Polycystic ovary syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.
Ovulation occurs when a mature egg is released from an ovary. This happens so it can be fertilized by a male sperm. If the egg is not fertilized, it is sent out of the body during your period.
In some cases, a woman doesn’t make enough of the hormones needed to ovulate. When ovulation doesn’t happen, the ovaries can develop many small cysts. These cysts make hormones called androgens. Women with PCOS often have high levels of androgens. This can cause more problems with a woman’s menstrual cycle. And it can cause many of the symptoms of PCOS.
Treatment for PCOS is often done with medication. This can’t cure PCOS, but it helps reduce symptoms and prevent some health problems.
What causes PCOS?
The exact cause of PCOS is not clear. Many women with PCOS have insulin resistance. This means the body can’t use insulin well. Insulin levels build up in the body and may cause higher androgen levels. Obesity can also increase insulin levels and make PCOS symptoms worse. PCOS may also run in families. It’s common for sisters or a mother and daughter to have PCOS.
What are the risks for PCOS?
You may be more likely to have PCOS if your mother or sister has it. You may also be more likely to have it if you have insulin resistance or are obese.
What are the symptoms of PCOS?
The symptoms of PCOS may include:
- Missed periods, irregular periods, or very light periods
- Ovaries that are large or have many cysts
- Excess body hair, including the chest, stomach, and back (hirsutism)
- Weight gain, especially around the belly (abdomen)
- Acne or oily skin
- Male-pattern baldness or thinning hair
- Infertility
- Small pieces of excess skin on the neck or armpits (skin tags)
- Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts
How is PCOS diagnosed?
Your health care provider will ask about your medical history and your symptoms. You will also have a physical exam. This will likely include a pelvic exam. This exam checks the health of your reproductive organs, both inside and outside your body.
Some of the symptoms of PCOS are like those caused by other health problems. Because of this, you may also have tests such as:
- Ultrasound. This test uses sound waves and a computer to create images of blood vessels, tissues, and organs. This test is used to look at the size of the ovaries and see if they have cysts. The test can also look at the thickness of the lining of the uterus (endometrium).
- Blood tests. These look for high levels of androgens and other hormones. Your health care provider may also check your blood glucose levels. And you may have your cholesterol and triglyceride levels checked.
How is PCOS treated?
Treatment for PCOS depends on a number of factors. These may include your age, how severe your symptoms are, and your overall health. The type of treatment may also depend on whether you want to become pregnant in the future.
If you do plan to become pregnant, your treatment may include:
- A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.
- Medications to cause ovulation. Medications can help the ovaries to release eggs normally. These medications also have certain risks. They can increase the chance for a multiple birth (twins or more). And they can cause ovarian hyperstimulation. This is when the ovaries release too many hormones. It can cause symptoms such as abdominal bloating and pelvic pain.
If you do not plan to become pregnant, your treatment may include:
- Birth control pills. These help to control menstrual cycles, lower androgen levels, and reduce acne.
- Diabetes medication. This is often used to lower insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help you ovulate more regularly.
- A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.
- Medications to treat other symptoms. Some medications can help reduce hair growth or acne.
What are the complications of PCOS?
Women with PCOS are more likely to develop certain serious health problems. These include type 2 diabetes, high blood pressure, problems with the heart and blood vessels, and uterine cancer. Women with PCOS often have problems with their ability to get pregnant (fertility).
Living with PCOS
Some women struggle with the physical symptoms of PCOS, such as weight gain, hair growth, and acne. Cosmetic treatments, such as electrolysis and laser hair removal, may help you feel better about your appearance. Talk with your health care provider about the best ways to treat the symptoms that bother you.
When should I seek medical care?
If you have missed or irregular periods, excess hair growth, acne, and weight gain, call your doctor for an evaluation.
Important Facts and Research Regarding PCOS
- PCOS is a complex hormonal, metabolic and reproductive disorder that affects 1-in-10 women of childbearing age.
- PCOS is the leading cause of infertility in women.
- Women with PCOS constitute the largest group of women at risk for developing cardiovascular disease and type 2 diabetes.
- The National Institutes of Health (NIH) estimate more than 50% of women with PCOS will become diabetic or prediabtic before age 40.
- Some studies have shown women with PCOS to be at three times higher risk for endometrial cancer, two times higher risk for ovarian cancer, and two to four times higher risk for breast cancer.
- Some studies have shown due to symptoms of anxiety and depression, suicide attempts are up to seven times more common in women with PCOS than other women.
- Pre-teens and teens can develop PCOS. Earlier diagnosis can give them the opportunity to better manage the emotional, internal and physical effects of PCOS. It can also help them prevent the onset of more serious illnesses related to PCOS.
- Despite affecting millions of women and the serious health consequences, PCOS is unknown to most people and a staggering 50% of the women living with PCOS are going undiagnosed.
MYTH 1: PCOS Will Make You Obese
Although many women diagnosed with PCOS have spoken regarding their difficulty in losing weight, there is no research to prove this myth’s credibility. One of the basic symptoms of PCOS is insulin resistance, causing sugar levels to fluctuate greatly in a woman’s body. This fluctuation confuses the body making it touse existing energy. With regular physical activity and healthy nutrition, putting on weight or obesity can definitely be controlled. Considering today urban women lead a sedentary lifestyle and often pay least attention towards an exercise regime it can lead to complications.
MYTH 2: PCOS Will Affect Pregnancy
Since PCOS adversely affects the follicles and ovaries, it is taken for granted that the chances of conception is zero. Being diagnosed with PCOS is not an excuse to stop contraception. Women who have PCOS most certainly can have similar number of children without assistance like any woman. With advice and guidance from you gynaecologist, who can prescribe medicines to enhance ovulation, women with this condition can conceive. This myth has caused high levels of anxiety and panic among several women, which is completely unnecessary. Even if in certain cases natural pregnancy is difficult, there are high-end assisted reproductive technology available today to help result in a successful pregnancy. PCOS is definitely not an excuse to skip practicing safe sex or skip on contraception.
MYTH 3: PCOS Is Just About Menstrual Health, Nothing More
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Absolutely not! PCOS, if left untreated, can cause several complications in the heart and liver. In PCOS, the lipids go erratic, cholesterol becomes high and the blood pressure rises up as well. All these symptoms together can increase the risks of having a heart attack or a stroke (insulin risk + diabetic). PCOS patients, particularly those who are obese, must be screened for non-alcoholic liver fatty acids. PCOS also affects the thyroid glands and the adrenalin glands, if left unattended to. Unfortunately in some cases PCOS can also increase the risk of endometrial cancer and breast cancer. Therefore it is advisable to seek medical intervention early in life rather than prolonging the same.
MYTH 4: PCOS Can Be Self-Diagnosed
Irregular periods, mood swings, weight gainand acne are all common symptoms for PCOS. However, just because you are experiencing there does not mean you have PCOS. These can be caused due to various other possibilities like change of lifestyle, change of food habits, skin type and others. The only way to confirm if one has PCOS is by visiting the gynaecologist and getting it professionally checked. Most commonly an ultrasound is done to confirm the presence of PCOS.
PCOS can be found commonly in people who have family members previously diagnosed with the condition. The COVID-19 pandemic has raised stress levels that women with PCOS have been struggling a lot more and having a harder time getting by. A few things that can be done to control the condition and make sure you lead a healthy life is by practicing a healthy routine with adequate physical activity, right nutrition with a balanced diet, practicing yoga and meditation to control stress and balance your mental health and above all following a healthy sleep pattern. It is crucial that you not only follow these healthy practices, but also keep your doctor notified every time you see changes or new symptoms. This will allow the doctor to handle the situation carefully, prescribe the right medicines and give you better healthcare options and alternatives as found necessary. Although the condition has no cure, it can definitely be treated and brought under control with the right care and attention. Awareness and timely treatment are key to maintaining great health.
Sources:
https://www.pasobrewing.com/health-and-medical/all-about-pcos/
https://pcoschallenge.org/symposium/what-is-pcos/
https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
