Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder in which the balance of the two sex hormones estrogen and progesterone in women gets disturbed. Due to this hormonal imbalance, an ovarian cyst can form.
PCOS can affect a woman’s life in many ways: this can affect the menstrual cycle, fertility, heart function, and appearance.
Nowadays, Polycystic ovary syndrome is one of the main causes of decreased fertility.
The PCOS problem mainly occurs in women in the age group of 15 to 30 years. About 10% of women in India suffer from PCOS.
Yet the awareness about this problem is negligible, and women do not get it diagnosed for many years.
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Types of Polycystic Ovary Syndrome (PCOD)
- Insulin Resistant PCOS
This is the most common type of PCOS and is caused by insulin resistance – when the body becomes less effective against insulin and the blood sugar becomes unbalanced. Excessive insulin and leptin inhibit ovulation and stimulate the ovaries to make testosterone.
Insulin resistance is caused by excess obesity, sugar intake, smoking, trans fats, and environmental toxins.
- Immune-Related PCOS
The second type of PCOS is caused by chronic inflammation, which can be caused by several factors.
This inflammation inhibits ovulation (the production of eggs in the ovaries) and inhibits hormone receptors, stimulating adrenal gland androgens such as DHEA. Women who have had a family member who has had an immunodeficiency disease have a higher risk of developing this type of PCOS.
- Post-Pill PCOS
Slow-resuming periods will return to normal in most women about six months after stopping birth control pills; But in some, this blockage can last for years and may require treatment.
Controlling hormones with pills over a long period makes it difficult for the body to re-make estrogen and progesterone on their own, which leads to problems with ovulation.
- Environment PCOS
In this type of PCOS, an environmental (or other hormonal) imbalance interferes with the body’s ability to ovulate regularly. Trial and error methods have to be adopted to diagnose this type of PCOS, although once the diagnosis is made then it is easy to be treated.
In sensitive patients, certain foods can interfere with the body’s ability to make eggs by the ovaries.
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Symptoms of PCOS
Symptoms are mild in the beginning. Symptoms may seem minimal but symptoms may be severe. The most common symptoms are:
- Acne, Weight gain or trouble losing weight
- Excessive hair on face and body. Often women have thick and dark hair on their face, abdomen, navel, and back.
- Hair loss
- Menstrual irregularities
- Problems with fertility
It is not necessary that above list problems are happening because of PCOS but other factors may also play.
Causes of PCOD (PCOS)
The exact cause of PCOS is unknown, although doctors believe that hormonal imbalances and genetic problems play a role in it.
Women whose mother or sister has had PCOS are more likely to develop this condition.
Overproduction of androgen hormones can also be a factor. Androgen is a male sex hormone that is also produced in the body of women.
Women with PCOS often produce higher-than-normal levels of androgens. It can affect the development and release of eggs during ovulation. Excess insulin (a hormone that helps convert sugars and starches into energy) may cause higher androgen levels.
Prevention of PCOS (PCOD)
PCOS cannot be prevented, but with timely diagnosis and treatment, long-term complications such as decreased fertility, metabolic syndrome, obesity, diabetes, and heart disease can be avoided.
- PCOS Test
There is no one specific test to diagnose PCOS. Your doctor may discuss your medical condition, past medical problems, a physical exam, and several different tests to help diagnose this and find out other reasons for your symptoms.
- Physical Exam:
Your doctor will take measurements of your blood pressure, body mass index (BMI), and waist. They will check for excess hair, acne, or skin discoloration on the skin of the face, chest, or back. Doctors also consider hair loss or other symptoms, such as an enlargement of the thyroid gland.
- Pelvic Exam:
To check for extra male hormones or to see if the ovaries are enlarged or swollen, doctors do a pelvic exam.
- Pelvic Ultrasound:
In this test, the ovaries are examined using sound waves to see if any cysts have formed and the lining of the uterus is also examined.
- Blood Tests:
Doctors check the rate of male hormones by doing a blood test.
The doctor may also check the cholesterol rate and diabetes.
Once diagnosed that you don’t have these symptoms due to another problem, Doctors diagnose PCOS if you have two of the following symptoms:
- irregularity in the menstrual cycle
- Signs of having more male hormones than normal
- Multiple cysts in the ovaries (in one or both).
Treatment of PCOS (PCOD)
PCOS cannot be completely cured but as a part of treatment it can be prevented.
Treatment focuses on controlling the symptoms and managing the condition so that complications can be avoided. The course of treatment will vary depending on the specific symptoms the women have individually.
Measures to control symptoms:
- Eat a healthy diet:
Every woman suffering from PCOS should eat a healthy diet and exercise regularly, especially those who are overweight. This will help regulate the menstrual cycle and lower the blood glucose rate.
- Take birth control pills:
If you are not planning for pregnancy then you can take a birth control pill as per the advice of the doctor.
These can treat acne, regulate the menstrual cycle, and reduce the level of male hormones, such as testosterone, in the body. Fertility drugs may be prescribed for ovulation; if the woman has problems with fertility.
Medicine is prescribed as per the conditions and symptoms and it is not advisable to take medicine without the doctor’s advice.
Surgery may also be used to treat PCOS in some women. Ovarian drilling is a procedure in which the doctor makes a hole in the ovary with the help of a small needle, which carries an electric current and the affected part is destroyed. This is a short-term remedy to increase ovulation and reduce male hormones. In severe cases, cysts can also be removed by cystectomy.
Risks and Complications of Polycystic Ovary Syndrome
Women with PCOS have a higher risk of developing the following problems:
- High BP (hypertension)
- High cholesterol anxiety and depression
- Trouble breathing while sleeping (Sleep Apnea)
- Endometrial Cancer
- Heart attack diabetes
- Breast Cancer
If you become pregnant, doctors may recommend that you seek treatment from a doctor who specializes in high-risk pregnancies. Women who have PCOS have an increased risk of miscarriage, gestational diabetes, or premature labor. They may need to be monitored more during pregnancy.
The sooner PCOS is diagnosed and treated, the lower the risk of complications.
(Disclaimer: The information in this part of the article is for educational purposes only. All results must be clinically correlated with patient data in order to make an accurate diagnosis.)
- Enrico Carmina Rogerio A. Lobo Polycystic Ovary Syndrome (PCOS): Arguably the Most Common Endocrinopathy Is Associated with Significant Morbidity in Women. The Journal of Clinical Endocrinology & Metabolism, Volume 84, Issue 6, 1 June 1999, Pages 1897–1899
- Rotterdam ESHRE/ASRM. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004 Jan;81(1):19-25. PMID: 14711538