QuestionCan polycystic ovary syndrome cause ovarian cancer? I recenetly have been diagnosed with pcos and heard that it can cause ovarian cancer. I alo have fibroids on my uterus. whatcould come from that?
AnswerDear Nettisha,
First, I would like to apologize for the delay in answering. Unfortunately, my son required emergency surgery this past week and I have been needed as "nurse mom".
Polycystic ovary syndrome (PCOS) is a health problem that can affect a woman's menstrual cycle, ability to have children, hormones, heart, blood vessels, and appearance. About one in ten women of childbearing age has PCOS and is the most common cause of female infertility (not being able to get pregnant). With PCOS, women typically have:
- high levels of androgens (male hormones- although females also make them)
- missed or irregular periods
- many small cysts in their ovaries
The cause of PCOS is unknown. Most researchers think that more than one factor could play a role in developing PCOS. Genes are thought to be one factor. Women with PCOS tend to have a mother or sister with PCOS. Researchers also think insulin could be linked to PCOS. For many women with PCOS, their bodies have problems using insulin so that too much insulin is in the body. Excess insulin appears to increase production of androgen. This hormone is made in fat cells, the ovaries, and the adrenal gland. Levels of androgen that are higher than normal can lead to acne, excessive hair growth, weight gain, and problems with ovulation.
PCOS symptoms often include:
- infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
- infertility (not able to get pregnant) because of not ovulating
- increased hair growth on the face, chest, stomach, back, thumbs, or toes - a condition called hirsutism
- ovarian cysts
- acne, oily skin, or dandruff
- weight gain or obesity, usually carrying extra weight around the waist
- insulin resistance or type 2 diabetes
- high cholesterol
- high blood pressure
- male-pattern baldness or thinning hair
- patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
- skin tags, or tiny excess flaps of skin in the armpits or neck area
- pelvic pain
- anxiety or depression due to appearance and/or infertility
- sleep apnea - excessive snoring and times when breathing stops while asleep
Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatment goals are based on your symptoms, whether or not you want to become pregnant, and lowering your chances of getting heart disease and diabetes. Many women will need a combination of treatments.
- For women who don't want to become pregnant, birth control pills can control menstrual cycles, reduce male hormone levels, and help to clear acne. However, the menstrual cycle will become abnormal again if the pill is stopped.
- The medicine metformin (Glucophage) is used to treat type 2 diabetes. It also has been found to help with PCOS symptoms, although it is not FDA-approved for this use. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone production.
- Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. For most patients, clomiphene citrate (Clomid, Serophene) is the first choice therapy to stimulate ovulation. If this fails, metformin taken with clomiphene is usually tried. When metformin is taken along with fertility medications, it may help women with PCOS ovulate on lower doses of medication. Gonadotropins also can be used to stimulate ovulation. These are given as shots. But gonadotropins are more expensive and there are greater chances of multiple births compared to clomiphene. Another option is in vitro fertilization (IVF).
IVF offers the best chance of becoming pregnant in any one cycle and gives doctors better control over the chance of multiple births. But, IVF is very costly.
- "Ovarian drilling" is a surgery that brings on ovulation. It is sometimes used when a woman does not respond to fertility medicines.
- Keeping a healthy weight by eating healthy foods and exercising is another way women can help manage PCOS. Many women with PCOS are overweight or obese. Eat fewer processed foods and foods with added sugars and more whole-grain products, fruits, vegetables, and lean meats to help lower blood sugar (glucose) levels, improve the body's use of insulin, and normalize hormone levels in your body. Even a 10% loss in body weight can restore a normal period and make a woman's cycle more regular.
It has been demonstrated in numerous studies that women who have not achieved a pregnancy have two to three times the risk of developing endometrial cancer compared to women who have been pregnant. Many women who are unable to achieve a pregnancy are anovulatory. Anovulatory cycles result in chronic estrogen exposure to the endometrial lining (the lining of the uterus) and an increased risk of developing endometrial cancer. Polycystic ovary syndrome (PCOS) is one of the most common causes of anovulation.
It has also been noted that women who are 21 to 50 pounds overweight have a three fold increase in the risk of endometrial cancer. And women who weigh more than 50 pounds over their recommended weight have a 10 fold increase in risk.
It is felt that the peripheral conversion of adrenal androstenedione (an androgenic male hormone) to estrone results in chronic exposure of the endometrium to increased circulating estrogen, thus increasing the risk of endometrial cancer.
Polycystic ovary syndrome is often associated with weight problems. Estrogen producing ovarian tumors are also associated with an increased risk of endometrial cancer.
As far as the uterine fibroids - Fibroids are actually quite common -between 50% and 80% of all women have at least one. For the most part, these fibroids cause no symptoms, though they can be problematic for about 20% of women. Uterine fibroids are tumors or growths, made up of muscle cells and other tissues that grow within the wall of the uterus (or womb). Although fibroids are sometimes called tumors, they are almost always benign (not cancerous). They are the most common, benign tumors in women of childbearing age, but no one knows exactly what causes them. Causes could be hormonal (affected by estrogen levels), genetic (running in families), environmental, or a combination of all three. Because no one knows for sure what causes fibroids, we also don't know what causes them to grow or shrink. For the most part, fibroids stop growing or shrink after menopause. However, this is not true for all women with fibroids.
They can be frustrating to live with when they cause symptoms. Not all women with fibroids have symptoms, but some have pain and heavy menstrual bleeding. Fibroids also can put pressure on the bladder, causing frequent urination.
The only absolute CURE for uterine fibroids would be a hysterectomy. Otherwise, if you are prone to them, even after treatment, they may grow back.
I hope this has helped you and answered your question. I wish you well.
Brenda
