Understanding PCOS

Summary:

Polycystic ovary syndrome affects an estimated 5% to 10% of U.S. women. The clinical definition of PCOS is oligomenorrhea, or irregular menstrual flow and cycles, associated with high levels of circulating androgens as well as an increase in nitrogen and water retention. PCOS is a complex, heterogeneous metabolic disorder with many manifestations, including amenorrhea, anovulation, infertility, acanthosis nigricans, hirsutism, androgenic alopecia, pelvic pain, acne, central obesity, and/or hyperinsulinemia. While the reproductive dysfunction has historically been seen as the most serious consequence, it is becoming increasingly clear that other consequences may be even more serious. PCOS appears to be a precursor to metabolic syndrome (also called insulin-resistance syndrome) and Type 2 diabetes.

Objectives:

• Define and describe polycystic ovary syndrome.
• Identify the physical (visible) and clinical signs of PCOS.
• Describe the role of insulin and androgens in PCOS.
• List the environmental factors that contribute to insulin resistance.
• Explain the relationship of insulin resistance to infertility and central obesity.
• Understand and describe the relationship of PCOS to dyslipidemia and cardiovascular disease.
• Explain and understand the role of diet modification and therapy, especially recommendations regarding dietary carbohydrate intake, in treating PCOS.
• Describe the potential protective and therapeutic role of supplemental doses omega-3 fatty acids in PCOS.
• Identify and understand the role of medications (oral contraceptive pills, insulin-sensitizing drugs, fertility drugs) frequently prescribed to treat or manage PCOS.
• List the dietary macronutrient and micronutrient recommendations for a woman with PCOS.