Polycystic Ovarian Syndrome - A Reproductive and Metabolic Disorder
by Beth Kushnick

Polycystic ovarian syndrome, considered the most under diagnosed of all womens health disorders, is characterized by a collection of symptoms. PCOS affects 7-10% of all women. In the past called Stein-Leventhal Syndrome, PCOS has come full circle in the medical community from virtual obscurity to now gaining serious attention by both physicians and the media.

Within the last ten years researchers have discovered that PCOS is associated with insulin resistance. In addition to insulin resistance, the other symptoms of PCOS includeirregular menstrual cycles, infertility, hirsuitism, obesity, and acne. Due to the insulin connection there is also an increased risk of diabetes and hypertension. With this wide range of symptoms it is often difficult for a diagnosis to be made. It is common for women not to know they have PCOS until child bearing age. PCOS is a genetic disorder. Often, once a diagnosis is complete for many women years of confusion becomes clear.

Since the symptoms are numerous, particular concerns vary from patient to patient. For many women the obesity associated with being insulin resistant is the most troubling symptom. For others it is the infertility caused by a lack of regular ovulation. There are many cosmetic symptoms such as hirsuitism and acne caused by excess androgens which, along with infertility, can be the most devastating emotionally. PCOS patients should be treated for both the physical manifestations as well as the psychological issues that can arise from living with the disorder.

Polycystic ovarian syndrome is diagnosed by a number of tests including a full medical and family history, a physical exam of hair growth, blood work, and a pelvic sonogram. The blood work may reveal both elevated male hormone and elevated fasting blood insulin levels. The pelvic sonogram will show the ovaries with multiple small cysts often called a string of pearls. It is important to have all of these tests done for a full diagnosis.

Symptoms present themselves in various degrees so seeing a physician who can recognize and treat PCOS is crucial. Typically women see a gynecologist, endocrinologist or reproductive endocrinologist. With the connection of PCOS to hyperinsulemia, specialists as well as general practioners have become more familiar with the complications that come with the syndrome. The recognition of how common place the syndrome is has brought about extensive research with studies currently taking place all over the country.

Once a woman is diagnosed and educated about PCOS it is possible to make living with the syndrome easier. Insulin sensitizing medications are being used with great success and birth control pills are commonly prescribed to decrease symptoms. Reducing carbohydrate intake has also had a huge impact for many patients. Altering the diet allows a women to take control of the syndrome and since having PCOS makes it harder to lose weight this is a significant piece of the puzzle. The long term health risks associated with Polycystic ovarian syndrome cannot be ignored. Getting a proper diagnosis is vital. Once a diagnosis has been made, information and support for the patient can be extremely beneficial. The American Infertility Association is a great resource for PCOS patients and their families.

Beth Kushnick, is a co-chair of the volunteer center for women with polycystic ovarian syndrome (PCOS) and a member of the board of directors of The American Infertility Association (AIA). Recently, Beth co-chaired the AIA's 1999 Conference on PCOS.