Polycystic Ovarian Syndrome (PCO)

Polycystic ovarian syndrome or PCO is an endocrine disorder, characterized by overproduction of androgens (male sex hormones), lack of ovulation (anovulation), and obesity. PCO results from flawed feedback among the hypothalamus, pituitary, and ovaries. Estimates on the incidence of PCO range from 5 to 10 percent of women. These are not hard numbers--the definition and diagnostic criteria used for PCO vary. PCO symptoms usually begin at puberty, although many women do not seek help until much later in life.

PCO or Stein-Leventhal Syndrome Symptoms Checklist

1. Irregular periods or amenorrhea (absence or suppression of menstruation).
2. Excessive hair growth (hirsuitism).
3. Obesity.
4. Annovulation (Not accompanied by production of and release of an ovum).
5. Elevated androgen (male sex hormone) levels.
6. In rarer cases where PCO produces extremely high androgen levels, a woman's voice may deepen and her clitoris may be enlarged.

When health care professionals treat ovarian cysts with oral contraceptives, they are suppressing ovarian activity, thereby giving the ovaries a rest. In treating PCO with birth control pills, the pills are being used for a different effect - to counteract the excess of male hormones. They need to be estrogen dominant pills such as those containing a weak progestin. Natural hormones can also be used to restore a PCO patient's hormone balance with significantly fewer side effects than birth control pills.

Of course, use of oral contraceptives to treat PCO is appropriate only in patients who aren't trying to become pregnant. In fact, infertility is often the PCO symptom that causes women to seek help, before other symptoms such as irregular periods, obesity, or hirsutism.

If pregnancy is a patient's goal, ovulation can be induced with medications such as Clomid or Metrodin. These medications produce significant side effects in some women, including mood swings, headaches, abdominal bloating, breast soreness and hot flashes, among others. Treatment is usually for five days per cycle to include ovulation.

The ideal surgical procedure for PCO is now called ''ovarian drilling.'' With a laparoscope, a surgeon inserts an electric needle into the ovary several times. This procedure reduces the size of the ovaries, and lowers androgen production.

Clarification Points:

Although a diagnosis of more than one cyst on your ovary may be referred to as ''polycystic ovaries,'' this is not the same as polycystic ovarian syndrome (PCO). If you are unsure about your diagnosis, be sure to ask your physician if your hormone levels are affected, as would be the case with PCO. We recommend testing hormone levels through saliva to assess for any imbalance.