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Polycystic Ovarian Syndrome | PCOS

Polycystic Ovaries

This is a syndrome in its own right, and is characterised by a necklacelike structure of at least ten cysts surrounding each ovary. On an ultrasound scan the ovaries would appear on average to be three times the size of normal.

This syndrome was originally associated with women who were of child-bearing age but whose periods had ceased, with an overgrowth of hair in unwanted places, and with a tendency to be considerably overweight, known as Stein-Leventhal syndrome. It is now thought that up to 90 per cent of women with infrequent periods and 30 per cent of women whose periods have ceased prematurely have this syndrome.

It has also been suggested that as many as 20 per cent of the normal population have mild polycystic ovarian disease, which can be detected by ultrasound, although in women whose periods are regular it is thought to be in the region of only seven per cent.

Top What causes it

• There is undoubtedly an hormonal disturbance in women with polycystic ovaries, with an excess of LH (luteinising hormone) from the pituitary and androgens (male hormones).

• The development of obesity is thought to be a precipitating factor.

• Medical conditions where there is an over-production of other hormones may stimulate the ovaries to develop this condition.

• Binge-eating as in bulimia nervosa has also been found to be associated with polycystic ovaries. In one study, published in The Lancet, it was discovered that it was rare for bulimics to have a normal ovarian picture on ultrasound. It is thought that the fluctuating levels of the hormone insulin, brought about because of the bingeing, may also stimulate the underlying tendency to polycystic ovaries.

Top What your doctor can do
• Examine you physically to determine whether there is any other underlying problem.

• Arrange for you to have an ultrasound scan.

• Suggest that you lose weight, if you are overweight.

• Prescribe the oral contraceptive pill or other hormonal therapy depending on whether you are hoping to conceive or not.

• In severe cases surgery is performed. The current favoured approach is laser or diathermy during a laparoscopy, which aims to pepper the ovarian surface, and is less likely to cause adhesions (fibrous tissues that sticks to other organs).
Top What you can do

• Lose weight if you are overweight by following The Simple Weight Loss Diet. This is vital. One study from St Mary’s Hospital in London revealed that even modest weight loss from a lowfat high-fibre diet can correct the hormonal abnormalities, reduce the hirsutism and improve the chances of conceiving. Don’t worry if you do not reach an ideal weight. A 6–7 kg (one stone) weight loss can produce a real change in body chemistry.

• Possibly cutting down on wheat (bread, cakes, biscuits and pasta) and relying upon rice, green vegetables and fish, might help hormonal balance.

• Reduce or completely avoid dairy products and use alternatives made from soya, rice, oats and nuts. Follow the Sample phytoestrogen-rich menu.

• Severely limit your intake of sugar as women with PCOS have a higher risk of developing adult onset diabetes.

• Take a good quality B-complex providing between 50–100mg per tablet. B vitamins are essential for the metabolism of oestrogen in the liver. Magnesium can also be taken in conjunction with the B-complex to help the process.

• Take a supplement of the herb agnus castus which is used successfully in balancing female hormones. The berries contain a wide range of active compounds, including flavonoids.