The Hidden Infertility Factor: Polycystic Ovarian Syndrome (PCOS)

It’s only Tuesday and she is the third patient I have seen with these symptoms this week.  She is hopeful and motivated, but confused by her inability to become pregnant.

A comprehensive history tells me how much she has been through already, but doesn’t provide me with the data I am seeking.  I probe further, inquiring about intimate details that women rarely share with anyone- sometimes even their doctors.  After a few moments of investigation and less than ten questions, there it is- the most likely reason for the infertility: Polycystic Ovarian Syndrome (PCOS).  She stares back at me: her look a combination of “deer in the headlights” and “PolyWHAT?”

PCOS is the most common metabolic disorder affecting women today, and goes undetected in approximately 75% of the women who have this disorder.  While women of all ethnic groups may suffer from PCOS, there is an increased incidence in women who are Hispanic, Native American and Asian.  It occurs in as many as 10% of women in their childbearing years and can wreak havoc with fertility.

PCOS was initially identified in 1935 and was known as Stein-Leventhal syndrome.  Whether incidence of this syndrome has increased, or has simply been better detected as physicians have become more equipped to diagnose and treat PCOS, this has become one of the most common culprits in infertility.

The mechanism in PCOS is an excessive production of androgens, or “male hormones” (although we all have them), that inhibit normal ovulation.  Instead of producing and ripening one large ovum, or egg, each month, women with PCOS may develop many, tiny, fluid-filled cysts on their ovaries (which, in turn, increases the androgen level even further).

Typical signs and symptoms associated with PCOS include:

  • Irregular menses (when not taking Oral Contraception)
  • Extremely light menstrual periods
  • Overweight, even if only by 5-10% of body weight
  • Excessive hair growth (on the face, pubic region, and abdomen particularly)
  • Acne
  • Increased levels of testosterone
  • Infertility

Other symptoms that may accompany PCOS are Insulin Resistance Syndrome (IR), Type 2 Diabetes Mellitus, high blood pressure, high cholesterol and Cardiovascular Disease.

Treatment for PCOS is grounded in lifestyle change.  By improving nutrition, increasing exercise, lowering cholesterol and avoiding tobacco and other toxins, the impact of PCOS may be significantly diminished.  In addition, treatment with medication such as metformin (Glucophage) may improve hyperinsulinism, menstrual regularity, and fertility.

At Reproductive Wellness™, we provide an integrative approach to reproductive and menstrual disorders.  We support lifestyle change, regular use of acupuncture to balance hormones and decrease stress, and full collaboration with your medical team!

 

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