A Question of Health: Polycystic ovaries, polio jabs for India

I have had an ultrasound scan recently that showed polycystic ovaries. When I looked up polycystic ovary syndrome on the internet, I found that it also includes a number of other symptoms (which I do not have), including excess body hair, irregular periods, infertility and acne. My question is this: is it possible to have polycystic ovaries without having polycystic ovary syndrome?

Is my scan correct?

I have had an ultrasound scan recently that showed polycystic ovaries. When I looked up polycystic ovary syndrome on the internet, I found that it also includes a number of other symptoms (which I do not have), including excess body hair, irregular periods, infertility and acne. My question is this: is it possible to have polycystic ovaries without having polycystic ovary syndrome?

Many women – perhaps as many as one in every five – have multiple cysts on their ovaries. The number of women who have polycystic ovary syndrome (PCOS), however, is much smaller. Women who have small cysts on their ovaries are not usually unwell in any way. The cysts are usually noticed coincidentally on an ultrasound scan that is being done for some other reason. The wide availability of ultrasound scanners has made it possible to look at the ovaries of many millions of women during the past 20 years. One study of healthy women in Finland showed that 20 per cent of women under the age of 35 had multiple cysts on their ovaries. These women did not have PCOS, they simply had cysts on their ovaries.

The ovary normally produces small cysts as part of its process of releasing eggs every month. If you do not have the other symptoms of PCOS – irregular periods, fertility problems, acne and hairiness – you do not have PCOS. The simple answer to your question is yes: many women have polycystic ovaries without having a condition called polycystic ovary syndrome.

Should i have a polio jab?

We are travelling to India for Easter and I have had conflicting advice about immunisations. I am particularly concerned about whether the whole family needs to be immunised against polio. We all had our jabs as children, and the youngest member of our family is now 18. I have heard that the risk of getting polio is greater from the vaccine than from the disease.

Polio has been almost completely eradicated from the face of the earth, but there are a few pockets where the disease is still found, and India is one of them. In 2002 there were about 1,500 cases of polio in India. This accounted for 85 per cent of all the cases in the world last year. There was a particularly severe outbreak in the Indian state of Uttar Pradesh, which had more than 500 cases.

Until polio is completely eradicated, the only sensible advice is to continue to be immunised. The risk of getting polio is obviously small, but it is such a devastating disease that even one case is one too many. It is true that there is a tiny risk of catching polio from the oral vaccine. The risk of this happening to healthy adults is less than one in a million. People who have caught polio from the vaccine are usually unimmunised adults who come into contact with a baby who has just been immunised. If you and your family have all been previously immunised, the risk of catching polio from a booster dose is vanishingly small.

People who have inadequate immune systems are also at higher risk of catching polio from the vaccine. I know of two people who caught polio while on holiday and are now permanently paralysed. My strong recommendation is to have a booster dose of the polio vaccine before you travel to India. At the same time you should make sure that you have had a tetanus booster within the past 10 years. You can discuss other immunisations, such as hepatitis A and typhoid, with a travel clinic. Don't bother with cholera vaccine, it's no longer available and it was pretty useless even when it was available. And don't forget malaria protection.

Have your say

Two more comments about phlegm and catarrh, from RM and GP:

Your reader's experience of chronic catarrh after a bout of influenza is exactly like mine. After 15 years of suffering and trying orthodox treatments I had the good fortune to visit Australia where I was advised by a medical herbalist to cut out all dairy products from my diet and drink nettle tea once a day. This alternative remedy worked.

After reading your replies about phlegm and catarrh, I feel obliged to add that the first symptom of mesothelioma (a malignant lung tumour) that my mother experienced was "catarrh" that wouldn't clear up. She was prescribed cough mixture and paracetamol.

Please send your questions and answers to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; or fax them to 020-7005 2182 or e-mail to health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions