Polycystic Ovarian Syndrome

WHAT YOU SHOULD KNOW:

• Polycystic (pol-e-SIS-tik) ovarian (o-VAR-e-an) syndrome (SIN-drom), also called PCOS, is a condition where the ovaries are enlarged with multiple small cysts. PCOS usually occurs when the ovaries produce higher levels of male hormones than female hormones. This may lead to formation of cysts (small fluid-filled sacs) on one or both ovaries. The ovaries are a pair of organs in the lower abdomen (stomach). An ovary is attached to each side of the uterus (womb) by the fallopian tubes. Ovaries produce eggs and hormones, including estrogen and progesterone. These hormones play an important role in how your body works.
  
  
• Signs and symptoms of PCOS include abnormal monthly periods, such as irregular or absent periods. You may also have pain or discomfort in your back or abdomen, acne, or weight gain. Other symptoms may include too much hair growth on your face and body, and thinning of scalp hair. PCOS is diagnosed by having a pelvic exam, an ultrasound, and blood and urine tests. Treatment may include surgery and medicines, such as steroids or hormones. With proper treatment and care, PCOS may be controlled and further problems prevented.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Treatment for PCOS may cause unwanted side effects. Some medicines may cause liver problems, abdominal pain, nausea (upset stomach), vomiting (throwing up), or mood changes. You could get an infection or bleed too much after surgery to remove the cysts in your ovaries. Sometimes even with treatment, your PCOS may return or become worse. If PCOS is not treated, you may continue to gain weight and have abnormal periods. You still may not get pregnant and have too much acne or facial and body hair. You may also have diabetes (high blood sugar), hypertension (high blood pressure), or other heart diseases. Problems with your ovulation may further lead to abnormal uterine bleeding or endometrial cancer. Ask you caregiver if you are worried or have questions about your condition, care, or medicine.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may have any of the following:

• Anti-androgen medicines: These medicines may lower or stop the release of male hormones from the ovaries. Anti-androgens may also help treat symptoms of PCOS, such as thinning of scalp hair or too much hair growth.
  
  
• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.
  
  
• Blood sugar medicines:
  
  
  • Hypoglycemic medicine: This medicine may be given to decrease the amount of sugar in your blood. Hypoglycemic medicine helps your body move the sugar to your cells, where it is needed for energy.
    
    
  • Insulin: This medicine may be given to decrease the amount of sugar in your blood. It helps your body move the sugar to your cells, where it is needed for energy.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Steroid medicines: Steroids may help lower the release of male sex hormones.

Tests:

You may have any of the following:

• Blood and urine tests: Samples of your blood and urine are sent to the lab for different tests. Caregivers may check the levels of your blood sugar and hormones.
  
  
• Computerized tomography scan: This test is also called a CT scan. A special x-ray machine uses a computer to take pictures of your abdomen (stomach), including your ovaries. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps your ovaries show up better on the pictures. Tell your caregiver if you are allergic to iodine or shellfish (lobster, crab, or shrimp) as you may also be allergic to this dye.
  
  
• Pelvic exam: This is also called an internal or vaginal exam. During a pelvic exam, feel free to ask for a woman to be present if one is not. Your caregiver gently puts a warmed speculum into your vagina. A speculum is a tool that opens your vagina. This lets your caregiver see your cervix (bottom part of your uterus). With gloved hands, your caregiver will check the size and shape of your uterus and ovaries.
  
  
• Ultrasonography: An ultrasound uses sound waves to look inside your abdomen. Caregivers may want to look at your liver, kidneys, uterus (womb), ovaries, fallopian tubes, or other organs.

Treatment options:

Treatment for PCOS is aimed at correcting and relieving your signs and symptoms. Ask your caregiver for more information about each treatment you may need. You may have any of the following:

• Hormone therapy: These are special hormones needed to control your periods or the release of eggs from your ovaries.
  
  
  • Birth control pills: These medicines have female hormones which may help lower levels of male hormones. Birth control pills may control your periods, prevent cysts, or cause them to shrink. These also help decrease your risk of endometrial cancer and correct abnormal bleeding.
    
    
  • Clomiphene citrate: This medicine, also called fertility medicine, releases more hormones, such as follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones cause the ovaries to produce an egg each month.
    
    
  • Gonadotrophins: These medicines act like hormones and make the ovaries release an egg.
    
    
  • Metformin: Your caregiver may offer you metformin medicine to help treat your PCOS. Metformin helps the ovaries speed up the release of eggs. Ask your caregiver for more information about metformin and its use in PCOS.
  
  
• Surgery: Your caregiver may do surgery to remove the cysts in your ovaries. Depending on the number and sizes of the cysts present, your caregiver may also remove one or both of your ovaries. Biopsies (tissue samples) of the cysts, your ovaries or lining of the womb may also be done. This will help caregivers learn more about your condition.
  
  
• Others: Removing too much hair may be done by shaving, waxing, or applying hair removal creams. Your caregiver may also use laser (narrow beam of light) to remove the excess hair on your face or body. Your caregiver may also suggest an exercise program to help you lose weight.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Polycystic Ovarian Syndrome (Inpatient Care)