Metabolic Syndrome and Polycystic Ovaries

By Shivani Narasimhan, MD

Endocrine & Metabolic Institute

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Metabolic Syndrome and Polycystic Ovaries

Polycystic Ovary Syndrome (PCOS) patients should be treated with a multidisciplinary approach that begins with education. PCOS is a clinical diagnosis characterized by different degrees of anovulation coupled with signs of hyperandrogenism signs of too much male type hormone. This often results in excess acne and hair on the face or body or thinning of scalp hair.
The initial evaluation is focused on extensive laboratory studies.
PCOS affects at least 10% of reproductive age women.
All patients suspected of having PCOS areevaluated for Cushings syndrome and Congenital Adrenal Hyperplasia uncommon but very serious conditions.A glucose tolerance test is ordered to evaluate any metabolic syndrome or glucose abnormality that is not routinely revealed on simple fasting lab work. Many of the patients will have some degree of glucose intolerance increasing their riskof premature cardiovascular disease and diabetes. Metformin might be offered to these patients, helping reduce glucose intolerance and improving ovulation.
It is essential to address the psychological impact the diagnosis has on our patients. Part of the diagnosis includes an excess of testosterone leading to acne, hirsutism and hair loss. This can lead to decreased fertility or first trimester miscarriages in reproductive age women. These issues should be treated with medications, as well as with a dose of sensitivity and discretion.