Polycystic Ovary Syndrome Treatment

Polycystic Ovary Syndrome Treatment

Polycystic Ovary Syndrome
Synonim : Stein-Leventhal Syndrome, polycystic ovarian syndrome (PCOS)

Polycystic ovary syndrome is one of the most common hormonal disorder in women, at about 5-10% women of reproductive age and so far it is thought to be one cause of female infertility. Polycystic ovary syndrome defined as a collection of these symptoms, that caused by hyperandrogenism (increasing in androgen hormones) and the presence of ovulation without congenital  adrenal hyperplasia, increasing prolactin hormone (hyperprolactinemia) or  caused by tumor/neoplasm that produces androgen hormone.

The term "polycystic" means "many cysts", but it is often misunderstood. Some people still think that any cyst should require surgery, and this understanding can worry patients and families. So what is actually polycystic ovary syndrome? There are some folicles (size 4-8 mm) that aren't well developed so they seem as very little cysts at the ovary. So, it is NOT a big cyst that indicates tumor/cancer.

Symptoms of Polycystic Ovary Syndrome 
The symptoms can vary from asymptomatic until symptomatic such as infertility, chronic anovulation that is characterized by amenorrhea (no menstruation), olygomenorrhea (few menstruation), menstrual disorder, dysfunctional uterin bleeding (DUB), masculinization, obesity, and acne. Symptoms and severity of polycystic ovary syndrome vary widely among women.

According to the Rotterdam's criteria (2003), the diagnosis of polycystic ovary syndrome is established if we meet two of three following symptoms:

1. The existance of menstrual disorder due to little (oligo) or no ovulation
2. The presence of biochemical or clinical signs of hyperandrogenism
3. The presence of polycystic ovary at USG examination.

Polycystic Ovary Syndrome & Infertility
One study found that 7 of 10 women who experience infertilility due to ovulation disorder and experience menstrual disorder was suffering from polycystic ovary syndrome. Patients with increasing luteinizing hormone (LH) cause hormonal imbalance that is likely to lead to polycystic ovary syndrome. If they become pregnant, the frequency of miscarriage is high.

Treatment of Polycystic Ovary Syndrome
Women with polycystic ovary syndrome don't mean they won't get pregnant. They just need some help to make them ovulate normally. They are several things to do:

1. How to lower insulin resistance. This can be obtained by reducing body weight. Exerciee regularly, low carbohydrate diet, and take some medications such as metformin and thiazolidinedione (proglitazone). Regular consumption of metformin will normalize ovary's function. Menstruation will be normal after + 2 months of therapy.
2. How to lower androgen hormones and regulate menstruation. High androgen hormones can be lowered by medications of cyproteron acetate (birth control pills). Birth control pills can also help normalizing the abnormal composition of polycystic ovary. After several treatments, the next therapy is to stimulate ovum growth.

Polycystic ovary syndrome treatment is important, not only for reproductive health but also long term health because women with polycystic ovary syndrome tend to have diabetes mellitus, hypertension, cardiac problems, and high risk of uterus cancer in the future.