Unveiling Polycystic Ovary Syndrome: Exploring Menstrual Irregularities

Polycystic ovary syndrome (PCOS) stands as the most prevalent endocrine disorder affecting women in their reproductive years, often becoming a primary cause of infertility.

1. Demystifying Polycystic Ovary Syndrome

Polycystic ovary syndrome is an intricate endocrine disorder recognized as a significant contributor to infertility, primarily due to irregular ovulation or ovulatory dysfunctions. Affecting around 7-10% of women within their reproductive age, PCOS commonly surfaces during puberty, but its emergence can extend to ages between 20 and 25.

Elevated levels of testosterone and LH (luteinizing hormone) disrupt ovarian follicle development in individuals with PCOS, resulting in the presence of numerous small follicles (ranging from 6 to 10 follicles < 10mm in size). Hindered follicle maturation leads to impaired egg development and subsequent ovulation challenges.

2. Exploring PCOS Origins

The precise origins of polycystic ovary syndrome remain elusive. This syndrome is marked by reproductive anomalies (hyperandrogenemia, anovulation) and metabolic imbalances (insulin resistance, obesity). However, it remains unclear which aspect is the primary contributor, as both intertwine in the development of the disorder. A solitary causative factor cannot account for the diverse abnormalities encountered in polycystic ovary syndrome.

3. Detecting Polycystic Ovary Indicators

Polycystic ovary syndrome presents through clinical and/or biochemical signs of hyperandrogenism, coupled with chronic anovulation. Many traits of the syndrome materialize during puberty, varying in severity from mild hirsutism to menstrual irregularities, such as oligomenorrhea, amenorrhea, and even infertility. The latter, infertility, often acts as a prompting factor for patients to seek medical intervention.

Unraveling Menstrual Disruptions

Central to diagnosing polycystic ovary syndrome is the presence of irregular menstrual cycles, which can manifest in diverse ways. Menstrual irregularities, characterized by fewer than 8 menstrual periods per year or menstrual cycles exceeding 35 days, frequently feature in PCOS. Women affected by this syndrome commonly display adequate estrogen levels but lack progesterone, leading to chronic estrogen stimulation, endometrial hyperplasia, and abnormal uterine bleeding, thereby escalating the risk of endometrial cancer. Occasionally, a subgroup of women with PCOS experiences secondary amenorrhea (~24%), marked by reduced estrogen levels, heightened levels of free testosterone and androgens, and reduced responsiveness to treatment approaches.