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PCOS symptoms can often be improved or reversed.
Polycystic ovary syndrome is a complex metabolic disorder that can develop in a woman during her childbearing years. Although named for its effects on the reproductive system and the ovary in particular, other organ systems are involved in PCOS, making its treatment potentially challenging. However, with careful management and treatment, its symptoms can be improved or reversed in many cases.
Polycystic ovary syndrome is named for the appearance of the ovary in a woman with the disorder. Many bubble-like structures or cavities, technically called cysts, are seen near the ovary's surface when the organ is magnified. These are abnormal follicles, where eggs normally grow during the menstrual cycle. Most women with PCOS have problems conceiving because they fail to ovulate regularly, a situation that often leads to the initial diagnosis of PCOS on a visit to a doctor to discuss fertility.
PCOS involves complex changes in a woman's body that are not fully understood. However, many women with the syndrome have high insulin levels, to which their bodies become insensitive. Called insulin resistance, this can eventually cause high blood glucose levels, often leading to weight gain and, in some cases, obesity. High insulin tends to stimulate production of male hormones, or androgens, by a woman's adrenal glands and ovaries. These male hormones contribute many of the symptoms that typically develop in women with PCOS.
In women with PCOS, levels of other important hormones such as estrogen and progesterone, and pituitary hormones that regulate their production, are often abnormal. These changes, along with the presence of male hormones, can cause a woman to have irregular or absent periods and to stop ovulating. In addition, some women experience physical changes due to the presence of male hormones. These can include growth of facial hair, thinning of the hair on the head resembling balding in a man, and facial acne. Weight gain is also a problem for some women, and tends to involve accumulation of excess fat in the abdomen. Occasionally, a woman with PCOS may also develop depression or anxiety, problems whose cause is not well understood. In many cases, treatment eventually restores a woman's fertility and can also reverse many of the other symptoms of the disorder.
Weight and Lifestyle Modifications
Treatments for PCOS are usually tailored to each patient and her individual symptoms. However, in many cases lessening insulin resistance by modifying a woman's diet and her lifestyle can lower insulin levels, helping reduce her body's production of androgen and improving fertility problems. Lowering intake of saturated fats while adding healthy fruits and vegetables, and whole-grain foods is often helpful, as is increasing activity by adopting a program of regular moderate exercise.
In some cases, a doctor may recommend a medication that helps sensitize the body to insulin. In a clinical research study published in 2010 in "Gynecology and Endocrinology," researchers studied the effect of a drug called metformin, which makes the body more responsive to insulin, in a group of 30 overweight women with PCOS. All subjects began consuming a healthy diet and exercising regularly, while half took the drug and the other half a placebo. All women experienced weight loss and improved menstrual regularity, but only those who took metformin had lower insulin levels.
Although the paper in "Gynecology and Endocrinology" suggests that changing diet and lifestyle can reverse some PCOS symptoms, some women who adopt these changes still experience fertility problems. In a workshop on PCOS sponsored by the National Institutes of Health in December 2012, possible treatment regimens were reviewed and evaluated. In addition to use of insulin-sensitizing drugs and lifestyle modifications, the panel reviewed other potential treatments, including drugs that stimulate ovulation directly or block action of male hormones. A review paper published in "Gynecology and Endocrinology" in December 2012 confirmed that combining insulin-sensitizing drugs with those that stimulate the ovary directly is more often successful in reversing infertility and other problems in women with PCOS.
If you have questions about PCOS and its treatment, talk to your family doctor or a specialist in endocrinology, who can advise you about its symptoms and treatments.