Poly­cystic ovary syndrome

Polycystic ovary syndrome (PCOS) is also known as Stein-Leventhal syndrome. In this condition, women have enlarged ovaries containing many small cysts around their edge.

Symptoms

Polycystic ovary syndrome can cause no symptoms and go unnoticed. Many women with the syndrome have raised androgens (male hormones), which can make conception difficult and cause symptoms such as:

• Irregular cycles or no periods at all (amenorrhoea)
• Weight gain (obesity)
• Excessive hair growth (hirsutism)
• Acne
• Oily skin

Diagnosis

The diagnosis can be made using a combination of hormone tests and a transvaginal ultrasound scan, on which the enlarged ovaries have a characteristic appearance.

Causes

The causes of the syndrome are still unclear. Insulin resistance often plays an important role. These women produce too much insulin, which is responsible for the increased release of androgens. As a result, the eggs fail to mature and there is no ovulation.

Lifestyle changes

Since PCOS is often linked to obesity and insulin resistance, changing your lifestyle – a balanced diet and more exercise – has a positive effect.

Medica­tion

In cycles without ovulation, some doctors recommend medication (gonadotrophins). These can lead to multiple ovulation. In some cases the medication is combined with metformin, which keeps the insulin level in the blood within the normal range.

Surgical treatment

The main cause of the lack of ovulation in women with polycystic ovaries is the thickening of the outer layer (cortex) of the ovaries and their increased volume. This can be treated surgically with laparoscopy, during which small holes are made in the ovarian cortex (ovarian drilling). After this operation, ovarian function tends to return to normal and normal ovulation begins.

Also read about in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI).