Your body contains two adrenal glands, one located on top of each kidney. Their function is to produce hormones that control your metabolism, heart rate, blood pressure, and other important body functions. Problems within the adrenal gland can cause increased levels of male hormones (also known as androgens). Even a slight increase of male hormone can interfere with the ovulation process and thus fertility. Signs of increased male hormone include excessive facial hair, hair on the lower abdomen, hair on the big toe, and extra hair around the anus. Acne and oily skin may also be associated with excessive male hormone.
LIFE'S NOT FAIR
You probably already know that life's not always fair. But here's just another reason that you can add to your list. When a female is born, she's born with her lifetime supply of eggs already inside her ovaries. However, a man generates a new supply of sperm about every three months. Therefore, any drugs, alcohol, or medications you take, or environmental elements you are exposed to can potentially damage all the eggs that you'll ever produce. In contrast, because a man generates a new sperm supply about every three months, his potentially damaged sperm are replaced with healthy new sperm every few months. It's easy to see how disease and toxic substances can have a much more severe and long-lasting effect on a woman than on a man. Not fair! Figure 1.1 illustrates normal female anatomy.
Figure 1.1. Anatomy of the Female Abdomen
Figure 1.1. Anatomy of the Female Abdomen
Specific Causes of Infertility for Women
Certain medical conditions can lead to infertility. Proper diagnosis and treatment may restore or improve your fertility.
The medical condition known as polycystic ovary syndrome (PCOS) causes your ovaries to act abnormally and leads to irregular or lack of menstrual periods, abnormal or absent ovulation, and, therefore, infertility. PCOS is a common cause of infertility and occurs in about 5 to 10 percent of reproductive-age women.
Symptoms of PCOS do not typically show up until after puberty, when menstruation begins. In some women, hormonal changes may begin as early as the very first menstrual cycle. In most women with PCOS, changes occur gradually, over time. Symptoms of PCOS may include:
• Increased body and facial hair (also known as hirsutism)
• Darkened color of the skin along the neck, armpits, groin, and inner thighs
• Irregular menstrual periods or no periods
• Vaginal yeast infections
What Does PCOS Do? How Does It Affect My Fertility?
The circumstance that causes PCOS usually originates in your pituitary gland. The pituitary gland is considered your body's master gland because it triggers the release of hormones for your entire body. Instead of the normal reproductive hormonal balance, PCOS causes your hormones to become out of sync. PCOS also causes higher concentrations of male hormones (androgens). The result of this complex hormonal imbalance is that ovulation occurs irregularly, if at all.
In a normal ovary with normal ovulation function, one follicle matures and an egg is released each month, and this corresponds to rising progesterone levels. In a polycystic ovary, there are many follicles, but they do not mature and, therefore, no egg is released. Because the eggs are not released, progesterone levels remain low and out of sync with the other hormone counterparts, androgen and estrogen. This results in irregular periods and continues the cycle of PCOS hormonal imbalance.
In addition, many women with PCOS produce too much insulin or the insulin they produce doesn't work properly. Insulin is a hormone that controls your body's use of sugar (glu cose) but also usually plays a role in PCOS. Insulin interrupts the normal growth of the follicle in the ovaries. The affected ovaries contain such a large number of immature egg follicles; that they become abnormally enlarged and function abnormally. (See Figure 1.1.)
Who Is at Risk? What Causes PCOS?
Women with PCOS often have a family member with the condition. In fact, PCOS is considered a genetic disorder. This means that if you have PCOS, most likely you were born with the condition. Remember that PCOS might also be passed to your female children.
How Is PCOS Diagnosed?
To diagnose PCOS, your doctor will ask you questions about your health, your menstrual cycle, and your family history. The doctor will also perform a physical examination and order blood tests to check your hormone levels. If PCOS is suspected, a pelvic ultrasound may be performed to closely view your ovaries.
How Is PCOS Treated?
Treatment depends on your symptoms and your desire for pregnancy. A low carbohydrate diabetic diet along with regular exercise may be prescribed to lower your insulin levels. Additionally, research has shown that approximately 75 percent of women with PCOS respond well to fertility medication. In some cases, laparoscopic surgery is required to remove ovarian cysts that resulted from PCOS.
Women with PCOS should be aware of potential long-term health risks. They are at an increased risk of developing uterine cancer and are at risk of developing diabetes. PCOS has also been linked to heart disease, abnormal lipid profile, and high blood pressure. Because of these increased health risks, women with PCOS should be evaluated carefully by their doctor on an annual or more frequent basis.
PCOS is a condition that you are born with, so you can never truly be cured. However, with proper treatment, your symptoms can be relieved and you can live a healthy and normal life. Becoming pregnant is certainly possible but may require some advance planning and treatments to be determined between you and your doctor.
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