Women with PCOS have characteristics like high levels of male hormones, also called androgens, an irregular or no menstrual cycle, may or may not have many small cysts (fluid-filled sacs) in their ovaries. PCOS is the most common hormonal reproductive problem in women of childbearing age.

Women with PCOS frequently have a mother or sister with PCOS. But there is not yet enough evidence to say that there is a genetic link to this disorder. Many women with PCOS have a weight problem.

Since some women with PCOS make too much insulin, it is possible that the ovaries react by making too many male hormones, called androgens. This can lead to acne, excessive hair growth, weight gain, and ovulation problems. Women with PCOS have trouble with their menstrual cycle also.

The ovaries are two small organs, one on each side of a woman's uterus. Each month about 20 eggs start to mature, but usually only one becomes dominant. In women with PCOS, the ovary does not make all of the hormones it needs for any of the eggs to fully mature. They may start to grow and accumulate fluid. But no one egg becomes large enough. Instead, some may remain as cysts.

Since no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent. Also, the cysts produce male hormones, which continue to prevent ovulation.

Women with PCOS experience the symptoms like infrequent menstrual periods, no menstrual periods, and/or irregular bleeding, infertility or inability to get pregnant because of not ovulating, increased growth of hair on the face, chest, stomach, back, thumbs, or toes, acne, oily skin, or dandruff, pelvic pain, weight gain or obesity, usually carrying extra weight around the waist, type 2 diabetes, high cholesterol, high blood pressure, male-pattern baldness or thinning hair, patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs, skin tags, or tiny excess flaps of skin in the armpits or neck area, sleep apnea, excessive snoring and breathing stops at times while asleep.

Because there is no cure for PCOS, it needs to be managed to prevent further problems. Treatment is based on the symptoms a patient is having and whether she wants to conceive or needs contraception.

Below are description of treatments used for PCOS.

Birth control pills: For women who do not want to become pregnant, birth control pills can regulate their menstrual cycles, reduce male hormone levels, and help to clear acne.

However, the birth control pill does not cure PCOS. The menstrual cycle will become abnormal again if the pill is stopped.

Fertility medications: The main fertility problem for women with PCOS is the lack of ovulation. Even so, her husband’s sperm count should be checked and her tubes checked to make sure that they are open before fertility medications are used.

Surgery: Although it is not recommended as the first course of treatment, surgery called ovarian drilling is available to induce ovulation.

By laparoscopy the doctor punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary. This procedure carries a risk of developing scar tissue on the ovary. This surgery can lower male hormone levels and help with ovulation.

A healthy weight: Maintaining a healthy weight is another way women can help manage PCOS. Since obesity is common with PCOS, a healthy diet and physical activity help maintain a healthy weight, which will help the body lower glucose levels, use insulin more efficiently and may help restore a normal period. Even loss of 10 percent of her body weight can help make a woman's cycle more regular.

Polycystic ovarian syndrome (PCOS) affects a woman while pregnant. There appears to be a higher rate of miscarriage, gestational diabetes, pregnancy-induced high blood pressure and premature delivery in women with PCOS.

Polycystic Ovarian Syndrome (PCOS) put women at risk for other conditions. Women with PCOS can be at an increased risk for developing several other conditions. Irregular menstrual periods and the absence of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Without progesterone, which causes the endometrium to shed each month as a menstrual period, the endometrium becomes thick, which can cause heavy bleeding or irregular bleeding.

Women with PCOS are also at higher risk for diabetes, high cholesterol leading to cardio vascular disease, high blood pressure, and heart disease.

Getting the symptoms under control at an earlier age may help to reduce this risk.

The writers is a Senior Consultant of Bhagirathi Neotia Woman and Child Care Centre, Kolkata, India.