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Polycystic Ovary Syndrome - Why is treatment so important now?

Q. Dear Lory, RD
My daughter has recently been diagnosed with Polycystic Ovary Syndrome (PCOS). From what I have read on-line, this disorder affects fertility. Since she is only 17 years old, and is not trying to get pregnant, why is treatment so important now?
Thanks,
Kasey
Little Falls, Minnesota

A. Dear Kasey,
This is a great question, and you are right, women with PCOS have an increased risk for infertility, but they also have an increased risk for obesity, cardiovascular disease, diabetes, cancer and depression. So, treatment at any age is crucial to overall health and wellbeing.

In order to properly treat PCOS, you must understand its cycle. PCOS is thought to be brought about by a condition called insulin resistance. This means, that when carbohydrates are eaten in the diet, they are broken down into smaller units called glucose. Glucose needs be stored in the muscle or liver to be used as energy later. The key to getting the glucose into the cells for storage is insulin. Insulin is a hormone secreted by the pancreas to assist in the storage of glucose. If the muscle or liver cells do not recognize the insulin secreted, then the glucose stays in the bloodstream and signals the pancreas to secrete more insulin in order to complete the storage of glucose. This creates an excess of insulin in the bloodstream.

This excess insulin creates a condition called hyperinsulinemia. Elevated insulin is a potent growth hormone, and therefore it is associated with weight gain (hence the tendency of PCOS patients to be obese). Hyperinsulinemia also may cause acanthosis nigricans, or black skin. This may appear as dark soft skin on the back of neck, elbows, knees, underarms, between the breasts, across the knuckles and groin.

The elevated insulin level also triggers the ovaries to secrete elevated amounts of testosterone. Women have small amounts of testosterone in the body already, but if the ovaries begin secreting more, then the ovaries cannot continue the job they were meant to be doing, and ovulation is inhibited. Women also experience unpleasant side effects of increased testosterone levels.

• Irregular menstrual cycles
• Infertility
• Severe Acne
• Hirsutism (hair growth) of the face, jaw, chest, lower abdomen, or upper shoulders
• Alopecia (hair loss) of the scalp

There are other conditions associated with PCOS

• Possibly a higher risk of endometrial cancer due to irregular, uncontrolled bleeding
• Obstructive sleep apnea-possibly from both the obesity as well as high testosterone and a central brain mechanism
• Depression-generally from a sense of helplessness re; weight and infertility

PCOS has been identified with multiple cardiovascular risk factors, including

• Hypertension (high blood pressure)
• Hyperlipidemia
• Abnormal carbohydrate metabolism
• Metabolic Syndrome
• Hypothyroidism

So, you can see, there is more at stake than fertility when diagnosed with PCOS. I strongly urge that you begin your treatment by sitting down with your healthcare team (physician, registered dietitian) and mapping out a health action plan. An appropriate PCOS plan should consist of a healthy diet and an active lifestyle. Your physician may also want to start medications to control glucose levels and regulate the menstrual cycles.

Sincerely,
Lory, RD

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Lory Hayon, B.S., R.D.
Registered Dietitian & Nutritionist.
Lory@FertilityCenterLV.com