In a recent NYTimes Personal Health column, Jane Brody addresses polycystic ovary syndrome (PCOS), an endocrine system disorder that can cause reduced fertility. PCOS affects up to 10 percent of women of reproductive age, but little is understood of its causes.
Paradoxically, not even polycystic ovaries are a requirement for the diagnosis. Some experts believe that cysts result from, rather than cause PCOS. Other associated signs, symptoms and findings may include effects of elevated levels of androgens (such as acne and excessive hair) and irregular menstrual cycles.
Genetics may play a role in PCOS. Some experts have suggested that insulin resistance could be an underlying factor. Insulin can stimulate the ovaries to secrete androgens, and can also result in weight gain. In fact, about half of American women with PCOS are obese. However, others believe that the key underlying factor may be hormonal dysregulation involving the hypothalamus a key regulator of several other glands.
There is no cure for PCOS, but it can be treated. Since the manifestations of the ailment are quite variable, and each woman has her own concerns, the best approach is to individualize treatment based on the goals of each patient. Estrogen and progestin-containing contraceptives can be used to regulate menstrual cycles and suppress androgen production. For women with PCOS who experience infertility issues, the drugs clomiphene (a stimulator of ovulation often used for infertility treatment) and letrozole (an aromatase inhibitor that influences female hormone levels) can be prescribed to stimulate ovulation. Weight loss can also result in more regular menstrual cycles and reduced levels of testosterone.
Read Jane Brody s informational article in full here.