Polycystic Ovarian Syndrome (PCOS)
Polycystic Ovary Syndrome or PCOS is a common hormone condition affecting approximately 5 – 7% of women during their reproductive years. The syndrome was first described more than 60 years ago, and over these years physicians have come to recognize the variable symptom and biochemical profiles that patients with PCOS can have.
In North America, a 1990 consensus established three criteria that were required for diagnosis:
Clinical signs or laboratory evidence of male hormone (androgen) excess,
Absent or infrequent ovulation (irregular or absent menses)
Exclusion of other endocrine problems that might share some PCOS features.
The more common reasons why women with PCOS seek a physician’s help include cosmetic problems (acne, increased facial and body hair), menstrual abnormalities (infrequent or absent ovulation), infertility and obesity.
More recently, physicians have appreciated that there may be associated insulin resistance and a greater chance of having other co-existing conditions (co-morbidities) such as cholesterol abnormalities, sleep apnea, hypertension, diabetes, and abnormalities of the endometrium.
After all this time, the definitive cause (or maybe causes) of PCOS are not really known, but there are several theories. While we have no cure for PCOS we can manage the symptoms. If the patient suffers with obesity, lifestyle changes become an important part of the management and will complement most of the various pharmacological interventions. It is often necessary use a combination of treatments when dealing with more than one problem related to PCOS or to treat a particular problem more effectively. Management decisions are tailored to each patient’s needs. Generally speaking, once therapy stops, the symptoms or problems return.
The natural history of PCOS is sketchy and its' co-morbidities infer a negative impact on long term health, but even here, solid information is lacking. Other questions about the progress of PCOS remain unresolved. When does PCOS actually begin? Is there a benefit to early intervention? What happens at menopause? Do the co-morbidities have a greater impact on this population when compared to the general population.? What are the true cancer risks? What are the best treatments and how long should they be continued?
Such prospective epidemiological data is lacking and we propose setting up a voluntary Polycystic Ovary Syndrome Registry to try and gather such information. We hope that women with PCOS might consider becoming participants, and once the Registry is set to go we will post more information on this site.