Polycystic ovary syndrome: Common cause of female infertility

Polycystic ovary syndrome is a condition that can cause women to have irregular periods, get acne (oily skin and pimples), grow extra facial hair, or lose hair from their head. The condition can also make it hard to get pregnant.

People sometimes refer to polycystic ovary syndrome as “PCOS.” It is very common affecting about 5 to 10 per cent of all women.

In women with PCOS, the ovaries don’t work very well. About once a month, the ovaries are supposed to make a structure called a follicle. As the follicle grows, it makes hormones. Then, it releases an egg. This is called “ovulation.”

But in women with PCOS, the ovary makes many small follicles instead of one big one, hormone levels can get out of balance and ovulation doesn’t happen every month the way it is supposed to.

The exact cause of PCOS is not completely understood, although research has linked it to hormonal imbalances that cause high levels of male hormones (androgens) in women which finally interfere with normal function of the ovaries.

These changes in hormone levels cause the classic symptoms of PCOS such as; absent or irregular and infrequent menstrual periods, abnormal body hair growth or scalp hair loss, acne, weight gain, and difficulty becoming pregnant.

Signs and symptoms of PCOS usually begin around the time of puberty, although some women do not develop symptoms until late adolescence or even into early adulthood. Because hormonal changes vary from one woman to another, patients with PCOS may have mild to severe acne, facial hair growth, or scalp hair loss.

Women with PCOS are also more likely to end up with other health problems, too. These include; diabetes (high blood sugar), high cholesterol levels, heart disease and sleep apnea (a sleep disorder that causes people to briefly stop breathing while they sleep).

There is no single test for diagnosing PCOS. One might be diagnosed with PCOS based on their symptoms, blood tests, and a physical examination. The diagnosis of PCOS is usually made when a woman has at least two of; irregular menstrual periods caused irregular ovulation, evidence of elevated male hormone levels, and polycystic ovaries seen on a pelvic ultrasound imaging scan.

Although PCOS is not completely reversible, there are a number of treatments that can reduce or minimise bothersome symptoms. Most women with PCOS are able to lead a normal life without significant complications. For women with PCOS who want to become pregnant, fertility pills or injections are often needed to help them ovulate normally and conceive.

Weight loss is one of the most effective approaches for managing abnormalities of blood sugar levels, irregular menstrual periods, and other symptoms of PCOS. For example, many overweight women with PCOS who lose 5 to 10 per cent of their body weight notice that their periods become more regular.

The primary treatment for women who are unable to become pregnant and who have PCOS is weight loss. Even a modest amount of weight loss may allow the woman to begin ovulating normally. In addition, weight loss can improve the effectiveness of other infertility treatments.

 Weight loss can often be achieved with a programme of diet and exercise. Weight loss surgery may be an option for severely obese women with PCOS. Women can lose significant amounts of weight after surgery, which can restore normal menstrual cycles, reduce the high male hormone levels and the other associated complications such as diabetes and heart diseases.

Dr. Ian Shyaka , Resident in Surgery,

Rwanda Military Hospital,