Polycystic ovarian disease (PCO) is a condition whereby the ovaries do not release egg cells, or only release them sporadically, and produce insufficient quantities of hormones. PCO is also called Stein-Leventhal syndrome. Women with PCO have slightly enlarged ovaries that contain multiple small cysts (cavities filled with fluid).

PCO can appear without any symptoms whatsoever and go completely unnoticed by a woman. In other women a diverse range of symptoms can be associated with PCO, such as:

• Irregular menstruation or the complete absence of menstruation (amenorrhoea).
• Weight gain particularly fat accumulation around the abdominal area.
• Excessive hair growth (hirsutism).
• Acne.
• Greasy skin.

In the presence of such physical symptoms PCO is referred to as polycystic ovarian syndrome (PCOS).

A diagnosis may be made through a combination of hormonal determinations and a vaginal ultrasound whereby the enlarged ovaries display a characteristic appearance.

Medication
In the event that a woman is not ovulating, doctors often use ovulation-stimulating medication and/or gonadotropins. These drugs can help the ovaries produce ova. The first course is often clomiphene tablets, the dosage of which (up to three tablets per day) could be increased on a monthly basis until ovulation takes place. However sometimes, the best method of restoring ovulation is by taking insulin regulating medication such as metformin (GlucophageÒ), possibly in combination with ovulation-stimulating drugs or alone. If clomiphene tablets do not succeed in bringing about ovulation, then you can move on to injections of gonadotropins or surgical treatment.

Surgery
One of the features of PCO is that the outermost layer of the ovary thickens. A wedge-excision used to be performed whereby a part of the ovary was removed in order to limit the production of androgen by the ovaries. This method is rarely used anymore. Instead, a more recent way of treating PCO surgically is the use of Laparoscopic electrocoagulation(LEO) to burn, small shallow holes into the ovaries, changing the hormonal activity of the ovary. There is then a chance, especially within the first few months, of ovulation and hence a regular cycle. The advantages and disadvantages of this system are not yet fully known, which is why LEO is still not universally employed.