Polycystic ovary

disease

Manjula. R
4th
semister
 contents
 Illustrations
 Alternative Names
 Definition
 Causes
 Symptoms
 Exams and Tests
 Treatment
 Possible Complications
 Definition   
 Polycystic ovary disease is characterized by enlarged
ovaries with multiple small cysts, an abnormally high
number of follicles at various states of maturation, and
a thick, scarred capsule surrounding each ovary.
 The syndrome was originally reported by Stein and
Leventhal in 1935 when they described a group of
women with amenorrhea (absence of menstrual period),
infertility, hirsutism (unwanted hair growth in women),
and enlarged polycystic ovaries
 Causes 
1. Polycystic ovary disease is an endocrine disorder, which
means normal hormone cycles are interrupted
• In polycystic ovary disease, under-developed follicles
accumulate in the ovaries. Follicles are sacs within the
ovaries that contain eggs.
• The eggs in these follicles do not mature and, therefore,
cannot be released from the ovaries. Instead, they
accumulate as cysts in the ovary.
 Causes 
• This can contribute to infertility.
2. The lack of follicle maturation and the
inability to ovulate are likely caused by
low levels of follicle stimulating
hormone (FSH) ,and higher-than-normal
levels of androgens (male hormones),
produced in the ovary.
3. Insulin resistance also seems to be a
key feature in polycystic ovarian
syndrome
 Causes 
 High levels of insulin can
contribute to lack of ovulation,
high androgen levels, infertility,
and early pregnancy loss.
 Many women with polycystic
ovary disease have irregular
periods and may have very little
menstruation (oligomenorrhea) or
no period at all (amenorrhea).
 Causes
 Women diagnosed with this disorder
frequently have a mother or sister with
similar symptoms commonly associated with
polycystic ovarian syndrome (PCOS).
 Conception is often possible with proper
surgical or medical treatments. Following
conception, pregnancy is usually uneventful.
Symptoms

 Abnormal, irregular, or scanty (very

light or infrequent) menstrual periods
 Absent periods , usually (but not
always) after having one or more
normal menstrual periods during
puberty (secondary amenorrhea)
 Weight gain, even obesity
 Insulin resistance and diabetes
 Infertility
 Symptoms
 Increased hair growth; distribution of
body hair may be in a male pattern
 Virilization -- development of male sex
characteristics in a female. This may
include an increase in body hair, facial
hair, a deepening of the voice, male-
pattern baldness, and clitoral
enlargement.
 Decreased breast size
 Aggravation of acne
 Exams and Tests
 In a pelvic examination, the health care
provider may note an enlarged clitoris
(very rare finding) and enlarged ovaries.
Tests include:
 FSH levels -- low or normal
 LH levels -- generally high
 Androgen (testosterone) levels -- high
 Exams and Tests
 Estrogen (primarily estrone and estradiol)
levels -- relatively high
 Urine 17-ketosteroids  -- possibly high
 Vaginal ultrasound and, possibly,
abdominal ultrasound
 Abdominal MRI
 Laparoscopy
 Ovarian biopsy
 Exams and Tests
Other blood tests that may be
done include:
 Serum HCG (pregnancy test)
negative
 Thyroid function tests
 Prolactin levels
  Treatment 
 Medications used to treat the symptoms of
polycystic ovary disease include birth control
pills, spironolactone, flutamide, and clomiphene
citrate. Treatment with clomiphene induces the
pituitary gland to produce more FSH, which in
turn stimulates maturity and release of the
eggs. Occasionally, more potent ovulation-
induction medications (fertility drugs, human
menopausal gonadotropins) are needed to
achieve pregnancy.
 Treatment 
 Weight reduction, which may be very difficult, may help
to reduce the elevated insulin levels in the blood in
patients with this disease. For those with polycystic
ovaries who are overweight, weight loss can reduce
insulin resistance, stimulate ovulation, and improve
fertility rates. Sometimes, part of the treatment for
polycystic ovaries is use of medications that make cells
more sensitive to insulin, like metformin or one of the
thiazolidinedione medications
 Possible Complications
 Sterility
 Obesity-related conditions, like high blood
pressure and diabetes
 Increased the risk of endometrial cancer -- this
is because the endometrium (lining of the
uterine wall that sheds when you menstruate)
can get thicker and thicker (hyperplasia) due
to the lack of ovulation
 Possible increased risk of breast cancer
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