Polycystic Ovarian Disease (PCO) is a condition being recognized in women with increased frequency. Women with PCO can have a variety of manifestations; however, most commonly women will present with irregular or infrequent periods, increased facial or body hair, and sometimes, but not always, weight gain or inability to lose weight. In order to make the diagnosis, the gynecologist must find evidence of two abnormalities: anovulation or absence of ovulation, which is what leads to irregular menses, and androgen excess or elevated male hormone levels, which is responsible for the increased body hair.
A Careful Approach
This clinical presentation of PCO is ultimately linked to abnormal glucose metabolism. Indeed, women with PCO are at increased risk for developing Diabetes. There is certainly a genetic basis as well. Needless to say, women with PCO deserve a comprehensive approach to their health. PCO is also found frequently in women presenting with infertility. Diagnosing and managing PCO in the setting of infertility also requires a careful approach.
Many Diseases Mimic PCO
Thus, it is important for the physician to make an accurate diagnosis. This can be somewhat challenging however, since other conditions may present with similar manifestations. The woman with Hypothyroidism, for instance, also may present with irregular or absent periods. Hyperprolactinemia, or an elevated milk hormone level, may also cause similar menstrual problems. Elevated androgen levels can be found in women with ovarian tumors or adrenal gland problems. So, it is important to sometimes screen for other diseases that may mimic PCO.
Accurate Diagnosis and Treatment
The workup for accurately diagnosing PCO includes a thorough patient history, a detailed physical exam, and careful laboratory evaluation. Ultrasound, though not necessary to make the diagnosis, can sometimes be helpful, as multiple small ovarian follicles in each ovary will usually be seen with a characteristic appearance.
In conclusion, Polycystic Ovarian Disease is a most remarkable condition found in women. PCO can affect a woman’s gynecologic health, causing menstrual irregularity and, sometimes, infertility. No less important, however, are the overall health conditions related to PCO, including Diabetes. We welcome appointments from women who may manifest the signs or symptoms of PCO.
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