Doctor’s Orders: Understanding polycystic ovarian syndrome
June 19, 2007 | Old Colony Memorial
By Dr. Shimon Segal
(contact info below)
At the present time there is a renewed interest in polycystic ovarian syndrome (PCOS). This is due in part to a significant change in lifestyle in many parts of the world; more people are experiencing a more sedentary existence combined with abundance of food. This has resulted in the modern epidemic of obesity and increased number of women diagnosed with PCOS.
Polycystic ovarian syndrome is the most common endocrine disorder that affects women during reproductive age, and it appears that its prevalence has increased. PCOS is often genetically inherited and seems to be ethnically predominant in the Hispanic population.
PCOS was first described by Stein and Leventhal in 1935. It is currently defined as the presence of two of the following three criteria: irregular ovulation; hyperandrogenism, which refers to elevated levels of male sexual hormones in female patients; or polycystic ovary, meaning more than 12 follicles less then 10 mm diameter arranged peripherally in enlarged ovaries.
Normal ovarian function relies on the selection of a follicle, containing an egg, which responds to follicle stimulating hormone (FSH) to become the dominant follicle that will release an egg. With PCOS women, this mechanism is disturbed, resulting in multiple small cysts, each containing a potentially valuable egg but within a dysfunctional follicle. The many follicles do not mature and an egg is not released. Because the egg is not released, progesterone levels are low and androgen and estrogen are too high. This may cause irregular periods, prolonged intervals between periods, which over years may cause endometrial hyperplasia (the lining of the uterus grows too much and is abnormal) or endometrial polyps (polyps in the uterus).
Many women with PCOS have a decreased sensitivity to insulin and develop insulin resistance. Insulin is a hormone that controls the body’s use of sugar. Abnormal insulin may contribute to the interruption of the normal growth of the follicles in the ovaries. High levels of insulin may contribute to excessive production of androgen, such as testosterone, and contribute to ovulation disorders.
PCOS is a lifelong condition and can be treated in different ways, including lifestyle and diet changes, as well as medical treatment. For women who want to conceive, ovulation induction medication is used. Many women with PCOS are at increased risk of certain health problems therefore it is very important to diagnose and treat patients with polycystic ovarian syndrome early. The early diagnosis of PCOS and the appropriate treatment would help prevent other medical problems such as diabetes high blood pressure and heart disease.
Dr. Shimon Segal specializes in reproductive endocrinology and menopause. His office is located at 95 Tremont St., Suite 10, Duxbury. He is on the medical staff at Jordan Hospital. The office phone number is 781-934-6019.
Source:
http://plymouth.wickedlocal.com/pfar...ealth&id=11050 
PCOS in MA newspaper. Specialist address mentioned. 
