Women’s Health / Reproductive Endocrinology
A woman menstrual cycle is often tightly regulated. Premature cessation of menses (premature ovarian failure) may signal underlying significant hormonal problems. In younger women with amenorrhea (absence menses) a multitude of hormonal problems such as PCOS, prolactinoma, thyroid problems, cortisol issues etc, may be the underlying cause. A proper hormonal work up is essential in the absence of a reasonable cause of amenorrhea.
Polycystic ovarian syndrome (PCOS), in short, is a condition in which a woman’s hormones are out of balance. The condition is frequently associated with weight gain in a young woman. This results in androgenization (acne, excessive facial and body hair), menstrual irregularities and infertility. PCOS is common, affecting as many as 1 out of 10 women. It is thought to be one of the leading causes of female subfertility and the most frequent endocrine problem in women of reproductive age. Besides the disturbances in the sex hormones, the sinister feature of the syndrome is insulin resistance and obesity, which lead to diabetes. In fact, as many as 1 in 4 women with PCOS have diabetes. As a result of these metabolic disturbances, women with PCOS have a higher risk of cardiovascular event in their lifetime. Although termed as an ‘ovarian’ syndrome, the underlying pathology is not restricted to the ovaries. Often, there is a conglomeration of endocrine and metabolic problems in a woman with PCOS. These hormonal and metabolic disturbances can be amenable to treatment, with restoration of menstrual cycles and fertility in many instances.