Running head: PCOS, AN UNDER DIAGNOSED DISORDER

PCOS, An Under Diagnosed Disorder

Abstract

A very common, but often under diagnosed hormone disorder is called Polycystic Ovary Syndrome also known as, PCOS. A positive diagnosis along with treatment can become the answer to many other health problems, including infertility, which may have plagued the patient.

Purpose Statement

Shows how PCOS, when diagnosed and treated properly can become the answer to many other health problems, including infertility, which may have plagued the patient.

Statement of Qualification

I bring knowledge to this study because I was diagnosed with PCOS 3 years ago at the age of 28. Having missed the proper diagnosis for the majority of my child-bearing years, I suffered from many of the symptoms that will be later discussed. I have since been under treatment and have found the answer too many of the health problems I had earlier in life.

PCOS, An Under diagnosed Disorder

In the medical field, Polycystic Ovarian Syndrome, also known as (PCOS) is a disorder of

hormones that is rarely diagnosed. Many women carry out their lives with this disorder and are

never treated for it. The disorder is common, affecting as many as one out of ten; however, this

number may be higher due to under diagnosis. PCOS carries a wide range of symptoms and

they vary from person to person. A few of these symptoms are obesity, excessive hair growth,

irregular or absent periods, and infertility. A positive diagnosis along with treatment can become

the answer to many health problems that may have plagued the patient.

Usually, a diagnosis of this disorder is found because the patient has a totally unrelated

chief complaint, or so they think. A patient who is unhappy with facial hair that she can

not seem to get rid of may set an appointment with her dermatologist and find a direct link to

PCOS. With a simple blood test and perhaps a few other fact finding questions, the medical

professional can give an educated guess as to the possibility of the patient having this disorder.

PCOS causes the testosterone levels in females to be higher than their estrogen level. This

Discovery is a sign that PCOS could be the underlining issue.

The absence of a menstrual cycle may bring on excitement to a young lady who is trying to

conceive or doom to a young couple who used a defective condom. However, the unknowing

PCOS patient is another story. The disorder is known for causing young ladies to go months

without a single sign of her period. This can cause uneasiness when there is a possibility of

pregnancy. It is most assuredly the basis of frustration when trying to calculate ovulation since,

ovulation rarely takes place.

According to Cornforth, “Most women have never even heard of PCOS, yet it causes

a wide variety of symptoms that often affect female reproductive health in ways that can be truly

devastating” (2003). Many young women wanting to conceive may find themselves sitting across

from their OBGYN trying to find out why they are not having regular menstrual cycles or why

after 2 years of unprotected sex they are still not pregnant. Questions such as these should prompt

their doctor to ask questions and order a blood test. Once the blood test is ordered and completed,

verification of the patient’s hormone levels should prompt the doctor to conduct an ultrasound of

the patient’s ovaries. The PCOS patient will yield ultrasound photos that show small cyst-like

lumps embedded predominantly in the lining of one of the their ovaries. The patient’s other

ovary may have cysts as well although not as many as the other. These cysts are actually the

eggs that were supposed to be released during the times the young ladies never saw their cycle.

A host of other health issues can prompt a physician to look at PCOS as a problem. Lipid

abnormalities, obesity, acne, and male pattern hair thinning are signs that a patient may have this

hormonal disorder. Cornforth also advises, “If you have two or more of these symptoms, you

should see a physician, preferably a reproductive endocrinologist”(2003). Research suggests that

this disorder is inherited however, the exact cause is unknown. PCOS symptoms usually start

with the onset of menstruation. Cases also have noted that this hormone disorder can start as

early as the preteen years. If a woman is in her child bearing years, she is susceptible to

developing this disorder.

Depending on the symptoms, a patient may have a variety of treatments available to them.

Patients who are overweight or obese may be given a special diet with medication to assist with

weight loss. Oral contraceptives are usually prescribed for women who have this disorder and are

not interested in becoming pregnant. Oral contraceptives will induce ovulation and regulate the

menstrual cycle. For those patients who are interested in conceiving, they may be prescribed

insulin-sensitizing anti-diabetes drugs which will also induce ovulation and regulate the

menstrual cycle. In addition, fertility therapy with ovulation-inducing drugs can be used.

Surgical therapy is also an option; however, it is held as a last resort if possible.

Frequently, PCOS can be associated with several serious medical conditions. Diabetes is one

of these conditions. The patient’s sensitivity to insulin is decreased and this can lead to an

increased risk of onset in adulthood. Mellitus, cardiovascular disease, uterine cancer, and

depression are all included as serious medical conditions that PCOS can support. Often times,

patients become depressed when faced with symptoms such as facial and body hair, infertility

and obesity. Patients should always try to have a good support system in place when faced with

any type of medical treatment.

At the age of 16, Ms. Jones was placed on birth control pills to regulate her menstrual cycle.

After several months, she noticed that she had gained a considerable amount of weight. After

much thought, she concluded that the weight gain was contributed by birth control pills as they

were the only change in her daily routine. Ms. Jones took these concerns to her OBGYN whom

advised ,”some weight gain or loss is normal.” Having never had weight problems before, she

decided to pay closer attention to her body and track the weight gain because she was not

convinced it was normal.

Throughout the next twelve years, Ms. Jones gained over 75lbs. For her, there was no doubt

that this was a result of the medication. Several times during these twelve years, she removed

herself from the pills in order to lose weight. Each time this happened, she lost only some of the

weight. She noticed that losing and keeping the weight off was now an issue and her menstrual

cycles had become irregular again. Jones says,” I remember not having a cycle for a little over 4

months. I still had a good bit of weight on me, so my first thought was, am I finally pregnant?”

She took a trip to a local hospital lab and had a private pregnancy test performed. The results

came back negative. Ms. Jones stated that she’d taken more pregnancy tests than she could count

and the news she received wasn’t a shock; however, she still had mixed emotions concerning the

results of this test. “Disappointment, relief, frustration, and bewilderment,” were several that she

named.

At the age of 28, Ms. Jones, who had since become Mrs. Willis returned to her OBGYN with

concerns of her menstrual cycle and the weight gain that was associated with her taking birth

control pills. Again her doctor pe4rscribed pills and responded, “You are not trying to get

pregnant, so this is the best treatment.” Feeling much like a number, unheard, and dismissed, she

decided to find a new doctor. Within 20 minutes of consulting her new OBGYN prospect, she’d

been given an explanation as to what could be causing her irregular cycles. Not only had the

mystery of her irregular cycles been possibly resolved, a list of other problems were discussed

that were most likely all linked together.

A blood sample was drawn and approximately two weeks later, the results were in . An

ultrasound was performed and her prospected OBGYN, sealed the deal on becoming her

permanent doctor. Within two weeks, Mrs. Willis had been tested, screened, diagnosed and

preparing to start treatment for PCOS. Four months from the start of treatment, Mrs. Willis was

pregnant for the first time. Although the pregnancy was ectopic, there was still hope and

excitement for future pregnancies. Now, at the age tender of 30, she is a proud parent, and is still

working on expanding her family by adding at least three more children.

Although PCOS is under diagnosed, if a patient is aware of basic signs they can find quick

treatment to help reverse the effects of this disorder. Because of a lack of knowledge, many

patients are not diagnosed with this disorder. Diagnosis along with treatment of PCOS can be the

beginning of relief to many health problems that the patient would have never known was all

linked by one under diagnosed disorder.

References
Barbier, R & Ehrmann, D (unknown). Patient information: Polycystic Ovary Syndrome (PCOS). Retrieved March 19, 2009 from www.uptodate.com/patients
Comforth, T (2003). PCOS What is Polycystic Ovarian Syndrome? Retrieved February 19, 2009, from http://womenshealth.about.com/cs/pcos/a/whatispcos.htm
Chen, P (2008). Poyctstic Overy disease, Retrieved February 23, 2009 from http://www.hlm.nih.gov/medlineplus/encyarticle/000369.htm
Hunter, M & Sterrett, J (2000), Polycystic Ovary Syndrome: It’s not just infertility. Retrieved February 21, 2009 from http://www.aafp.org/afp/20000901/1079.html

Chen

Melissa H. Hunter, M.D., and James J. Sterrett, Phar M.D. Medical University of South Carolina, Charleston, South Carolina (2000). Polycystic Ovary Syndrome: It's Not Just Infertility. Retrieved February 21, 2009, from the World Wide Web: http://www.aafp.org/afp/20000901/1079.html

Peter Chen, MD, Department of Obstetrics & Gynecology, University of Pennsylvania Medical

Center, Philadelphia, PA. (2008). Polycystic ovary disease. Retrieved February 23, 2009 from

the World Wide Web: http://www.nlm.nih.gov/medlineplus/ency/article/000369.htm