Hormonal Disorder Can Cause Infertility, Obesity

Six to 10 percent of women have a reproductive endocrine disorder that can cause infertility and many of them don’t even know it.

Polycystic ovarian syndrome (PCOS) is a common hormonal disorder among women of reproductive age. Women with PCOS produce excessive amounts of androgens (‘male’ hormones such as testosterone) in their ovaries, which may be enlarged with many small cysts (fluid-filled sacs). “No one knows exactly what causes PCOS,” says Mira Aubuchon, MD, assistant clinical professor in the University of Cincinnati (UC) obstetrics and gynaecology department. “It’s thought that insulin plays a role, because diabetes is so prevalent among women with this disease.” Women with PCOS often experience irregular or infrequent menstrual cycles, excessive hair growth, acne, infertility and obesity. “PCOS can cause long-term health risks,” says Aubuchon. “Women are at an increased risk of developing metabolic syndrome, type 2 diabetes, high blood pressure and heart disease.” Lack of ovulation in women with PCOS also results in continuous exposure of their uterine lining (endometrium) to oestrogen, which can cause excessive thickening and heavy, irregular bleeding. Endometrial cancer may result because of the continuous stimulation of the uterine lining by oestrogen unopposed by progesterone. According to Aubuchon, patients with PCOS are often simply told to lose weight and exercise, but are not given any plan or method for doing so. She points out that patients with PCOS frequently receive fragmented care with different specialists in various geographic locations with little or no coordination of care. Aubuchon is leading a comprehensive program at the St. Luke Hospitals specifically treating women with PCOS. Currently, it is one of only four such programs in the country. The focus of the six-week PCOS program at St. Luke is reproductive health, nutrition and exercise. Aubuchon treats patients for their reproductive needs, including fertility, uterine bleeding issues and control of hair growth. Nutritionists work closely with patients to optimise their nutrition intake using both individual and group therapy sessions. Exercise physiologists assess the fitness needs of patients, offer instruction and supervise them to help them reach their goals. The program is not currently covered by insurance. The actual cost of the six-week program is $2,200, but patients pay only $225. After six weeks, the cost is $30 a month. “This program allows patients to assume control of their own health,” says Aubuchon. She hopes it will expand beyond reproductive health, nutrition and exercise to address other issues caused by PCOS. “If we can show that these interventions work, perhaps insurance companies will begin to cover them,” she says.(Source: University of Cincinatti: September 2006).