By Jack Handlin L.Ac., Dipl OM
Common Abbreviations
PCO = Polycystic Ovary
PCOD = Polycystic Ovarian Disease
PCOS = Polycystic Ovarian Syndrome
Definitions
The polycystic ovary (PCO) is a change in the ovaries of women with polycystic ovarian syndrome (PCOS). Although there are several other extra-ovarian aspects in the pathophysiology of PCOS, ovarian dysfunction is central.
Polycystic Ovarian Syndrome (PCOS) is a general term to describe a broad spectrum of clinical and morphological findings in women with endocrine dysfunction.
The definition of PCOS has been much debated. The ESHRE/ARRM consensus meeting produced a refined definition of PCOS including two out of three of the following criteria:
- oligo- and/or anovulation (infrequent or no ovulation)
- hyperandrogenism (clinical or biochemical)
- polycystic ovaries
Polycystic Ovaries (PCO) is defined as an ovary with 12 or more follicles measuring form 2-9mm in diameter and/or increased ovarian volume. PCO is commonly detected on ultrasound in about 20-33% of the population. Although, not all women with polycystic ovaries demonstrate the clinical and biomedical features that define PCOS.
Biomedical features of PCOS are elevated levels of testosterone, androstenedione, luteinizing hormone (LH) and insulin may vary in individuals with the condition and vary over time.
Possible Causes of the Polycystic Ovary
The presence of polycystic ovaries presents the possibility for an hyperandrogenic state and the expression of PCOS. Another prospective is that PCO may be a secondary effect caused by abnormal exposure to ovarian androgens stimulate by insulin or LH that makes it polycystic.
Although the pathology of PCOS is not fully understood there are likely to be many routes in the development of the syndrome such as genetic predisposition, environmental factors, and disturbances in a number of endocrine pathways.
Prevalence
About 27% of the population have PCO and of those about 80% have symptoms associated with PCOS. So roughly 20% of women with PCO are symptom free. The presence of polycystic ovaries appears to be associated with an increase of ovarian reserve and a reduced rate of ovarian aging, which may provide a key to assisting fertility health in cases of PCOS and infertility.
In general PCOS is a difficult condition to diagnose because of changing criteria needed for an accurate diagnosis, and the symptoms themselves can vary over time.
Stay tuned for upcoming posts discussing the absence and presence many factors that may contribute PCOS such as: infertility, insulin resistance, hyperandrogenism, ovarian dysfunctions, menstrual cycle dysfunction, and polycystic ovaries.
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