Polycystic Ovary Syndrome (PCOS) in pregnancy - Causes, Symptoms and Treatment of Polycystic Ovary Syndrome

Up to one in three women with polycystic ovaries has polycystic ovary syndrome (PCOS), which means having ten or more cysts, plus some combination of obesity. Over one in three women with PCOS are overweight or often binge.

Production of testosterone and other androgens is raised in overweight women, some of this extra testosterone is converted to oestrogen, and the ovaries and pituitary become 'confused', encouraging egg follicles to become cystic, and disturbing menstrual hormone cycles, ovulation and periods. Interestingly, most women with bulimia have polycystic ovaries.

. Difficulty conceiving. Polycystic ovaries - though not necessarily PCOS itself

- are present in three in four women who aren't ovulating regularly, four in five who aren't ovulating at all, up to nine in 10with infrequent periods and over two in five with previously unexplained infertility.

. Irregular or absent periods. Up to 60 per cent of women with PCOS have irregular periods and 25 per cent have none at all.

. Acne. Around one in three women with persistent acne has pcos.

. Excess facial and body hair. While more than four in five 'hairy' women have PCOS, at least one in two women with PCOS have excess facial or body hair.

. Thinning of hair on temples and crown. In one study of 101 women with this 'male-pattern' thinning, 72 had pc as and thinning was sometimes the only symptom.

PCOS usually begins in the teens or 20s and symptoms often begin after gaining weight suddenly, or stopping the Pill. It can run in families and is the most common hormone disturbance in women. Various lifestyle factors encourage the hormone imbalance often associated with PCOS includingstress, obesity and bingeing. In some women with PCOS , their body cells fail to use energy at a higher rate after a meal- a process that normally accounts for 80 per cent of our energy use. PCOS can also be triggered by phenytoin, an anti-epilepsy drug.

Tests and investigations for Polycystic Ovary Syndrome

An ultrasound ovary scan can reveal multiple small cysts with a transvaginal ovary scan being most reliable. However, this isn't necessarily a great help as many women without polycystic ovary syndrome as such have polycystic ovaries. If you have irregular periods, a womb scan reveals any abnormal thickening of the womb lining.

Blood tests reveal any disturbance in hormones. The most common test is for LH, and is done in the first five days of the cycle. A raised level suggests PCOS , (The level of FSH is normal in women with PCOS.) Blood tests may also be done for testosterone or prolactin. If you have a high testosterone your doctor may rule out other possible causes - such as an adrenal or thyroid disorder and if you have a high prolactin, your doctor may need to rule out a pituitary tumor. You also need urine and blood tests for diabetes and blood tests for blood fats and cholesterol.

Medical treatment for Polycystic Ovary Syndrome

The progestogen-only Pill also reduces excess hair and another possibility is cream containing a hair-growth inhibitor drug called eflornithine.

If your main concern is infertility drug therapy with clomiphene or tamoxifen triggers ovulation in 70-90 per cent of women with PCOS,though only 30-70 per cent will conceive. If this doesn't work your doctor may try FSH,which enables

70-80 per cent to ovulate and 20-40 per cent to conceive. Less common treatments include cauterisation (destruction by heat) of large cysts during laparoscopy and IVF (test tube fertilisation). If a high oestrogen level has led to a high prolactin level you may need treatment with bromocriptine.

Researchers are investigating a drug called metformin that appears to help by making cells more sensitive to insulin. However, a recent study shows it doesn't encourage ovulation in women with fertility problems associated with PCOS.

Home remedies and Precaution for the treatment and cure of Polycystic Ovary Syndrome

Exercise - Help to balance hormone levels and protect arteries with half an hour's brisk daily exercise.

Exposure to light - Go outside in bright daylight for longer than usual each day to help balance hormones. This may be particularly important if you are overweight, often binge on carbohydrates, or suffer from winter depression.

Although any benefits are unproven, it may also be worth using a light box or a light visor in the early morning, or evening.

Acne and excess hair remedies- Over-the-counter acne products may help mild to moderate acne and plucking, depilatory creams, bleaching, shaving, waxing, electrolysis and laser therapy can help to manage unwanted hair.

Consider acupuncture - There is no proof that this helps but reports indicate that it helps horses, cows, pigs and dogs with PCOS, so it may be worth trying.

Herbal remedies for Polycystic Ovary Syndrome

It's best to consult a medical herbalist for personalized advice.

False unicorn root contains plant oestrogens that may help to counteract a high oestrogen level without suppressing ovulation. Black cohosh may be particularly helpful if you are stressed. And paeony or Vitexagnus castus may help an imbalance of oestrogen and progesterone and/or of luteinising hormone (LH) and follicle stimulating hormone (FSH) and a high level of prolactin or testosterone.

Liquorice or sarsarparilla (wild liquorice) is a useful addition to help acne and excess body hair.