Polycystic Ovaries & Polycystic Ovary Syndrome (PCOS)

Polycystic ovaries are ovaries containing multiple small cysts, which are undeveloped follicles that may contain eggs but usually do not exceed 8mm in size. Polycystic ovaries are common, affecting 20-30% of women, and should not be confused with Polycystic Ovary Syndrome (PCOS). The presence of polycystic ovaries alone does not necessarily mean a woman has PCOS. These cysts do not require removal, do not cause harm, and do not increase the risk of ovarian cancer.

What Is Polycystic Ovary Syndrome (PCOS)?

PCOS is a complex hormonal disorder characterized by:

• Irregular menstrual cycles
• Insulin resistance
• Multiple ovarian follicles

PCOS typically appears during adolescence but can develop later in life, especially if weight gain occurs. It results from a combination of genetic predisposition and environmental factors.

How Does PCOS Affect the Ovaries?

• Innormal cycles, one follicle matures and releases an egg (ovulation).
• InPCOS, many small, immature follicles fail to ovulate, appearing as tiny cysts on the ovaries.
• These folliclesdo not produce enough estrogen, leading to anovulatory cycles and irregular periods.
• Elevated androgen levelscontribute to hair loss, acne, and excessive hair growth.

Symptoms of PCOS

• Irregular or absent periods
• Infertility due to ovulation issues
• Excess hair growth (face, chest, stomach, back)
• Oily skin and acne
• Weight gain or obesity
• Insulin resistance or Type 2 diabetes
• High cholesterol levels
• High blood pressure
• Male-pattern hair thinning
• Skin changes (darkened skin patches)
• Sleep apnea

Symptoms vary among women, and not all women experience the same severity.

PCOS, Insulin Resistance & Health Risks

• Women with PCOS(even those of normal weight) often have insulin resistance, leading to poor blood sugar regulation and increased diabetes risk.
• 10% of obese women with PCOS develop Type 2 diabetes
• PCOS increases the risk ofheart disease and metabolic disorders.

Diagnosis of PCOS

• Medical history & physical exam
• Transvaginal ultrasound – Detects multiple small follicles and a thickened endometrium.
• Hormone testing – Evaluates estrogen, testosterone, insulin, and glucose levels.
• Exclusion of other causes, such as adrenal hyperplasia or hyperprolactinemia.

PCOS & Fertility Treatment

Ovulation disorders are the most common fertility issue in PCOS.
Medications to induce ovulation:

• Clomiphene Citrate (Clomid)
• Letrozole (Aromatase Inhibitor)– A newer, highly effective optionHor
• monal injections (gonadotropins)if oral treatments fail.
• Laparoscopic ovarian drilling (LOD)– A surgical option for ovulation induction.
• In vitro fertilization (IVF)if all other treatments fail.

Treatment & Management of PCOS

1. Lifestyle Changes:

• Weight lossimproves hormonal balance and insulin sensitivity.
• Healthy diet & regular exercisecan reduce symptoms.

2. Medical Treatment:

• Vitamin supplementsfor hormone regulation
• Hormonal therapy(low-dose birth control pills or anti-androgens) if lifestyle changes are not enough.

For women with absent periods, hormonal therapy is essential to prevent long-term estrogen exposure, which may increase the risk of uterine or breast complications.

PCOS & Long-Term Health Risks

Women with PCOS & insulin resistance are at higher risk for:

• Diabetes
• Cardiovascular disease
• Endometrial cancer (if untreated)

Expert PCOS Care at Thely Clinic

Our specialized gynecologists provide:

• Comprehensive diagnosis & tailored treatment plans
• Expert fertility carefor women with PCOS-related infertility
• Advanced surgical options if necessary