Polycystic Ovary Syndrome (PCOS): A Leading Cause of Female Infertility
Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age, and is increasingly recognized as a significant contributor to infertility. The French national health research institute, Inserm, highlights the complex and variable nature of this condition.
Understanding the Symptoms
The symptoms of PCOS vary greatly between individuals, but frequently center around disruptions to ovulation. These can range from infrequent or absent ovulation, leading to abnormally long menstrual cycles or amenorrhea (absence of menstruation), to infertility affecting nearly half of women with the condition.
beyond ovulation issues, PCOS frequently enough manifests as hyperandrogenism – an excess of male hormones – appearing typically during adolescence.This can result in increased hair growth (hirsutism), acne, and hair loss.
Importantly, PCOS is also linked to metabolic syndrome. Excess weight can contribute to insulin resistance and an increased risk of developing type 2 diabetes. Inserm notes a correlation between Body Mass Index (BMI) and infertility associated with PCOS, and highlights an elevated risk of high blood pressure and cardiovascular disease in affected individuals.The clinical picture frequently enough worsens with weight gain. The French and European association fighting against PCOS also emphasizes the significant pain experienced by some patients, impacting their daily lives. The World Health Organization (WHO) adds that the biological and psychological effects – particularly those related to obesity, body image, and infertility – can lead to mental health problems and social stigma.
Debunking the Name: Follicles, Not Cysts
The term ”polycystic ovary syndrome” is, historically, a misnomer. First described in 1935, initial observations led to the belief that patients had cysts on their ovaries. Tho, what appears on ultrasound are not cysts, but a large number of immature follicles. These follicles are normal structures within the ovaries, each containing an egg cell surrounded by nourishing cells. In a typical menstrual cycle, 5 to 10 follicles begin to develop, but only one becomes dominant and releases a mature egg. Inserm explains that in PCOS, this maturation process is blocked, causing the follicles to accumulate within the ovaries.
Diagnosis: Meeting the Criteria
A diagnosis of PCOS requires the presence of at least two of the following three criteria:
Signs or symptoms of high androgen levels (excess facial or body hair, hair loss, acne, or elevated testosterone levels in blood tests). Irregular or absent menstruation.
Polycystic ovaries visible on an ultrasound.
Diagnosis typically involves both an ultrasound examination and blood tests to assess hormone levels.
Management,Not Cure
Currently,there is no cure for PCOS. Treatment focuses on managing the symptoms.Weight loss (for those who are overweight) can reduce hyperandrogenism and lower the risk of metabolic complications. It can also improve menstrual regularity and fertility. For women experiencing hirsutism, the combined estrogen-progestin birth control pill is frequently enough recommended. Inserm explains that the progestin component inhibits the secretion of luteinizing hormone (LH) and reduces androgen production,while the estrogen component lowers circulating androgen levels.
Pregnancy with PCOS is Possible
despite the challenges, many women with PCOS can* conceive spontaneously, even with irregular cycles. When pregnancy doesn’t occur naturally, treatment options include ovarian stimulation and assisted reproductive technologies.
PCOS is a complex and multifaceted condition that represents a leading, and often preventable, cause of female infertility. Early diagnosis and appropriate management are crucial for improving the health and quality of life for those affected.
