Polycystic ovarian syndrome (PCOS) or Stein-Leventhal syndrome, is where numerous cysts develop in the ovaries, which results in reduced egg production to the point that ovulation does not occur (anovulation). It is a hormonal imbalance as well as a primary source of female infertility. According to the "Journal of the American Medical Association" (JAMA), PCOS is found in approximately 10 percent of women of child-bearing age and may involve the following: absence of menstrual periods, central obesity, excessive facial and body hair (hirsuitism), hypertension, and diabetes. The specific cause of this syndrome remains unknown.
Genetics
Contemporary medicine considers PCOS an inherited condition in that PCOS tends to run in families, according to the Mayo Clinic. Research, however, has yet to identify the gene mutation that would precisely explain the etiology of this syndrome. Additionally, another hypothesis is that fetal exposure to androgens in the womb may produce this syndrome.
Androgens
The pituitary gland releases luteinizing hormone (LH) and follicle stimulating hormone (FSH), which are salient to the menstrual cycle process and regulation of egg production. The ovaries produce the known female hormones of estrogen and progesterone; however, normally, the ovaries also produce androgens, male hormones, as, for example, testosterone. In this syndrome, the pituitary may release abnormal amounts of hormones, the ovaries may produce excessive amounts of androgens, or both; regardless, excessive androgens abnormally affect LH and FSH production, and also, stimulates the pattern of irregular or absent menstrual periods.
Causes: Metabolic
There is a positive relationship between the PCOS syndrome and insulin resistance or diabetes type II. The National Women's Health Information Clearinghouse predicts that over 50 percent of PCOS diagnosed women will have diabetes or a variant before reaching 40 years of age. This organization also notes that PCOS women are four to seven times more likely to have a heart attack than normal counterparts. These facts indicate deep, underlying biological processes with most contemporary focus on insulin production. Specifically, insulin resistance is when the pancreas has to produce more that normal insulin; and, high levels of insulin are thought to trigger increased androgen production by the ovaries. In reality, it is most likely that PCOS is a multi-factorial disorder.
