polycystic

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.

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.

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.

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.

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.

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).

A cyst is a fluid-filled sac. You may get simple kidney cysts as you age; they are usually harmless. There are also some diseases which cause kidney cysts. One type is polycystic kidney disease (PKD). It runs in families. In PKD, many cysts grow in the kidneys. This can enlarge the kidneys and make them work poorly. About half of people with the most common type of PKD end up with kidney failure. PKD also causes cysts in other parts of the body, such as the liver.

Often, there are no symptoms at first. Later, symptoms include:

• Pain in the back and lower sides
• Headaches
• Blood in the urine

Doctors diagnose PKD with imaging tests and family history. There is no cure. Treatments can help with symptoms and complications. They include medicines and lifestyle changes, and if there is kidney failure, dialysis or kidney transplants.

Acquired cystic kidney disease (ACKD) happens in people who have chronic kidney disease, especially if they are on dialysis. Unlike PKD, the kidneys are normal sized, and cysts do not form in other parts of the body. ACKD often has no symptoms. Usually, the cysts are harmless and do not need treatment. If they do cause complications, treatments include medicines, draining the cysts, or surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes, also known as diabetes mellitus, is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your body's main source of energy. Your body can make glucose, but it also comes from the food you eat. Insulin is a hormone made by your pancreas. Insulin helps move glucose from your bloodstream into your cells, where it can be used for energy.

If you have diabetes, your body can't make insulin, can't use insulin as well as it should, or both. Too much glucose stays in your blood and doesn't reach your cells. This can cause glucose levels to get too high. Over time, high blood glucose levels can lead to serious health conditions. But you can take steps to manage your diabetes and try to prevent these health problems.

There are different types of diabetes:

• Type 1 diabetes. If you have type 1 diabetes, your body makes little or no insulin. It happens when your immune system attacks and destroys the cells that produce insulin.
• Type 2 diabetes. This is the most common form of diabetes. If you have type 2 diabetes, your body may still be able to make insulin, but your cells don't respond well to insulin. They can't easily take up enough glucose from your blood.
• Gestational diabetes. This is a form of diabetes that develops during pregnancy. It happens when your body can't make the extra insulin it needs during pregnancy.

The different types of diabetes have different causes:

• Researchers think type 1 diabetes is caused by genes and factors in the environment that might trigger the disease.
• Type 2 diabetes is caused by several factors, including lifestyle factors and genes. The lifestyle factors include not being physically active and being overweight or having obesity.
• Researchers think gestational diabetes is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.

The different types of diabetes have different risk factors:

• You can develop type 1 diabetes at any age, but it most often starts in childhood. Having a parent or sibling with type 1 diabetes may increase your chance of developing it.
• You are at higher risk of developing type 2 diabetes if you:
• Are overweight or have obesity.
• Are over age 35. Children, teenagers, and younger adults can get diabetes, but it is more common in middle-aged and older adults.
• Have a family history of diabetes.
• Have prediabetes. This means that your blood glucose is higher than normal, but it's not high enough to be called diabetes.
• Had gestational diabetes.
• Have given birth to a baby weighing 9 pounds or more.
• Are African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander.
• Are not physically active.
• Have certain other health conditions, such as high blood pressure or polycystic ovary syndrome (PCOS).
• You are at higher risk of developing gestational diabetes if you:
• Are overweight or have obesity.
• Have a family history of diabetes.
• Had gestational diabetes in a previous pregnancy.
• Have given birth to a baby weighing 9 pounds or more.
• Have polycystic ovary syndrome (PCOS).
• Are African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander.

The symptoms of diabetes may include:

• Feeling very thirsty
• Feeling very hungry
• Urinating (peeing) more often, including at night
• Fatigue
• Blurry vision
• Numbness or tingling in the feet or hands
• Sores that do not heal
• Losing weight without trying

But it's important to know that your symptoms may vary, depending on which type you have:

• The symptoms of type 1 diabetes usually come on quickly and can be severe.
• With type 2 diabetes, the symptoms often develop slowly, over several years. The symptoms can be so mild that you might not even notice them.
• Gestational diabetes often has no symptoms. If you do have symptoms, they may be mild. If you are pregnant, you will usually be screened for this condition between 24 and 28 weeks of pregnancy.

To find out if you have diabetes, your health care provider will use one or more glucose blood tests. There are several types, including the A1C test.

Treatment for diabetes involves managing your blood glucose levels:

• If you have type 1 diabetes, you will need to take daily doses of insulin, either by injection or through a special pump. Some people also need to take another type of diabetes medicine that works with insulin.
• If you have type 2 diabetes, you may be able to manage or even reverse it by making lifestyle changes. These include eating a healthy diet, staying at healthy weight, and getting regular physical activity. Some people also need to take diabetes medicines to manage their diabetes.
• If you have gestational diabetes, you may be able to lower your glucose levels by eating a healthy diet and getting regular exercise. But be sure to talk to your provider about your treatment options. Gestational diabetes usually goes away after you give birth. But you will have a higher risk of developing type 2 diabetes later.

Checking your blood glucose levels is also an important part of managing your diabetes. Ask your provider about the best way to check your blood glucose level and how often you should check it.

Type 1 diabetes can't be prevented.

You may be able to delay or prevent type 2 diabetes through the same lifestyle changes that are used to manage diabetes (eating a healthy diet, staying at a healthy weight, and getting regular physical activity). These lifestyle changes may also help prevent gestational diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Infertility means not being able to get pregnant after at least one year of trying (or 6 months if the woman is over age 35). If a woman keeps having miscarriages, it is also called infertility. Female infertility can result from age, physical problems, hormone problems, and lifestyle or environmental factors.

Most cases of infertility in women result from problems with producing eggs. In primary ovarian insufficiency, the ovaries stop functioning before natural menopause. In polycystic ovary syndrome (PCOS), the ovaries may not release an egg regularly or they may not release a healthy egg.

About a third of the time, infertility is because of a problem with the woman. One third of the time, it is a problem with the man. Sometimes no cause can be found.

If you think you might be infertile, see your doctor. There are tests that may tell if you have fertility problems. When it is possible to find the cause, treatments may include medicines, surgery, or assisted reproductive technologies. Happily, many couples treated for infertility are able to have babies.

Dept. of Health and Human Services Office on Women's Health

Your bones help you move, give you shape and support your body. They are living tissues that rebuild constantly throughout your life. During childhood and your teens, your body adds new bone faster than it removes old bone. After about age 20, you can lose bone faster than you make bone. To have strong bones when you are young, and to prevent bone loss when you are older, you need to get enough calcium, vitamin D, and exercise. You should also avoid smoking and drinking too much alcohol.

Bone diseases can make bones easy to break. Different kinds of bone problems include:

• Low bone density and osteoporosis, which make your bones weak and more likely to break
• Osteogenesis imperfecta makes your bones brittle
• Paget's disease of bone makes them weak
• Bones can also develop cancer and infections
• Other bone diseases, which are caused by poor nutrition, genetics, or problems with the rate of bone growth or rebuilding

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical condition such as alcoholism, a tumor, or a stroke. Other causes may include toxins, chemicals, and viruses. Sometimes the cause is unknown.

Degenerative nerve diseases include:

• Alzheimer's disease
• Amyotrophic lateral sclerosis
• Friedreich ataxia
• Huntington's disease
• Lewy body disease
• Parkinson's disease
• Spinal muscular atrophy

Degenerative nerve diseases can be serious or life-threatening. It depends on the type. Most of them have no cure. Treatments may help improve symptoms, relieve pain, and increase mobility.

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

Some people already have diabetes before they get pregnant. But others may develop diabetes during pregnancy. This type of diabetes is called gestational diabetes. It usually develops around the 24th week of pregnancy. It happens when your body can't make the extra insulin it needs during pregnancy. Researchers think gestational diabetes is caused by the hormonal changes of pregnancy, along with genetic and lifestyle factors.

Anyone who is pregnant could develop gestational diabetes. But you are more likely to develop it if you:

• Are overweight or have obesity
• Have a family history of diabetes
• Had gestational diabetes in a previous pregnancy
• Have given birth to a baby weighing 9 pounds or more
• Have polycystic ovary syndrome (PCOS)
• Are African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander person

Gestational diabetes often has no symptoms. If you do have symptoms, they may be mild, such as being thirstier than normal or having to urinate (pee) more often.

If you are pregnant, you will most likely be screened for gestational diabetes between 24 and 28 weeks of pregnancy. But if you have an increased chance of developing gestational diabetes, you may be tested during your first prenatal visit. Your health care provider will use one or more blood glucose tests to check for gestational diabetes. You may have the glucose challenge test, the oral glucose tolerance test (OGTT), or both.

For these two tests, you will drink a sugary liquid and wait for an hour before your blood sample is taken. If you have an oral glucose tolerance test, you will also get your blood drawn after 2 and 3 hours.

Having diabetes during pregnancy can affect your health. For example:

• You are more likely to develop preeclampsia, a serious medical condition that causes a sudden increase in your blood pressure.
• You are more likely to need a cesarean delivery, because your baby is more likely to be bigger than average.
• Changes to your hormones and your body during pregnancy can affect your blood glucose levels. If you had diabetes before pregnancy, you may now need to adjust your meal plan, physical activity routine, and/or medicines. If you have any diabetes health problems, they may get worse during pregnancy.
• Gestational diabetes usually goes away after you have your baby. But you will be at higher risk of developing type 2 diabetes later.

Having diabetes during pregnancy can also affect the health of your developing baby:

• If you have high blood glucose levels at the beginning of your pregnancy, there is a higher risk of birth defects.
• Your baby will be at risk for obesity and type 2 diabetes later in life.
• Your baby is more likely to be born early.
• Your baby may have breathing problems or hypoglycemia (low blood glucose levels) right after birth.
• There is a higher risk of miscarriage and stillbirth.

There are steps you can take to manage your diabetes before, during, and after pregnancy.

If you already have diabetes, the best time to control your blood glucose is before you get pregnant. High blood glucose levels can be harmful to your developing baby during the first weeks of pregnancy, even before you know you are pregnant. See your provider to help you plan for pregnancy. You can talk about how to lower the risk of health problems for you and your developing baby. You can also discuss your diet, physical activity, and which diabetes medicines are safe during pregnancy.

During your pregnancy, you will work with your provider to manage your blood glucose levels. You may be able to manage them with a healthy diet and regular physical activity. If that's not enough, then you will need to take diabetes medicines. It's also important that you:

• Get regular prenatal checkups
• Take your prenatal vitamins
• Don't use harmful substances such as alcohol, tobacco, and illegal drugs

After pregnancy, there are steps you need to take to stay healthy:

• If you had gestational diabetes, you are at risk of developing type 2 diabetes. You will be tested for it within 4 to 12 weeks after giving birth. Even if your blood glucose levels have returned to normal, you will need to get them tested every 1 to 3 years.
• If you already had diabetes before pregnancy, you and your provider will monitor changes to your blood glucose levels. They will tell you if you need to adjust your diabetes management plan.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Type 2 diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your main source of energy. It comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. If you have diabetes, your body doesn't make enough insulin or doesn't use insulin well. The glucose then stays in your blood and not enough goes into your cells.

Over time, having too much glucose in your blood can cause health problems. But you can take steps to manage your diabetes and try to prevent these health problems.

Type 2 diabetes may be caused by a combination of factors:

• Being overweight or having obesity
• Not being physically active
• Genetics and family history

Type 2 diabetes usually starts with insulin resistance. This is a condition in which your cells don't respond normally to insulin. As a result, your body needs more insulin to help the glucose enter your cells. At first, your body makes more insulin to try to get cells to respond. But over time, your body can't make enough insulin, and your blood glucose levels rise.

You are at higher risk of developing type 2 diabetes if you:

• Are over age 45. Children, teenagers, and younger adults can get type 2 diabetes, but it is more common in middle-aged and older people.
• Have prediabetes, which means that your blood glucose is high for you but not high enough to be called diabetes
• Had diabetes in pregnancy or gave birth to a baby weighing 9 pounds or more.
• Have a family history of diabetes
• Are overweight or have obesity
• Are Black or African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
• Are not physically active
• Have other conditions such as high blood pressure, heart disease, stroke, polycystic ovary syndrome (PCOS), or depression
• Have low HDL (good) cholesterol and high triglycerides
• Have acanthosis nigricans - dark, thick, and velvety skin around your neck or armpits

Many people with type 2 diabetes have no symptoms at all. If you do have them, the symptoms develop slowly over several years. They might be so mild that you do not notice them. The symptoms can include:

• Increased thirst and urination
• Increased hunger
• Feeling tired
• Blurred vision
• Numbness or tingling in the feet or hands
• Sores that do not heal
• Unexplained weight loss

Your provider will use blood tests to diagnose type 2 diabetes. The blood tests include:

• A1C test, which measures your average blood glucose level over the past 3 months.
• Fasting plasma glucose (FPG) test, which measures your current blood glucose level. You need to fast (not eat or drink anything except water) for at least 8 hours before the test.
• Random plasma glucose (RPG) test, which measures your current blood glucose level. This test is used when you have diabetes symptoms and the provider does not want to wait for you to fast before having the test.

Treatment for type 2 diabetes involves managing your blood glucose levels. Many people are able to do this by living a healthy lifestyle. Some people may also need to take medicine:

• A healthy lifestyle includes following a healthy eating plan and getting regular physical activity. You need to learn how to balance what you eat and drink with physical activity and diabetes medicine, if you take any.
• Medicines for diabetes include oral medicines, insulin, and other injectable medicines. Over time, some people will need to take more than one type of medicine to control their diabetes.
• You will need to check your blood glucose regularly. Your provider will tell you how often you need to do it.
• It's also important to keep your blood pressure and cholesterol levels close to the targets your provider sets for you. Make sure to get your screening tests regularly.

You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. If you have a condition which raises your risk for type 2 diabetes, managing that condition may lower your risk of getting type 2 diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

The average person has 5 million hairs. Hair grows all over your body except on your lips, palms, and the soles of your feet. It takes about a month for healthy hair to grow half an inch. Most hairs grow for up to six years and then fall out. New hairs grow in their place.

Hair helps keep you warm. It also protects your eyes, ears and nose from small particles in the air. Common problem with the hair and scalp include hair loss, infections, and flaking.

A health problem in pregnancy is any disease or condition that could affect your health or the health of your fetus. Some health problems may make it more likely that you will have a high-risk pregnancy. A high-risk pregnancy is one in which you, your fetus, or both are at higher risk for health problems than in a typical pregnancy.

But just because you have health problems, it doesn't mean that you, or your fetus, will have a problem during the pregnancy. Taking care of yourself and getting early and regular prenatal care from a health care provider may help you reduce pregnancy risks from health problems.

Every pregnancy has some risk of problems, but your lifestyle, as well as factors like certain conditions and health issues, can raise that risk, such as:

• A health condition you had before you got pregnant
• A health condition you develop during pregnancy
• A pregnancy with more than one baby
• A health problem that happened during a previous pregnancy and could happen again
• Substance use during pregnancy
• Being over age 35

Any of these can affect your health, the health of your fetus, or both.

Every pregnancy is different. If you have specific risks in one pregnancy, it doesn't mean that you will have them in another. But, if you have a chronic condition, you should talk to your provider about how to minimize your risk before you get pregnant. Once you are pregnant, you may need a health care team to monitor your pregnancy. Some common conditions that can complicate a pregnancy include:

• High blood pressure
• Polycystic ovary syndrome (PCOS)
• Kidney problems
• Autoimmune disorders
• Thyroid disease
• Obesity
• HIV
• Cancer
• Infections

Other conditions that may make pregnancy risky can develop during pregnancy - for example, gestational diabetes and Rh incompatibility.

You may be able to lower your risk of certain health problems by making healthy lifestyle changes before you get pregnant. These can include reaching a healthy weight, not smoking, and managing any health conditions.

However, health problems during pregnancy are not always preventable. Some chronic conditions can be treated and controlled, while others aren't treatable and carry a higher risk than usual, even if the health problem is well-managed.

Share your symptoms with your provider for early detection and treatment of health problems. Sometimes, it's hard to know what's normal. Some symptoms, like nausea, back pain, and fatigue, are common during pregnancy, while other symptoms, like vaginal bleeding or a severe or long-lasting headache, can be signs of a problem. Call your provider to let them know if something is bothering or worrying you.