Polycystic Ovary Syndrome: Mysterious and Serious

What you don't know can hurt you. Six to 10 percent of all women have polycystic ovary syndrome (PCOS), and many don't even realize it. Physicians often overlook the diagnosis although PCOS is one of the most common causes of female infertility and has other serious and far-reaching health repercussions. Learn more about this mysterious condition.

• Strange bodily changes. When Amy (not her real name) entered her twenties, her body went haywire. Dark coarse hair appeared on her abdomen. Her menstrual cycles lengthened until she menstruated only every four to six months. She was plagued by acne. She gained weight that she couldn't lose. She and her husband tried for years to have a child. It wasn't until Amy was in her thirties that an infertility specialist mentioned that she might have polycystic ovary syndrome.
  "I couldn't believe how much those symptoms sounded like me," says Amy. Desperate for information, she searched the Internet. She subscribed to some lists and found support in a wide group of "cysters" (as some of the PCOS women call themselves). "It was a very liberating experience."

• What is PCOS? No one knows what causes PCOS, a hormonal disorder also known as Stein-Leventhal syndrome. Somehow, the hormones that regulate ovulation are disrupted. Normally, estrogen, testosterone, and luteinizing hormone rise and fall to cause a normal menstrual cycle. But in PCOS, these hormones stay at elevated levels. Eggs don't mature, ovulation doesn't occur (or occurs infrequently), and the ovaries become enlarged and often filled with small cysts. Without nature's hormonal signal to menstruate, the lining of the uterus builds up and bleeding can be heavy and irregular.
  To confirm the diagnosis, your doctor will most likely perform blood tests to check for elevated hormones. He or she may also use an ultrasound to search for enlarged ovaries or ovarian cysts. The primary diagnostic process is to eliminate other conditions that could cause similar problems. Diagnosis is a matter of piecing together all the puzzle pieces to see the big picture of PCOS.

• Warning signs. Robert A. Greene, MD, FACOG, director of Specialty Care for Women in Redding, California says, "Symptoms of PCOS can be very subtle," because victims aren't necessarily heavy, hairy, balding, or acne-plagued.
  Red flags that you may have PCOS include the following:

• Irregular, absent, or heavy periods
• Excess body or facial hair
• Thinning head hair
• Ovarian cysts
• Acne
• High insulin levels, insulin resistance, or diabetes
• Infertility
• Unexplained weight gain or inability to lose weight

• Possible long-term health effects. In the past, some physicians considered PCOS to be "only" a cosmetic problem or even "just" an infertility issue. But today we know that women with the condition are at increased risk for certain chronic and serious illnesses including:

• Diabetes. Some women with PCOS have trouble using the insulin in their bodies—the hormone that maintains proper blood sugar levels.
• Endometrial cancer. Failure to have regular menstrual cycles prevents the uterine lining from shedding monthly, increasing the risk for endometrial cancer at a younger age.
• Heart disease. Women with PCOS tend to have low HDL (good ]]>cholesterol]]>) levels combined with high LDL (bad cholesterol) and triglyceride levels. Along with high blood pressure, these cholesterol levels may indicate an increased chance of heart problems or stroke.