Polycystic Ovary Syndrome

1 What Is Polycystic Ovary Syndrome (PCOS)?

Polycystic ovary syndrome, or PCOS, is an endocrine system disorder that usually affects women in the reproductive age bracket. It is a common medical condition faced by many women. PCOS is usually caused due to an imbalance in reproductive hormones. This imbalance in the hormones can lead to problems in the ovaries. In a normal, healthy state, the ovaries make the egg and release it every month as part of a healthy menstrual cycle, however, for those with PCOS, the egg may not completely develop as it should, or it does not get released during the ovulation process. Women suffering from PCOS have multiple cysts on their ovaries, hence the name polycystic ovary syndrome. These cysts are usually not considered harmful, but they can lead to an imbalance in hormones.

PCOS is characterized by the enlargement of the ovaries. These enlarged ovaries contain a collection of fluids in small amounts, called follicles. They are located in each of the ovaries, as can be seen while performing an ultrasound.

Women suffering from PCOS experience an irregular menstrual period or a missed period and, due to this irregularity in periods, it can lead to an inability to get pregnant, or infertility, and the development of cysts in the body.

Symptoms, such as excessive hair growth, irregular menstrual cycle, obesity, and acne may occur in women with the condition. In adolescents, suspicion for PCOS arises when menstruation becomes infrequent or absent.

While the cause is still unknown, early diagnosis can help minimize the risk of complications like heart disease and type 2 diabetes.

Women tend to realize they have PCOS when they reach their twenties or thirties. This is when they usually start having trouble bearing a child. But one should note that, after puberty, PCOS can happen at any age. There is no differentiation as to who specifically would get PCOS; women of all races and places are at risk of PCOS, however, the risk tends to increase if the individual is obese or if PCOS is hereditary, wherein someone in the family, such as the mother, sister, or aunt, also suffers from PCOS.

If treatment is not started on time, it can alter the way you look as well as worsen and cause other medical problems, such as diabetes and heart disease.

What Are Hormones and How Does PCOS Impact Them?

Hormones are chemical messengers which assist in various bodily processes, such as development and growth, along with energy production. Most of the time, one hormone signals another hormone to release in the body. When a woman has PCOS, the hormone balances are disturbed for reasons yet not understood. For instance, the sex hormone: In the usual process, the ovaries’ job is to make small amounts of male sex hormones, which are called androgens, but when a body is impacted by PCOS, the ovaries start to create androgen in large numbers. This in turn leads to an increase in acne, excessive hair growth on the face and certain other parts of the body, and the cessation of the ovulation process.

In some cases, the body has problems using insulin, which is also called insulin resistance. When the body does not make use of the required insulin in a proper manner, the sugar levels in the blood tend to rise. As time passes, the increase in sugar levels can lead to diabetes.

Symptoms

The symptoms of PCOS are usually mild in the initial phase and gradually worsen if not diagnosed or treated in a timely manner. Also, all the symptoms would not be experienced at first; initially, there would be just a few. The common symptoms a woman would experience are:

  • Weight gain
  • Increased acne on the face, chest, and upper back
  • Delay in menstrual period or irregular periods wherein there can be less than nine periods in a given year. In some cases, women would have periods alternately once in three months, or, in some cases, they would not have periods at all. Certain other women would experience heavy menstrual bleeding.
  • Due to persisting symptoms and the hormonal imbalance, women undergo mental changes, which could lead to depression.
  • Hair thinning on the scalp. This is quite common, but can also lead to other medical conditions. This pattern of thinning is also related to male pattern baldness.              
  • Issues relating to fertility wherein women diagnosed with PCOS have trouble getting pregnant or, if they are pregnant, it can lead to complications that need to be properly dealt with.
  • Excess hair growth on the face and other parts of the body. Similar to men, women would get thicker, darker hair on the face, such as below the chin and the sides of the cheek. There would also be thicker hair on the belly, back, and chest. This problem is also medically termed hirsutism, and it tends to affect at least seventy percent of women with PCOS.
  • Skin turning dark and pale, usually the creases around the neck, underneath the breast, and the groin.
  • Excess formation of skin flaps in the area around the armpits or neck region

Causes

The exact cause of PCOS is still not known, but there are various factors which are known to play some role in the condition:

  • Heredity: In some cases, this condition is carried through the genes. If a member of the family, such as the mother or a sister, has PCOS, one might also have an increased chance of getting the disorder.
  • Excess levels of insulin: Insulin is an important hormone produced by the pancreas. It allows the cells to use sugar, or glucose, to produce energy. Improper use of insulin, called insulin resistance, forces the pancreas to work harder to release more insulin so that glucose is available to the cells. Insulin generation in excess tends to affect the ovaries, which leads to an increase in the production of androgen, and it can impact and cause interference with the ovaries’ ability to ovulate and produce eggs.
  • Excess androgen production: Androgen are also called male hormones. Every woman has some amount of androgen present in the body. Androgen in women help control the development of male traits, such as baldness. However, in women who suffer from PCOS, the level of androgen tends to be higher than estrogen, which are the female hormones. Higher-than-normal androgen levels can also cause interference in the ovulation process and thus prevent the ovaries from releasing eggs for the reproductive process. It also leads to excess growth of hair and acne.

Diagnosis

There are different tests used to diagnose PCOS. The doctor will ask questions about one’s medical history, when the symptoms started to occur, and the frequency of periods, whether it is regular every month, alternates months, or if there is a long gap. The doctor will also ask if the bleeding is heavy or light and how many days it lasts.

The doctor will then conduct a physical examination to check for any signs pertaining to PCOS, such as growth of excess hair on the face and body, as well as high blood pressure. The weight and height of the individual will also be checked to calculate the body mass index and thus ascertain if the individual falls within a healthy BMI.

A number of tests would also be carried out in the lab, such as a blood test to check for sugar levels, insulin level, and other hormones in the body. With the help of a hormone test, the doctor can rule out the possibility of a thyroid disorder or problems related to other glands, since the symptoms in these cases are very similar to PCOS.

In certain cases, the doctor may ask for a pelvic ultrasound, wherein the doctor looks for any cysts present in the ovaries. PCOS can be diagnosed without an ultrasound, however, carrying out the test will help confirm the condition as well as rule out the possibility of any other medical problems.

Treatment

Currently, there is no cure for PCOS, however, certain medicines, therapies, changes in lifestyle, and exercise can help manage the symptoms to a great extent. These may reduce the unpleasant symptoms and also prevent any health problems for a longer duration of time.

  • Try to keep the body as active as possible. Walking is considered one of the best exercises and can be done anytime during the day. If possible, try to fit in light-to-moderate exercises as part of one’s daily routine, preferably in the morning.
  • Make changes in diet, such as opting for healthy foods. Include fresh fruits and vegetables in the diet, as well as seeds, nuts, whole grains, and beans. Remove foods that are high in saturated fats, such as fried foods, cheese, butter, and meats. Avoid the use of aerated drinks, too, since they can only harm the body.
  • Women suffering from PCOS tend to gain weight easily, since the metabolism rate drops down. Try to maintain an ideal weight. Losing weight will also help balance out the hormones and maintain a regular menstrual cycle every month. It also helps prevent many medical problems.
  • Avoid drinking alcohol and smoking, since they only cause more harm and worsen the condition. Women who smoke tend to have higher levels of androgen in the body, which is also one of the biggest contributors of PCOS symptoms.
  • It is very important to go in for regular check-ups with the doctor to ensure the body is responding to treatment. Regular blood tests are required to check for diabetes, high blood pressure, and other related problems.

Those dealing with PCOS may find it hard to deal with the symptoms, so one should not stress about appearance and instead look for ways to change the lifestyle. In such cases, positive thinking is a must to avoid depression and anxiety.

Below are certain types of medicine which can be used to treat this condition:

  • Anti-androgen medicine: These medicines block the impact of androgens and reduce hair loss as well as the growth of facial and body hair, along with healing acne. However, this medicine could lead to certain problems for those trying to conceive.
  • Hormonal birth control: Women who do not want to get pregnant at the moment can take birth control pills as recommended by the doctor. These medicines help bring the menstrual cycle back on track and make it more regular. They also lower the individual’s risk of endometrial cancer and improve acne, along with reducing facial and body hair.
  • Medicine for ovulation: If one is trying to get pregnant, the doctor can prescribe certain medicines, such as clomiphene, to help one ovulate. Clomiphene is an oral medicine that has to be taken in the first part of one’s menstrual cycle. If this medicine alone is not effective, the doctor may also prescribe metformin to induce ovulation. Before trying these medicines, though, it is important to work with a reproductive specialist and conduct regular ultrasounds to monitor progress and avoid any problems.
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