Polycystic Ovary Syndrome

What is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is the name for set of symptoms that are related to an imbalance of hormones. PCOS affects the ovaries, as well as many other parts of the body.

People with PCOS usually have at least two of these problems:

• Not ovulating. Normally, your ovaries make the egg that is released each month as part of a healthy menstrual cycle. This is called ovulation. But with PCOS, the egg may not develop as it should, or it may not be released during ovulation. Your periods may be irregular, or you may not have them at all.
• High levels of androgens. Androgens are hormones that are important for normal male sexual development. Women normally make smaller amounts of androgens. Having higher levels of androgens can cause you to have extra body or facial hair (called hirsutism).
• Cysts in one or both ovaries. Cysts are growths that are small, fluid-filled sacs.

What causes polycystic ovary syndrome (PCOS)?

The exact cause of PCOS in unknown. Research has shown that different factors may play a role, including:

• Genetics. PCOS tends to run in families.
• Imbalances in androgen levels.
• Insulin resistance. This is a condition in which your body can't use insulin properly. Insulin is a hormone that helps move blood glucose (sugar) into your cells to give them energy. Insulin resistance can lead to high blood glucose levels.

What are the symptoms of polycystic ovary syndrome (PCOS)?

PCOS often develops as young as age 11 or 12, around the time of your first period. But you can develop it later.

The symptoms can vary from person to person. Some people have few or even no symptoms. They may not realize they have PCOS until they have trouble getting pregnant. Other people may have more severe symptoms.

The symptoms of PCOS may include:

• Irregular or missed menstrual periods.
• Too much hair on the face, chest, stomach, or thighs.
• Obesity, weight gain, or trouble losing weight.
• Severe acne which may be hard to treat.
• Oily skin.
• Patches of thickened dark skin (called acanthosis nigricans).
• Infertility. PCOS is one of the most common causes of infertility. But many women with PCOS can still get pregnant.

What other health problems are linked to polycystic ovary syndrome (PCOS)?

PCOS is linked to many other health problems, including:

• Insulin resistance, which can lead to prediabetes and type 2 diabetes.
• Heart disease. Having PCOS increases your risk, and this risk goes up as you age.
• High blood pressure.
• High LDL ("bad") cholesterol and low HDL ("good") cholesterol. This increases your risk of heart disease.
• Sleep apnea, a disorder that causes you to repeatedly stop breathing during sleep.
• Depression and anxiety.

Although there are links between PCOS and these conditions, researchers do not know whether:

• PCOS causes some of these problems
• Some of these problems cause PCOS, or
• There are other conditions that cause both PCOS and these other health problems

Not everyone who has PCOS will have all these problems. However, you and your health care provider may want to monitor your health for signs of them, so they can be treated early.

How is polycystic ovary syndrome (PCOS) diagnosed?

There is no specific test for PCOS. To find out if you have PCOS, your provider:

• Will do a physical exam, which will include looking for the physical signs of PCOS.
• Will ask about your medical history and family health history.
• May do a pelvic exam to check for signs of extra male hormones and to see if your ovaries are enlarged or swollen.
• May order a pelvic ultrasound to look for cysts on your ovaries and check the thickness of your endometrium (the lining of your uterus, or womb).
• May order blood tests, including tests to check your hormone levels.

What are the treatments for polycystic ovary syndrome (PCOS)?

There is no cure for PCOS, but treatments can help you manage your symptoms. The treatments may include:

• Lifestyle changes, which can help reduce many symptoms. They can also lower your risk for or help manage related health problems. These changes include:
  • Maintaining a healthy weight
  • Getting regular physical activity
  • Eating healthy foods
• Medicines:
  • Hormonal birth control, such as pills, shots, and IUDs, can make your period more regular. They may also help remove acne and extra facial and body hair. But you would only use them if you don't want to get pregnant.
  • Anti-androgen medicines, which block the effect of androgens. This can help reduce hair loss on your head, the growth of facial and body hair, and acne. Providers do use them to help with these symptoms, but anti-androgen medicines are not approved by the U.S. Food and Drug Administration (FDA) to treat PCOS. These medicines can cause problems during pregnancy. Your provider may have you take them with birth control (to prevent pregnancy).
  • Insulin-sensitizing medicines, which are medicines that are used to treat type 2 diabetes. They improve insulin resistance and keep your blood glucose levels steady. They may also lower your androgen levels. They are not approved by the FDA to treat PCOS. But they may help with your symptoms.
  • Medicines for acne. These medicines come in pills, creams, or gels.
• Treatments for hair removal, such as facial hair removal creams, laser hair removal, and electrolysis.
• Fertility treatments if you are having trouble getting pregnant. They include medicines and procedures such as in vitro fertilization (IVF).

Prostate Diseases

What is the prostate?

The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

What are prostate diseases?

There are many types of prostate diseases:

• Prostatitis is inflammation (swelling and pain) in the prostate gland. It's the most common type of prostate problem in people under than age 50. There are different types:
  • Chronic prostatitis is also called chronic pelvic pain syndrome. It's the most common type of prostatitis.
  • Acute bacterial prostatitis starts suddenly from a bacterial infection and is treated with antibiotics. It is not common.
  • Chronic bacterial prostatitis happens when a bacterial infection keeps coming back. The symptoms usually start slowly. It may take longer to treat than acute bacterial prostatitis.
  • Asymptomatic prostatitis has no symptoms and usually doesn't need treatment. You may learn you have it after having tests for other health problems.
• Enlarged prostate is also called benign prostatic hyperplasia (BPH). The prostate gland tends to grow larger with age. That's why enlarged prostate is very common in older people and rare in those who are under age 40. When the prostate grows larger, it may press on your urethra and cause problems with urination.
• Prostate cancer happens when cancer cells form in the prostate gland. Prostate cancer is a common type of cancer in those aged 50 and older. Most prostate cancers grow slowly and may never cause health problems. But certain prostate cancers are serious.

Who is more likely to develop prostate diseases?

Anyone with a prostate can develop prostate problems. But some people are at higher risk.

You may be more likely to develop prostatitis if you have:

• A lower urinary tract infection, also called a UTI. An infection in your lower urinary tract (bladder and urethra) may lead to acute or chronic bacterial prostatitis.
• Nerve damage in your lower urinary tract from surgery or an injury. This may lead to chronic prostatitis.
• Emotional stress, which can lead to chronic prostatitis.

You may be more likely to develop an enlarged prostate (BPH) if you:

• Are age 40 or older.
• Have family members who have had BPH.
• Have certain health conditions such as:
  • Obesity.
  • Heart disease and problems with blood circulation.
  • Type 2 diabetes.
• Don't get enough physical activity.

You may be more likely to develop prostate cancer if you:

• Are older than age 50.
• Have a parent, sibling, or child who has or had prostate cancer.
• Are African American.

What are the symptoms of prostate diseases?

The symptoms of prostate problems include:

• Needing to urinate a lot.
• Needing to rush to the bathroom, but not being able to urinate or only going a little.
• Leaking or dribbling urine.
• Having a weak urine stream.

Other symptoms depend on the type of prostate problem you have and may include:

• Not being able to urinate at all. This is a medical emergency.
• Any problems, starting or controlling urine flow.
• Waking up often to urinate.
• Blood in your urine or urine that has an unusual smell or color.
• Fever, chills, or body aches.
• Great discomfort or pain:
  • While urinating or after ejaculation.
  • In your abdomen (belly), between your scrotum and anus, or in your scrotum or penis.

Contact your provider if you have any of these symptoms.

How are prostate diseases diagnosed?

To find out if you have a prostate problem, your provider will:

• Ask about your medical history and symptoms.
• Ask about your family health history.
• Do a physical exam. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to feel the general size and condition of your prostate.
• Order tests, if needed. Tests may include:
  • Blood and urine tests to look for infection.
  • Urodynamic testing to see how well you can hold and release urine.
  • Cystoscopy to look inside your urethra and bladder.
  • Ultrasound pictures of your prostate and urinary tract.
  • A PSA blood test (prostate-specific antigen test).
  • Prostate biopsy to diagnose or rule out cancer.

Treatment depends on what prostate disease you have and which symptoms bother you most.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Urinary Tract Infections

The urinary system is the body's drainage system for removing wastes and extra water. It includes two kidneys, two ureters, a bladder, and a urethra. Urinary tract infections (UTIs) are the second most common type of infection in the body.

You may have a UTI if you notice:

• Pain or burning when you urinate
• Fever, tiredness, or shakiness
• An urge to urinate often
• Pressure in your lower belly
• Urine that smells bad or looks cloudy or reddish
• Pain in your back or side below the ribs

People of any age or sex can get UTIs. But about four times as many women get UTIs as men. You're also at higher risk if you have diabetes, need a tube to drain your bladder, or have a spinal cord injury.

If you think you have a UTI it is important to see your doctor. Your doctor can tell if you have a UTI with a urine test. Treatment is with antibiotics.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Weight Control

Why is weight control important?

If you are struggling with your weight, you are not alone. In the United States, more than 70 percent of adults are overweight or have obesity. Having this extra weight raises your risk for many health conditions, such as type 2 diabetes, heart disease, kidney disease, and certain cancers.

Reaching and staying at a healthy weight can be challenging. But having a healthy lifestyle, including healthy eating patterns and regular physical activity, can help you lose weight. It can also lower your chance of developing weight-related health conditions.

What factors affect weight and health?

You gain weight when you take in more calories (through food and drinks) than you use up from physical activity and daily living. But there are many different factors that can affect weight gain, such as:

• The world around you. Your home, community, and workplace all may affect how you make daily lifestyle choices. For example:
  • It is often easier to find food and beverages high in calories, sugar, and fat. For instance, vending machines, cafeterias, and special events may not offer healthy, lower calorie options.
  • Less healthy foods may be cheaper than healthier foods.
  • Many people are getting less physical activity because they are spending more time using smartphones and other devices.
• Families. Overweight and obesity tend to run in families. This suggests that genes may play a role in weight gain. Families may also share eating and lifestyle habits. For example, some families may often have foods and drinks that are high in calories, sugar, and fat. And some families may tend to be less active and spend more time doing things like sitting and watching TV or using computers.
• Not enough sleep. People who don't get enough sleep may eat more calories and snack more.
• Emotions. Some people eat when they feel bored, sad, or stressed, even if they are not hungry.
• Medicines and health conditions. Taking certain medicines, such as steroids and certain antidepressants, can lead to weight gain. Some chronic health problems can also cause you to gain weight. A few examples are Cushing's syndrome and polycystic ovary syndrome (PCOS).

How can I get to and stay at a healthy weight?

Getting to and staying at a healthy weight involves finding a balance of food and activity. To lose weight, you need to take in fewer calories than you use up. Some ways to do this are:

• Eating more nutrient-rich foods, such as foods with lots of vitamins, minerals, and fiber.
• Eating and drinking less of the foods and beverages that have lots of calories, salt, sugar, and fat.
• Limiting alcohol.
• Finding healthier ways to cook, such as using healthier oils to cook with and baking or grilling instead of frying foods.
• Getting more physical activity. The general recommendation is for adults to get 150 minutes of physical activity each week. This time can be broken down into short bursts of activity throughout your day. Types of physical activity include:
  • Aerobic activity, which is also called cardio. It uses your large muscle groups (chest, legs, and back) to speed up your heart rate and breathing.
  • Muscle-strengthening activity, which is also called strength training. It works your muscles by making you push or pull against something.

You may decide to do these lifestyle changes on your own, or you may decide to try a weight-loss diet or program. Before you start, it's important to check with your health care provider first. Your provider can tell you what a healthy weight is for you, help you set goals, and give you tips on how to lose weight.

What are weight management medicines?

If making lifestyle changes or doing a weight-loss program are not enough to help you lose weight, your provider may prescribe medicines. These medicines are meant to help people who have weight-related health conditions and should be used along with healthy eating and physical activity. The prescription medicines to treat overweight and obesity work in different ways. Some may help you feel less hungry or full sooner. Others may make it harder for your body to absorb fat from the foods you eat.

Another treatment is weight loss surgery. Your provider may recommend the surgery if you have severe obesity or serious obesity-related health problems and you have not been able to lose enough weight.

How can I maintain my weight loss?

Maintaining weight loss can be challenging, and it's normal to slip back into old habits sometimes. The key is to keep a healthy balance of food and activity that works for you. Checking your weight regularly can help you notice small changes early and stay on track. And if you have a setback, don't be discouraged, simply refocus on your healthy habits and keep going.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Addison Disease

Your adrenal glands are just above your kidneys. The outside layer of these glands makes hormones that help your body respond to stress and regulate your blood pressure and water and salt balance. Addison disease happens if the adrenal glands don't make enough of these hormones.

A problem with your immune system usually causes Addison disease. The immune system mistakenly attacks your own tissues, damaging your adrenal glands. Other causes include infections and cancer.

Symptoms include:

• Weight loss
• Muscle weakness
• Fatigue that gets worse over time
• Low blood pressure
• Patchy or dark skin

Lab tests can confirm that you have Addison disease. If you don't treat it, it can be fatal. You will need to take hormone pills for the rest of your life. If you have Addison disease, you should carry an emergency ID. It should say that you have the disease, list your medicines and say how much you need in an emergency.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases