What is Polycystic ovaries (PCO)?
Polycystic ovaries (PCO) is a condition that literally means many cysts on the ovaries.
Within the ovaries are sacs (follicles) that contain eggs. Normally, one egg, occasionally more, matures and is released during each menstrual cycle. This is called ovulation. With polycystic ovaries the egg matures but it is not released, instead it stays on the surface of the ovary and forms a cyst. The cyst can get larger with time and the whole ovary can become covered with cysts.
For these reasons, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent.
These cysts, usually no bigger than 8 millimetres each, are egg-containing follicles that have not developed properly because of hormones not working effectively.
It is not completely understood why or how the abnormalities in the hormone levels occur.
Most women have cysts in their ovaries. However, if you have polycystic ovaries, you’ll have nearly twice as many cysts as women without the condition.
What are the Symptoms of Polycystic Ovaries (PCO)?
- absent or reduced periods
- difficulty in conceiving.
- polycystic ovaries are almost always associated with a weight problems either overweight or underweight or women with eating disorders.
How common is Polycystic ovaries (PCO)?
Polycystic ovaries (PCO) are very common, affecting around 20 per cent of women.
What is Polycystic Ovary Syndrome (PCOS)?
Polycystic ovary syndrome is the name given to a condition in which women with polycystic ovaries also have one or more additional symptoms. It was first ‘discovered’ in 1935 by Doctors Stein and Leventhal, so for many years it was known as the Stein-Leventhal syndrome.?? Polycystic ovary syndrome (PCOS) is also very common, affecting 5–10 per cent of women.
Symptoms of PCOS
PCOS affects women in different ways, so not all women will have all these symptoms. Some women may have only mild symptoms, while others may have a wider range of more severe symptoms.
Symptoms can include:
- irregular periods, or a complete lack of periods
- irregular ovulation, or no ovulation at all
- reduced fertility – difficulty becoming pregnant, recurrent miscarriage
- unwanted facial or body hair (hirsutism)
- oily skin, acne
- thinning hair or hair loss from the scalp (alopecia)
- weight problems – being overweight, rapid weight gain, difficulty losing weight
- depression and mood changes
How common is Polycystic ovaries Syndrom (PCOS)?
About one in ten women in the UK has PCOS to some degree.
What is the difference between PCO and PCOS ?
PCOS is a more extreme version of PCO. Many women have polycystic ovaries without having the syndrome (without the symptoms). Some women have the syndrome, but have normal looking ovaries on ultrasound.
What causes polycystic ovaries / PCOS?
It is believed that polycystic ovaries are casued by abnormalities in some of the hormones that control the menstrual cycle.
These abnormalities typically include: higher than normal levels of LH and of androgens, and below normal levels of FSH and progesterone. The most important androgen is testosterone, which is produced by all women from the ovaries. Testosterone is a normal and essential product of the ovary because most of it is converted, within the ovarian follicle, to estrogen, which is the main female hormone.
Women with PCO produce higher than average amounts of testosterone from the ovaries, and it is this that results in many of the symptoms of the condition. Testosterone is often thought of as a ‘male hormone’, but this is not the case – it is just that men produce 10 times as much testosterone as women.
Women with PCO usually have a testosterone measurement that is either slightly above the female range or at the upper end of the normal range for women.
It is also thought that another hormone – insulin – may be involved in the development of PCOS. Insulin is a hormone produced by the pancreas to regulate the level of glucose in the blood. Many women with PCOS have been found to have a condition known as insulin resistance, in which the body’s tissues are resistant to the effects of insulin (particularly on the ability of insulin to get glucose into muscle tissue), so the body has to produce more insulin to compensate. It seems that these high levels of insulin then affect the ovaries, contributing to the abnormal hormone environment. The excessive amounts of testosterone may be a result of these abnormaliteis in insulin production.
Doctors do not yet fully understand what causes these hormonal abnormalities. It may be that there are several causes, which could explain why different women have such different symptoms. Much research is still going on in this area.
It is currently thought that there is a hereditary link, whereby some women inherit a greater chance of having PCOS, but whether or not these women actually develop PCOS depends on a number of additional factors. These factors include diet and lifestyle. Women with PCOS often have a mother or sister with the condition, there is not enough scientific evidence to prove that the condition may be inherited.
What is the cure for PCO and PCOS?
Unfortunately there is no cure. But several medications that stimulate ovulation can help women with PCOS become pregnant. The most favoured is Clomid.
