Month: February 2017

Polycystic Ovarian Syndrome (PCOS) is a disorder that causes the ovaries to develop small cysts, which cause the ovaries to enlarge.  The cysts themselves are generally not painful, but they can lead to hormonal and metabolic imbalances. PCOS is fairly common, affecting 5-10% of women of childbearing age, regardless of ethnicity.

Cause.  The cause of PCOS is not completely understood, but there does seem to be a strong genetic link.  Therefore, the chance of developing PCOS increases if another woman in your family has been diagnosed with it.  High levels of androgen (male hormones) and/or insulin are also thought to play a role.

Diagnosis.  Your doctor may suspect PCOS based on your reported symptoms, but the only way to definitively diagnose it is to have a pelvic ultrasound.  This allows your doctor to look for cysts on your ovaries.

Symptoms. Common symptoms of PCOS include irregular, heavy, or missing periods; unexpected weight gain; acne; oily skin; infertility; hair loss; development of male features such as unwanted facial hair; and depression.

Complications.  If untreated, long-term complications of PCOS may include infertility, endometrial cancer, diabetes, high cholesterol and heart disease as a result of these hormonal imbalances.

Treatment.  Unfortunately, there is not cure for PCOS, so treatment focuses on management of symptoms. Oral contraceptives (birth control pills) help regulate the menstrual cycle.  Weight loss, regular exercise and a healthy diet may help prevent diabetes and heart disease.  Facial creams and/or electrolysis  can aid with hair removal. Additionally, counseling and/or antidepressants can be used to help manage symptoms of depression.  Though it is still possible to get pregnant if suffering from PCOS, fertility treatments may be recommended to improve your chances.

Ovarian cysts are fluid-filled sacs that develops on one of the ovaries.  Most women experience them at one time or another, but they are often painless and symptomless.   Ovarian cysts are simply the presence of said cysts in the ovaries, while polycystic ovarian syndrome (PCOS) is a complicated collection of symptoms resulting from the presence of those cysts.  In other words, it is possible for a woman to have ovarian cysts without it developing into PCOS.  On the other hand, PCOS is a cascade of symptoms and complications resulting from the development of ovarian cysts.

Risk Factors.  Known risk factors of ovarian cysts include being post-menopausal; being a smoker; being overweight; not having had children; taking certain infertility drugs; undergoing hormone replacement therapy; and a family history of ovarian, breast, or colorectal cancer.

Symptoms.   If symptoms are present, one may experience abdominal bloating or swelling; painful bowel movements; painful menstruation; painful sex; pain in the abdomen or lower back; weight gain; breast tenderness; or nausea and vomiting.

Complications. In most instances, ovarian cysts are benign.  But occasionally, they can be cancerous.  Ovarian torsion occurs when a large cyst causes an ovary to twist or shift from its usual position.  As a result, the blood supply to that ovary is cut off, which can cause death or damage to the affected tissue.  Ruptured cysts occur when the cyst(s) burst, causing internal bleeding and severe pain.  Untreated recurrent ovarian cysts during childbearing years may lead to infertility.

Diagnosis.  In most cases, an ovarian cyst is first detected via  manual pelvic exam by your gynecologist.  Confirmatory testing may be done via a CT scan, PET scan, MRI, or ultrasound.

Treatment.  Most cysts disappear on their own, so your doctor may not recommend any interventions if it is not causing any severe symptoms.  Oral contraceptives may be prescribed to stop ovulation and prevent the development of additional cysts.  As an added bonus, birth control decreases your risk of ovarian cancer.  In severe cases, the cyst(s) may be surgically removed, sometimes requiring a full hysterectomy.  Cancerous cysts can be treated with chemotherapy and/or radiation.

Pelvic inflammatory disease (PID) is an infection of the female reproductive system.  PID can lead to irreversible damage of varying organs within the reproductive system to include the uterus, ovaries, and fallopian tubes.  PID is common, affecting 1 million American women each year, and is the #1 preventable cause of infertility in women.

Cause. Sexually transmitted diseases, such as gonorrhea and chlamydia, are the most common causes of PID.  Abortion, childbirth, and other trauma may also cause PID.

Symptoms. Common symptoms of PID are abdominal pain; vaginal discharge; painful urination; chills; high fever; nausea and vomiting; and painful sexual intercourse.

Complications.  Recurrent PID may lead to infertility, ectopic pregnancy, and chronic pelvic pain.

Risk Factors.  Risk factors of PID include douching; using an IUD as a form of birth control; having unprotected sex (particularly with more than one partner); having an untreated STD; and a personal history of PID.

Diagnosis.  PID is usually first suspected by your doctor after performing a manual pelvic exam.  An ultrasound, biopsy, or laparoscopy can help confirm the presence of PID.

Treatment.  Oral antibiotics are generally the first line treatment for PID.  For severe infections, hospitalization and IV antibiotics may be warranted.  Generally, your sexual partner(s) should be treated too as the assumption is they also have the causative STD.  They need to be treated even if they are not experiencing any symptoms.  Otherwise, reinfection may occur the next time the two of you have sex.  If your PID has caused an abscess, surgery may be needed to remove it and prevent it from rupturing.

Prevention.  To avoid PID, it is important to practice safe sex.  Avoid multiple sexual partners, use protection (either a condom or diaphragm), and consider forms of birth control other than IUDs.  Be sure to seek medical care at the first sign of vaginal discharge, pelvic pain, or bleeding.  Lastly, be sure to maintain your annual gynecological visits.