Polycystic ovary disease Health Article

Signs and tests

During a pelvic examination, the health care provider may note an enlarged clitoris (very rare finding) and enlarged ovaries.

Tests include:

• Abdominal ultrasound
• Abdominal MRI
• Biopsy of the ovary
• Estrogen levels
• Fasting glucose and insulin levels
• FSH levels
• Laparoscopy
• LH levels
• Male hormone (testosterone) levels
• Urine 17-ketosteroids
• Vaginal ultrasound

Blood tests that may be done include:

• Pregnancy test (serum HCG)
• Prolactin levels
• Thyroid function tests

Treatment

Medications used to treat the symptoms of polycystic ovary disease include:

• Birth control pills
• Clomiphene citrate
• Flutamide
• Spironolactone

Treatment with clomiphene citrate causes the pituitary gland to produce more FSH. This causes the egg to mature and be released. Sometimes women need stronger fertility drugs to get pregnant.

In women with polycystic ovary disease who also have insulin resistance, glucophage (Metformin), a medication that makes cells more sensitive to insulin, has been shown to make ovulation normal.

Losing weight (which can be difficult) may help to reduce the high insulin levels in the blood. For women with this condition who are overweight, weight loss can reduce insulin resistance, stimulate ovulation, and improve fertility rates.

Expectations (prognosis)

Women who have this condition can get pregnant with the right surgical or medical treatments. Pregnancies are usually normal.

Complications

• Increased risk of endometrial cancer
• Infertility
• Obesity-related conditions, such as high blood pressure and diabetes
• Possible increased risk of breast cancer

Calling your health care provider

Call for an appointment with your health care provider if you have symptoms of this disorder.

References

Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby;2007.