What is Polycystic Ovarian Syndrome (PCOS)?
• Polycystic Ovarian Syndrome (PCOS) is a condition affecting women’s endocrine system, which is responsible for regulating various body processes by secretion of hormones.
• It usually affects women during their childbearing years which adversely affects their ability to have a child.
• Women with PCOS may experience irregular menstrual cycle periods and produce excessive levels of male hormones known as androgen.
• PCOS causes the formation of small fluid-filled sacs in a woman’s ovaries.
• It can cause an outbreak of acne and also unwanted hair, and increase the risk of developing other health problems such as high blood pressure and diabetes.
What are the causes of Polycystic Ovarian Syndrome?
The exact cause of this condition remains unknown. However, some factors do influence the onset of this condition. They are:
Genetics: Research has found that some genes are linked to PCOS and that it may be hereditary.
Excess insulin: The pancreas produces insulin hormone to enable your body to utilize the sugar from the food for energy. If the cells become resistant to insulin, the blood sugar level rises, causing the body to produce more insulin. This excess insulin simulates the production of male hormones known as androgens, which can cause difficulties with ovulation.
Inflammation: Studies have shown that woman with PCOS are likely to have a low-grade inflammation that simulates the production of androgens, leading to heart and blood vessel complications.
What are the symptoms of PCOS?
The common signs and symptoms of this condition are:
• Hirsutism: Excessive hair growth is known as hirsutism. In other words, a woman might experience unwanted hair growth in areas such as face, chin, stomach and chest.
• Irregular Period: Infrequent or irregular periods due to lack of ovulation is one of the most prominent symptoms of PCOS. In some cases, a woman may get fewer than 8 or nine periods in a year.
• Baldness: Women with PCOS might see thinning hair on the scalp and hair loss.
• Acne: Due to the hormonal changes, a woman might develop oily skin with pimples and cause breakouts in areas like face, chest, back etc.
• Weight Gain: Most of the women with PCOS are overweight or obese.
• Headaches: Due to hormonal changes, a woman may experience frequent headaches.
• Darkened Skin: High insulin levels due to abnormal hormonal changes results in a skin condition known as acanthosis nigricans, which is characterized by dark, velvety patches of skin in the body creases like those on the neck and in the groin.
Some other symptoms which may occur include dandruff, problems falling asleep, feeling tired all the time, high cholesterol levels and blood pressure. With the exception of irregular periods, which is a definite symptom of PCOS, all the other symptoms may or may not be present.
How is PCOS diagnosed?
The doctor starts diagnosis for PCOS in case the patient exhibits any of the following symptoms:
• Hyperandrogenism, characterized by high levels of male hormones (androgens) present in the blood or external symptoms like acne, excess hair growth on face, chin or chest and male-pattern balding.
• Irregular periods
• Ovarian cysts
In order to correctly diagnose PCOS, the doctor needs to exclude other illnesses which exhibit similar symptoms of menstrual dysfunction, such as hypothyroidism. PCOS can be diagnosed through the following means:
Family History: Before starting the diagnosis, the doctor will take a full family history for any incidents of infertility and verify if the patient’s mother and/or sister exhibit signs of PCOS, and ascertain the patient’s menstrual cycle.
Physical Examination: The doctor checks the blood pressure, Body Mass Index (BMI) and also looks out for extra hair growth, acne and discolored skin. Physical examination also includes a pelvic exam where the doctor checks for any growths or abnormalities in the reproductive organs such as the ovaries or the uterus.
Ultrasound: An ultrasound may be taken in order to get a picture of the pelvic area and inspect the thickness of the lining of the uterus
Blood Tests: A small sample of the patient’s blood is taken to check the levels of cholesterol, sugar and hormones such as the Follicle-Stimulating Hormone, testosterone, estrogens and androgens. During this test, the doctor also checks the lipid profiles to check the levels of cholesterol and triglycerides and test the body’s response to insulin.
How is PCOS treated?
Treatment for PCOS consists of a few lifestyle changes as well as medical care.
Healthy Lifestyle: Following a healthy diet and exercising regularly is one of the best ways to treat PCOS. Losing just 5% to 10& of the body weight may help ease some symptoms of PCOS in obese women such as bringing blood sugar levels under control, preventing the onset of heart disease and regulating the ovulation. It is recommended to eat nutritious foods rich in fiber and indulging in regular physical activity.
Medication: Birth control pills and other medicines can help regulate the menstrual cycle and combat the symptoms of PCOS.
Taking hormones like progestin and estrogen can rectify the hormonal imbalance, regulate ovulation and alleviate common symptoms like acne, excess hair growth etc. However, oral contraceptives do have some level of risk for side-effects, so they should be taken in consultation with your doctor.
Metformin (Glucophage, Fortamet) is a drug that lowers insulin levels and is used to treat type 2 diabetes.
Fertility medications like clomiphene or injectable gonadotrphins such as follicle stimulating hormone (FSH), luteinizing hormone (LH) and fertility treatments like in-vitro fertilization (IVF) or inseminations can also be curative options for PCOS.
Hair removal medicines like Eflornithine that slows hair growth and procedures like laser hair removal and electrolysis can get rid of unwanted hair on the face and body.
Retinoids, anti-bacterial agents and antibiotics are some of the acne treatments available. It should be noted that women planning for pregnancy should not use retinoids as they can cause birth defects.
Surgery: If all other treatments have no effect, surgery can be an option to improve fertility. A process called ovarian drilling is a procedure that makes tiny holes in the ovary with a laser or a thin heated needle in order to restore normal ovulation.
PCOS adversely affects a woman’s menstrual cycle and make it harder for them to get pregnant. Therefore, it is recommended to visit your doctor if you have skipped periods, experienced other symptoms associated with PCOS and/or if you’ve been trying to get pregnant for a year or longer unsuccessfully.