Polycystic Ovarian Syndrome (PCOS)
Introduction
Polycystic Ovarian Syndrome (PCOS) is a complex hormonal disorder that affects individuals with ovaries, primarily during their reproductive years. It is one of the most common endocrine disorders, impacting an estimated 5–10% of women worldwide. The condition derives its name from the presence of multiple fluid-filled sacs, or cysts, on the ovaries, though not all individuals with PCOS will exhibit this characteristic.
PCOS causes several little fluid-filled sacs to form around the ovary’s periphery. We term them cysts. There are immature eggs inside the tiny fluid-filled cysts. We call them follicles. The follicles don’t consistently release eggs.
PCOS’s precise etiology is uncertain. In addition to weight reduction, early identification and treatment may reduce the risk of long-term consequences including heart disease and type 2 diabetes.
What Is Polycystic Ovarian Syndrome (PCOS)?
An excess of hormones produced by your ovaries, the organ responsible for producing and releasing eggs, can lead to a hormonal imbalance known as polycystic ovarian syndrome( PCOS). When you have PCOS, your ovaries produce androgens in abnormally large quantities.
Your reproductive hormones go out of balance as a result. Because of this, individuals with PCOS frequently have irregular ovulation, missing periods, and irregular menstrual cycles. Anovulation, or the absence of ovulation, can cause small follicular cysts, which are fluid-filled sacs containing immature eggs, to appear on your ovaries on ultrasound. The term “ polycystic, ” still, doesn’t always relate to the presence of ovarian cysts.
One of the most conventional reasons for infertility in women and individualities designated female at birth( AFAB) is PCOS. It may also raise your chance of developing further medical disorders. Based on your symptoms and desire to conceive, your healthcare practitioner can treat PCOS.
Causes Of PCOS
- Genes
- Insulin resistance
- Low-grade inflammation
- Excess androgen
Genes: Research suggests that several genes may be linked to PCOS. A person’s record of PCOS may contribute to the progression of the disorder.
Insulin resistance: Insulin resistance, which occurs when cells are unable to utilize insulin as intended, affects up to 70 of women with PCOS.
To aid the body in using sugar from food as fuel, the pancreas creates the hormone insulin.
Insulin is needed more often by the body when cells are unable to utilize it correctly. Too much insulin is produced by the pancreas to promote healing. The ovaries respond to excess insulin by producing more male hormones.
Insulin resistance is largely caused by obesity. Your threat of type 2 diabetes can be increased by both insulin resistance and obesity.
Low-grade inflammation: When there’s an infection or damage, white blood cells produce chemicals. Polycystic ovaries generate androgens as a result of a form of low-grade, chronic inflammation that’s found in patients with PCOS. Problems with the heart and blood vessels may be affected by this.
Excess androgen: The ovaries may create a lot of androgen when a person has PCOS. Overproduction of androgen disrupts ovulation. This indicates that eggs aren’t frequently discharged from the follicles in which they grow and don’t develop regularly. Acne and hirsutism are other side effects of too much testosterone.
Symptoms Of PCOS
Some women own symptoms around the time of their initial menstrual cycle. Others only become aware that they’ve PCOS after experiencing difficulties becoming pregnant or after gaining a significant amount of weight.
PCOS has a range of symptoms. PCOS is diagnosed when at least two of these are present.
- Irregular periods
- Abnormal hair growth
- Acne
- Obesity
- Darkening of the skin
- Cysts
- Infertility
- Weight gain
Unusual periods: Unusual periods include those that are missed or nonexistent. Significant bleeding during periods may similarly be a part of it.
Abnormal hair growth: In addition to having an overabundance of facial hair, you may also have hirsutism, or excessive hair growth on your arms, chest, and belly. Up to 70 of PCOS sufferers have this condition.
Acne: Acne is a side effect of PCOS, particularly on the face, chest, and back. It may be challenging to cure acne that persists after a minority.
Obesity: The percentage of obese PCOS patients who struggle to maintain a healthy weight ranges from 40 to 80.
Darkening of the skin: You could develop dark skin patches, particularly under your breasts, in the crotch( between your legs), armpits, and neck folds.
Cysts: On ultrasonography, many PCOS patients have enlarged ovaries or numerous follicles( egg sac cysts).
Infertility: Among AFAB individuals, PCOS is the most frequent cause of pregnancy. Being unable to conceive may be the result of irregular or infrequent ovulation.
When to see a doctor
See a physician if
- In addition to missing periods, you aren’t pregnant.
- PCOS is denoted by the rise of hair on your body and face.
- You have been unsuccessful in your attempt to conceive for over a time.
- Diabetes symptoms include impaired eyesight, excessive appetite or thirst, and inexplicable weight loss.
- However, don’t wait a year to get assessed by a professional, If you’re attempting to conceive and your periods are already irregular or nonexistent.
- Additionally, remember that irregular or nonexistent periods aren’t enough to prevent pregnancy if you don’t want to become pregnant.
- Even with these complications, pregnancy could still be feasible. In this situation, using contraception is the best option, even if you have PCOS.
- Make an appointment with your primary care physician on a regular basis if you have PCOS. To screen for diabetes, high blood pressure, and other potential problems, you’ll need to undergo routine testing.
Diagnosis
PCOS is often diagnosed by your healthcare professional following an examination and discussion of your symptoms. They could do an ultrasound or prescribe blood tests to aid in the diagnosis.
What your doctor will do is
- Discuss your symptoms and medical background with them.
- Find out about the health history of your biological family members.
- Take a blood pressure and weight reading.
- In particular, check for acne, discolored skin, skin markers, inordinate facial hair, and hair loss during a physical examination.
- Examine the pelvis to rule out any reasons for the unusual bleeding.
- Get blood tests to measure glucose and hormone levels.
- Check the thickness of your uterine lining, examine your ovaries, and search for further reasons for unusual bleeding by performing a pelvic ultrasound.
A doctor will Diagnose PCOS based on three Symptoms
- Irregular or missed periods.
- high androgen levels
- cysts in the ovaries
Treatment
PCOS symptoms like acne and hair growth can be treated with birth control tablets and other drugs that help manage the menstrual cycle.
- Birth control
- Metformin
- Clomiphene
- Hair removal medications
- Surgery
Birth control:
Daily progestin use can:
- return the hormone balance to normal.
- reduce symptoms including ovulation control and excessive hair growth.
- To prevent endometrial cancer
These hormones can be purchased as a vaginal ring, patch, or tablet.
Metformin: A medication called metformin (Glucophage, Fortamet) is used to treat type 2 diabetes. It also improves insulin levels, which helps treat PCOS.
In comparison to diet and exercise alone, one research revealed that using metformin in conjunction with these modifications increases weight loss, decreases blood sugar, and restores a regular menstrual cycle.
Clomiphene: A fertility medication called clomiphene (Clomid) can aid in the conception of children in PCOS patients.
Because clomiphene raises the risk of twins and other multiple births, it’s crucial to remember this while talking about family planning.
Hair removal medications: Hair growth can be inhibited or undesirable hair can be removed with a few treatments. Hair growth is slowed with the prescription medication eflornithine (Vaniqa) cream.
Surgery: If other methods of improving fertility are unsuccessful, surgery may be a possibility. Ovarian drilling is a technique used to re-establish regular ovulation by creating microscopic holes in the ovary using a laser or a thin, heated needle.
Complication
Among the PCOS complications are:
- Infertility.
- Pregnancy-related hypertension or gestational diabetes.
- Infertility or miscarriage
- Fat accumulation in the liver causes nonalcoholic steatohepatitis, a severe liver inflammation.
- High blood pressure, high blood sugar, and bad cholesterol or triglyceride levels are all part of metabolic syndrome, a group of diseases that greatly raise your risk of heart and blood vessel (cardiovascular) disease.
- Diabetes type 2 or prediabetes
- Apnoea in sleep
- Anxiety, depression, and eating problems
- One kind of cancer of the uterine lining is endometrial cancer.
PCOS is frequently associated with obesity, which can exacerbate its consequences.
Summary
A woman’s menstrual cycles may be disturbed by PCOS, which can also make pregnancy more difficult. Excessive male hormones can also cause undesirable side effects, such as facial and body hair development. Doctors typically advocate lifestyle changes as the initial line of therapy for PCOS, and they frequently have good results.
Losing weight can help with PCOS symptoms and increase the likelihood of becoming pregnant. Losing weight can be achieved by both aerobic activity and diet. If modifications in lifestyle are ineffective, medications may be used. Both metformin and birth control pills help alleviate PCOS symptoms and return menstrual periods to a more regular pattern.
FAQ’s
What is the main cause of PCOS?
Insulin resistance is common in PCOS-afflicted women. As a result, the body is unable to utilize insulin effectively. The body accumulates insulin, which can lead to elevated testosterone levels.
Can I live a normal life with PCOS?
While there is no cure for PCOS, there are some treatments that might lessen or eliminate uncomfortable symptoms. Without major difficulties, the majority of girls with PCOS can enjoy regular lives. Abnormalities of the reproductive system — PCOS’s precise cause is unclear.
What food to avoid in PCOS?
French fries, potato chips, corn chips, and fried fish or chicken are examples of fried dishes.
Red meat includes processed luncheon meat, hot dogs, roast beef, steaks, and hamburgers.
processed treats, such as pies, cakes, cookies, and candies
Can PCOS cause weight gain?
The inability to lose weight or increased body weight are two of the most prevalent signs of PCOS. PCOS and weight gain have a complicated relationship, although irregular hormone levels are a major factor for many people. Hormone treatment can assist some people in controlling the variables that contribute to weight gain.
What is the difference between PCOD and PCOS?
The ovaries begin to release immature eggs in PCOD, which causes hormonal imbalances and enlarged ovaries, among other symptoms; in PCOS, endocrine problems cause the ovaries to generate too much androgen, which increases the risk of cyst formation in eggs.
References:
- Polycystic ovary syndrome (PCOS) – Symptoms and causes. (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
- Polycystic ovary Syndrome (PCOS). (2024, December 2). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos
- Watson, S. (2023, February 26). Polycystic ovary Syndrome (PCOS): symptoms, causes, and treatment. Healthline. https://www.healthline.com/health/polycystic-ovary-disease