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Polycystic Ovary Syndrome (PCOS)
MEDICAL ANIMATION TRANSCRIPT: Polycystic ovary syndrome, also called PCOS, is an imbalance of the female sex hormones. The ovaries are part of the female reproductive system along with the fallopian tubes, uterus, and vagina. Your ovaries contain your lifetime supply of eggs. These eggs are immature, and are stored in tiny, fluid-filled structures called follicles. Your pituitary gland, located at the base of the brain, produces hormones that direct the function of your ovaries. Each month, the pituitary gland secretes follicle-stimulating hormone, or FSH, and luteinizing hormone, or LH, into the bloodstream. After these hormones reach the ovaries, several hundred immature eggs start to mature, expanding the size of the follicles. As the eggs mature, the follicles secrete estrogen, the main female sex hormone. Once the amount of estrogen in the blood reaches a certain level, the pituitary sends a surge of luteinizing hormone to the ovaries, causing the most mature follicle to open and release its egg, in a process called ovulation. The free egg travels through the fallopian tube, where it awaits fertilization. Eventually, the remaining immature follicles and eggs dissolve. If the egg is not fertilized, the egg and the lining of the uterus are shed during the next menstrual period. If you have polycystic ovary syndrome, your pituitary gland may release abnormally high amounts of luteinizing hormone into your bloodstream, disrupting your normal menstrual cycle. As a result, your follicles do not mature and ovulation does not occur, which can lead to infertility. Some of the immature follicles do not dissolve, and remain as fluid-filled sacs, or cysts. In addition, your doctor may find your blood has high levels of insulin, a hormone produced by the pancreas. Too much insulin, combined with high levels of luteinizing hormone, can lead to excess production of a male hormone called testosterone in your ovaries. Abnormally high levels of testosterone prevent ovulation, which can lead to infertility. High levels of testosterone also cause many of the physical features associated with polycystic ovary syndrome, such as acne and abnormal hair growth. Having polycystic ovary syndrome raises your risk for Type II diabetes because of excess insulin and insulin resistance; heart disease; high blood pressure; cholesterol abnormalities in the blood; and endometrial cancer. Since there is no cure for polycystic ovary syndrome, your doctor may recommend one or more medications to treat your symptoms, such as hormonal birth control which, while preventing pregnancy, also regulates your menstrual cycle and reduces testosterone production in your ovaries; anti-androgen medications, which reduce abnormal hair growth and acne; diabetes medications such as Metformin, which lowers your insulin levels and regulates your menstrual cycle; and fertility medications, which can stimulate ovulation so you can become pregnant. If you want to become pregnant and fertility medications have not succeeded in restoring ovulation, your doctor may recommend laparoscopic ovarian drilling. During the procedure, your surgeon will insert a small needle into the ovary, and use an electric current to destroy small areas of ovarian tissue where testosterone is produced. Over time, testosterone production diminishes and ovulation may occur.