Chapter 1: What is polycystic ovary syndrome (PCOS) and how common is it?
What is polycystic ovary syndrome? Thanks for asking. Polycystic ovary syndrome, or PCOS for short, is related to hormonal imbalances in women's bodies. It's the leading cause of female fertility problems and affects one in 10 women of childbearing age in the UK, according to the NHS. Despite that, there is very little awareness about the condition.
The most important thing to know about PCOS is that it leads to excessive production of androgen and hormones, especially testosterone. High testosterone levels in women disrupt the ovarian cycle and in particular see fluid-filled sacs called follicles develop in the ovaries. How does it affect the body apart from causing cysts?
Chapter 2: How does PCOS affect the body beyond ovarian cysts?
Well, actually, it doesn't cause cysts at all, contrary to what the name suggests. Steen and Laventhal, the two American gynecologists who discovered the disease in 1935, mistook the follicles in their research subjects' ovaries for cysts.
As for the rest of the body, ovulation is directly affected, which means patients suffer from irregular cycles or even a total absence of periods known as amenorrhea. However, PCOS does not only affect ovaries, it's a full-body endocrine and metabolic disorder. Half of affected women also develop fertility problems.
Another common symptom is hirsutism, a condition that results in excessive growth of thick dark hair in a male-like pattern on the face, chest and back. it is mainly caused by high testosterone levels. Patients also sometimes report acne breakouts and alopecia, or in other words, hair loss.
And finally, the majority of people with polycystic ovary syndrome have insulin resistance or high insulin and may go on to develop type 2 diabetes.
Is the disease still understudied?
No, it's actually over-diagnosed by doctors, as some women may have polycystic ovaries on ultrasound without suffering from PCOS. That is to say, they have follicles in their ovaries, but do not necessarily suffer from a hormonal imbalance. To identify PCOS, the patient must have at least two of the following three symptoms.
An irregular menstrual cycle, polycystic ovaries on ultrasound, and or a high level of androgen hormones in the blood.
Do we know why some women produce too many androgens?
It's a multifactorial disease, which means there is no one single cause, but we do know that there is a genetic predisposition and that environmental factors can contribute, in particular endocrine disruptors found in certain plastics. Unfortunately, there's currently no treatment.
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