1 out of every 5 women has PCO.

Even though many have never heard of PCO, 1 out every 5 women in the child-bearing age has it.

PCO (polycystic ovaries) is a condition where an abnormally large number of follicles are produced in the ovaries. Normally the follicles are distributed evenly in the ovaries. With PCO the follicles are most often found in the outer periphery, while the middle is filled with a dense tissue. The ovary itself is larger than normal. There are no noticeable symptoms for this type of ovaries – many women with this condition never know they have them.

PCO can develop into PCOS

1 out of every 7 women in the child-bearing age has PCOS. PCOS means polycystic ovarian syndrome and is a condition where – in addition to having polycstic ovaries - a woman also has the following:

  • higher than normal amounts of androgen (the male sex hormone) and/or
  • infrequent or no ovulation.

(These symptoms can also be caused by other factors. These must also be investigated.)

Symptoms of higher than normal amounts of male sex hormone are:

  • a tendency to excessive hair growth (hirsutism) – downy/fluffy facial (beard) hair and excessive body hair combined with thinner hair on the head.
  • increased tendency for acne
  • abnormally high rates of androgen in blood tests.

The degree to which these symptoms cause problems depends upon the individual woman’s sensitivity for androgens. The problems caused by these symptoms are often the reason the woman seeks her doctor’s help.

Infrequent or no ovulation can not be directly seen, but can lead to the following symptoms:

  • disrupted menstruation cycle as evidenced by long intervals between menstruation cycles – or no menstruation at all.
  • difficulty becoming pregnant caused by lack of ovulation.

Difficulty becoming pregnant most often leads women with PCOS to consult their doctors. Polycystic ovaries are revealed by ultrasound scanning, providing an explanation for her difficulties – and lead to treatment.

For a woman who does not wish to have children, the long intervals between menstruation cycles can seem practical and even pleasant. This condition is, however, a sign of imbalance in the body, and should as such lead to treatment to ensure routine menstruation with normal intervals.

What causes PCO? - and how does PCO develop into PCOS?

PCO is believed to be inherited. Some women are perhaps more likely – due to genetic factors – to develop PCOS than others. The current trend towards increased weight (overweight) combined with too little physical activity contribute to a spread of PCOS.

Overweight

Unfortunately, women with PCO have an increased tendency to gain weight. Because of the additional androgens, all extra fat accumulates around the waist. This is also true for women with PCO who are not overweight.

70-80% of women with PCO are overweight. This is unfortunate because being overweight worsens the symptoms of PCOS.

Why is being overweight particularly unfortunate for women with PCOS?

Fatty tissue emits chemical substances that reduce sensitivity to insulin (insulin resistance). To counter the reduced sensitivity, the pancreas (which produces insulin) produces greater amounts of insulin.

This results in:

  • increased amounts of androgen in the blood
  • worsened skin and hair problems
  • a stop in the development of eggs in the ovaries
  • no ovulation
  • disrupted menstruation
  • infertility

Why is a lack of physical activity particularly unfortunate for women with PCOS?

Lack of physical activity can in itself lead to insulin resistance – both in individuals who are overweight and those who are not.

This is because muscles release an important chemical substance (IL-6 or interleukin 6) as they work. This substance works to insure, maintain or increase sensitivity to insulin. Thus, physical activity results in a release of IL-6, in turn increasing insulin sensitivity: an increase in physical activity = greater insulin sensitivity.

Using our muscles too little – not uncommon in today’s society - weakens our insulin sensitivity.

Be aware of the long term consequences to your health

Reduced insulin sensitivity and the resulting increase in insulin production increases the risk of developing Type 2 diabetes – also among those who are not overweight.

Reduced insulin sensitivity also disrupts the fat metaborism in the blood and increases the risk of cardiovascular problems. This risk is increases more by being overweight.

It is therefore important to consciously reinforce/strengthen your insulin sensitivity by maintaining a normal weight and engaging in physical activities. This is the best form of preventive action.

In cases with abnormal menstruation cycles – or no menstruation at all – the lack of expulsion of the mucous membrane from the uterus increase the risk of developing cancer of the mucous membrane of the uterus.

Preventive treatment

If you are of normal weight (body mass index no higher than 25), you should maintain your weight – i.e. avoid becoming overweight.

If you are overweight, losing weight is the most effective treatment.

Physical activity is of benefit to all – overweight or not. One half hour a day is very beneficial.

Medical treatment of reduced insulin sensitivity with Meformin

If you have developed insulin resistance as a result of PCOS, you may have begun using the drug Metformin (also called Orabet or Glycophage) against Type 2 diabetes. This is true whether you are overweight or not. Metformin increases sensitivity to insulin and can therefor correct many of the attendant imbalances.

Not all benefit from taking Metformin, and it cannot be predicted who will benefit and who will not.

Meformin has also side effects such as nausea, diarrhea, and a metallic taste in the mouth.

Treatment of abnormal hair growth

Birth control pills sometimes reduce abnormal hair growth, but are not always effective.

Spironolacton (Spiron), an anti-androgen, is sometimes effective.

Hair removal by laser is probably the most effective treatment, but is expensive and the result temporary.

Treatment of acne

Birth control pills sometimes work, but are not always effective.

Treatment where pregnancy is desired

While PCOS is not an impediment to becoming pregnant, many with PCOS need a little help getting pregnant. Since pregnancy requires normal follicular development and ovulation, hormone treatments can be of help.

With PCOS it is often the case that ÆGBLÆRERNE begin to grow normally, but stop growing at an early stage, disrupting ovulation.

Many women with PCOS will occasionally have completely normal ovulation. Thus, many can become pregnant without treatment. In fact, many women with PCOS never learn that they have it, and become pregnant and give birth completely naturally.

Where can I learn more about PCOS?

Some cases of PCOS are diagnosed early – some already in their teens – when they seek their doctor’s help for abnormal hair growth or acne. Other cases are first diagnosed when a woman seeks help for infertility, and yet others are never diagnosed.

No matter when PCOS is diagnosed, many questions arise, and it can be difficult to find answers to some.

Read more about female causes of infertility

 

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