Symptoms of PCO


Name: Stein-Leventhal Syndrome

Alternate names: solcrocystic ovarian disease; polycystic ovaries; polycystic ovarian disease (PCOD)

Definition: An accumulation of many incompletely developed follicles in the ovaries. This condition is characterized by scanty or absent menses (menstruation), multilple cysts on the ovaries and infertility.

Causes, incidence & risk factors: Abnormal ovarian function, sometimes causes incompletely developed follicles (ova) to accumulate in the ovaries. These ova fail to mature therefore causing infertility in women. Polycystic ovaries are 2 to 5 times as large as normal ovaries and they have a white, thick, very tough outer conering. PCO usually presents itself shortly after puberty. A woman with PCO will stop menstruating (or may have never even started) or will menstruate erratically. She will gain weight, eventually becoming obese, and she may develop excessive amounts of facial or body hair (hirsutism).

Although the cause of PCO is not fully understood, there are a few theories suggesting that problems with estrogen production and hypothalamic-ovarian feedback may be responsible. Ovarian function will not procede normally under reduced amounts of pituitary hormones, however, an increase in the amount of follicle-stimulating hormone (FSH) which is one of the hormones normally produced by the pituitary gland, is frequently successful in stimulating the underdeveloped ova to mature and be released from the ovary.

Women diagnosed with this disorder frequently have a mother of sister with similar symptoms associated with PCOD. However, there is not currently enough evidence to prove a genetic linkage of the disease.

Conception is frequently possible with proper surgucal or medicinal treatments. Following conception, pregnancy is normally uneventful.

Prevention: There is no known prevention.


Symptoms:
     menstrual periods, abnormal, irregular, or scanty (oligomenorrhea)

     absent menses (amenorrhea), usually (but not always) after
     having one or more normal menstrual periods during puberty
     (secondary amenorrhea)

     obesity

     infertility

     increased hair growth (hirsutism)

     aggravation of acne

     unusual growth and distribution of body hair in a male
     pattern (virilization)

Signs and tests: In a pelvic examination, the health care provider may note an enlarged ovary. In an ultrasound, the effect of the eggs resembling a "pearl necklace".


Tests:  
     urine 17-ketosteriods (may be elevated)
  
     LH to FSH ratio increased

     laparoscopy

     ovarian biopsy

     androgen (testosterone) levels elevated

     elevated LH (luteinizing hormone)

     estrogen level relatively high

     FSH (follicle stimulating hormone) decreased

     serum HCG (pregnancy test) negative

   This disease may also alter the results of the following tests:

     estriol - urine

     estriol - serum

Treatment: Medications used to treat the symptoms of Stein-Leventhal include oral contraceptives, Testolactone, and Clomiphene Citrate (chlomid) Treatment with Clomiphene induces the pituitary gland to produce more FSH which in turn stimulates maturity and release of the ova.

A "wedge resection" of the ovaries may be used to remove cysts and still allow contraception (since ova don't mature)

Finally, weight reduction, which may be very difficult, is very important. Maintaining general good health and eliminating the complications of obesity is essential.

Expectations:(prognosis): Pregnancy can be achieved with appropriate medical intervention.

~~I compiled this list thru the internet and thru books I have, including "Getting Pregnant, What Couples Need to Know Right Now" by Niels H. Lauersen and Colete Bouchez~~


Counter added on 16 July, 1998

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