal menstrual periods during puberty (secondary amenorrhea )
  • Acne that gets worse
  • Decreased breast size
  • Development of male sex characteristics (virilization ), such as increased body hair, facial hair, a deepening of the voice, male-pattern baldness, and enlargement of the clitoris
  • Diabetes
  • Increased hair growth; body hair may be in a male pattern
  • Infertility
  • Poor response to the hormone, insulin (insulin resistance), leading to a build-up of insulin in the blood
  • Weight gain, or obesity


Signs and tests:

During a pelvic examination, the health care provider may note an enlarged clitoris (very rare finding) and enlarged ovaries.

Tests include:

Blood tests that may be done include:



Treatment:

Medications used to treat the symptoms of polycystic ovary disease include:

  • Birth control pills
  • Clomiphene citrate
  • Flutamide
  • Spironolactone

Treatment with clomiphene citrate causes the pituitary gland to produce more FSH. This causes the egg to mature and be released. Sometimes women need stronger fertility drugs to get pregnant.

In women with polycystic ovary disease who also have insulin resistance, glucophage (Metformin), a medication that makes cells more sensitive to insulin, has been shown to make ovulation normal.

Losing weight (which can be difficult) may help to reduce the high insulin levels in the blood. For women with this condition who are overweight, weight loss can reduce insulin resistance, stimulate ovulation, and improve fertility rates.



Support Groups:



Expectations (prognosis):

Women who have this condition can get pregnant with the right surgical or medical treatments. Pregnancies are usually normal.



Complications:
  • Increased risk of endometrial cancer
  • Infertility
  • Obesity-related conditions, such as high blood pressure and diabetes
  • Possible increased risk of breast cancer


Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of this disorder.



Prevention:



References:

Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby;2007.




Review Date: 2/5/2008
Reviewed By: Peter Chen, MD, Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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