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Polycystic Ovary Syndrome (PCOS)
What is PCOS?
Polycystic ovary syndrome (PCOS) is a
mild hormone imbalance that can cause irregular periods, unwanted
hair growth, and acne. It can be mild or severe. This is a common
condition that begins during the teenage years. In fact, almost
one out of fifteen women has PCOS.
What are the signs of PCOS?
Adolescents with PCOS can have a
range of signs. Some of the most common include:
-
Irregular
periods-periods that come every few months, not at all, or too
frequently
-
Extra hair
on your face or other parts of your body
-
Acne
-
Weight gain
and/or trouble losing weight
-
Patches of
dark skin on the back of your neck and other areas
Could I have PCOS?
If you have some or all of the above
symptoms, you might have PCOS. There are also other reasons why
you might have these signs and symptoms. Only your doctor can tell
for sure. If you do have PCOS, you'll want to know what causes
PCOS, how it works, and how to treat it. Read on for more
information and answers to your questions!
What causes PCOS?
PCOS is caused by an imbalance in the
hormones (chemical messengers) in your brain and your ovaries.
For a more detailed explanation, take a look at the figure below:
-
The
pituitary gland in your brain makes the hormones luteinizing
hormone and follicle-stimulating hormone (LH and FSH). These are
the messengers that tell the ovaries to make other hormones.
-
The ovary
then makes estrogen and progesterone (female sex hormones). All
normal ovaries also make little bit of the androgen testosterone
(a male sex hormone).
PCOS occurs when these hormones don't
communicate appropriately. Specifically, the pituitary gland makes
too much LH. In turn, this causes your ovaries to start to make
extra testosterone.
Why are my periods so irregular?
Having PCOS means that your ovaries
don't get the correct hormonal signals to allow you to have your
period once a month. To answer this question in more detail, first
let's look at the cycle of a normal menstrual period.
-
The cycle
starts when the brain sends LH and FSH to the ovaries. A big surge
of LH is the signal that tells the ovaries to ovulate, or release
a ripe egg.
-
The egg
travels down the fallopian tube and into the uterus. Progesterone
from the ovary tells the lining of the uterus to thicken.
-
If the egg isn't
fertilized, you shed the lining of the uterus as a
menstrual period and the cycle begins all over again.
Now, let's look at why having PCOS
means that you don't get your period regularly. Remember that your
LH levels are much higher than your FSH levels. The LH surge that
is supposed to come once a month does not occur. This finding,
combined with the extra testosterone in your blood, keeps you from
ovulating. The diagram above shows that the whole cycle stops just
before ovulation. As a result, women with PCOS have irregular
periods (too frequent or late) or don't get their periods at all.
What are these cysts on my ovaries?
The term "polycystic ovaries" means
that there are lots of tiny cysts, or bumps, inside of your
ovaries. Not all women with PCOS have these cysts. Even if you do
have them, they are not harmful and do not need to be removed.
Why do I get acne and/or extra hair
on my body?
Acne and extra hair on your face and
body can be the result of slightly too much testosterone. All
women make testosterone. If you have PCOS, your ovaries make a
little bit more than they are supposed to, or your body is more
sensitive to testosterone. Testosterone tells your hair follicles
to "turn on, " causing hair growth. Testosterone also affects skin
cells, resulting in acne.
Why do I have patches of dark skin?
Many adolescents with PCOS have
higher levels of insulin (a hormone) in their bloodstream. This
can sometimes cause patches of darkened skin on the back of your
neck. This hormone may also send a signal to your ovaries,
resulting in their making extra testosterone.
Can I have kids some day?
Yes! Women with PCOS have a normal
uterus and healthy eggs. Some women have trouble getting pregnant,
and some women have no trouble at all. If you are concerned about
your fertility in the future, talk to your doctor about all the
new options available (including medications to lower your insulin
levels and help you ovulate each month).
What else do I need to know?
Your doctor needs to monitor you for
possible complications that may occur in the future. You may have
a slightly higher chance of developing diabetes or endometrial
cancer, but proper treatment and follow-up can help prevent these
and other complications.
What can I do about PCOS?
While you can't cure PCOS, you can
treat it. There are excellent long-term medications to help you
manage irregular periods, hair growth, and acne.
Ask your doctor about hormone
treatment The most common and effective form of hormone treatment
is the birth control pill. By taking the birth control pill you
can:
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keep your
hormone levels in balance. This helps your periods come on a
regular basis.
-
improve
acne and lessen hair growth
-
lower the
risk of endometrial cancer
-
prevent
yourself from getting pregnant if you are sexually active
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