"What are polycystic ovaries (PCO)?
PCO are ovaries which contain an excessive number of primordial follicles. (Despite the name, there are no cysts, so the condition should really be called polyfollicular ovaries). These follicles are tiny fluid-filled sacs which contain the eggs. An ultrasounds of the ovaries during the reproductive years usually shows, on average, 5-12 follicles in each ovary. When more than 12-15 follicles are present, the ovary is called 'polycystic'. This itself does not cause adverse symptoms and should not be confused with PCOS.
Normal: less than or equal to 12 follicles
Borderline: 13-15 follicles
Mild: 16-30 follicles
Moderate: 30-50 follicles
Severe: more than 50 follicles, as a general guide - these women usually have Polycystic Ovarian Syndrome (PCOS), associated with infertility, increased facial hair, and a disturbance of hormone levels.
What is the cause of polycystic ovaries?
In a normal menstrual cycle there are usually 5-10 follicles at the beginning of the cycle. Later in the cycle usually around day 14, one follicle gets bigger (leading follicle) and shortly thereafter ovulation takes place with release of the egg. The remaining eggs regress and disappear before the next cycle. These events typically occur every 4 weeks and result in the monthly menstrual bleed. With polycystic ovaries, this cyclical sequence of events does not take place. Instead, no leading egg develops and there is a build up of small immature follicles with successive cycles. Despite extensive research no single cause explains this variation from normal.
PCO is very common - it is estimated that 1 in 3 women have them. For most, this does not cause a problem and is often left undiagnosed unless they have difficulties becoming pregnant. Even in this case, many women achieve ovulation and therefore pregnancy with minimal drug involvement.
PCO is a genetic condition, and tends to develop during your 20's. PCOS usually develops much sooner, with symptoms appearing when a girl is around 16.
PCO causes a mild hormone imbalance which may cause one or more of the following:
1. Acne
2. Irregular, infrequent periods
3. Slightly reduced fertility
4. Oily skin
5. Mild hair excess on face, nipples or pubic area
6. Some degree of resistance to your body's natural insulin
Treatment:
Exercise - this burns up sugar and helps lower the strain on insulin which helps your ovaries.
Keep weight low - increased weight increases resistance to insulin in everyone.
Low carbohydrate, low GI diet - all carbs except fibre and metabolised to sugar, so low carbs lowers the strain on insulin which helps your ovaries.
Oral contraceptive pill - this treats the hormone disturbance and stops the ovaries trying to make more follicles.
If trying to become pregnant, simple agents like Metformin (which decreases your resistance to insulin) or the fertility drug Clomephene may be needed."
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