Polycystic ovary syndrome (PCOS) occurs when a hormone change causes problems with ovulation, the release of an egg from a woman’s ovary. PCOS is a major cause of infertility. The name of the syndrome, however, focuses on the ovarian cysts that may be present with PCOS. Now, experts want to change the name of this complex disease, as the presence of cysts on the ovaries is no longer the definitive factor in the diagnosis.
The ovaries normally make a small amount of the male hormone androgen, but in women with PCOS, the ovaries produce significantly larger amounts of androgen. The menstrual cycle in women with PCOS is typically abnormal and irregular. Increased amounts of androgen cause acne, as well as excessive facial and body hair in women with PCOS. Other symptoms of PCOS may include unexplained weight gain, thinning scalp hair, high blood pressure and high blood sugar levels. The cause of PCOS is unknown; however, insulin resistance is a major factor in many cases. Insulin is a hormone produced in the body that help the cells of the body get the sugar they need for energy. When the cells don’t respond to the insulin, they become insulin resistant. The insulin resistance predisposes women to diabetes.
On many women diagnosed with PCOS, an ultrasound examination will uncover numerous small cysts, which are really immature egg follicles, on the ovaries. This is how the name polycystic ovary syndrome was derived. However, researchers have concluded that a woman can still have PCOS without having polycystic ovaries, and they are looking closely at the range of health issues related to PCOS. The high levels of insulin can lead to high cholesterol, the hardening of arteries, high blood pressure, and coronary artery disease, which all can lead to a heart attack.
According to members of the independent panel convened by National Institutes of Health, “the name PCOS is a distraction that impedes progress. It is time to assign a name that reflects the complex interactions that characterize the syndrome.” The panel recommends that a new name that encompasses the whole picture of PCOS will “enhance recognition of this major public health issue, educational outreach, ‘branding,’ and public relations, and will assist in expanding research support.”
Currently there are three diagnostic classification systems used for PCOS. The panel supported the Rotterdam diagnostic criteria from 2003, which diagnoses PCOS based on the presence of two out of three criteria: abnormal periods, excessive production or secretion of androgens and polycystic ovaries.
According to the panel, the use of multiple classification systems hinders the ability of clinicians to successfully partner with women in addressing the health issues that concern them. Standardization of the classification system would be helpful for patients and clinicians going forward. I agree with the Rotterdam classification requiring two out of three abnormalities to define PCOS. A name change seems reasonable, but it may take some time to be well accepted by physicians and patients.