Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder affecting 5-15% of women in the reproductive age. It is characterised by chronic anovulation, hyperandrogenism and polycystic ovaries.
Polycystic Ovary Syndrome (PCOS) is a complex condition that may require management by a multidisciplinary team. Despite the fact that no cure is available for this condition, good control of the symptoms can be achieved with lifestyle and dietary modifications. PCOS should be diagnosed early to promote long-term health and prevent metabolic and cardiovascular complications.
Approximately 60-70 percent of women with Polycystic Ovary Syndrome (PCOS) exhibit menstrual dysfunction related to anovulation. The most common abnormalities are infrequent periods (oligomenorrhoea) and absence of period (amenorrhoea). Frequent and prolonged periods (polymenorrhoea) are very uncommon (less than two percent). One quarter of patients have regular periods.
They are either markers of hyperandrogenism (excessive production of male hormones) or insulin resistance.
The difficulty in conceiving is mainly due to chronic anovulation. Polycystic Ovary Syndrome (PCOS) accounts for approximately 75 percent of anovulatory subfertility.
Obesity is often associated with PCOS (30-70 percent), but many patients with PCOS are of normal weight.
The exact causes remain unclear but more than one can be involved. Genetic and environmental contributors combined with obesity, ovarian dysfunction and hormonal changes contribute to Polycystic Ovary Syndrome (PCOS).
The diagnosis criteria follows the 2003 Rotterdam diagnosis consensus workshop:
The diagnosis of Polycystic Ovary Syndrome (PCOS) is present if any two out of the following three criteria are met and other hormonal conditions are excluded:
And exclusion of other causes such as pregnancy, thyroid diseases, hyperprolactinemia, congenital adrenal hyperplasia, hypothalamic amenorrhoea, premature ovarian insufficiency, androgen secreting tumour, Cushing syndrome and acromegaly.
To prevent endometrial cancer, a woman should have at least four to six periods in a year. This can be achieved through the following methods:
Choice of options depends on the patient’s preferences, impact on wellbeing, and access and affordability:
The following options are available:
Studies with clomiphene citrate show ovulation rates of 60–85 percent and pregnancy rates of 30-50 percent after six ovulatory cycles.