Understanding Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome commonly known as PCOS is a condition in which the ovaries produce an abnormally high amount of androgens. These are male sex hormones that are usually present in women in small amounts. The condition affects women during their childbearing years (ages 15 to 44) and often goes undetected in many women. Despite its name, not all women with the disorder develop multiple small cysts in the ovaries. 

PCOS 2

Causes of PCOS

While the exact cause of PCOS is not clear, many women with the condition have insulin resistance. This means the body is unable to use insulin properly resulting in a build up of insulin levels. This may cause higher androgen levels. Obesity is a major cause of insulin resistance and make PCOS symptoms worse.

Sometimes PCOS may also run in families, where sisters or mother and daughters have it. Additionally, low-grade inflammation is also common in women with PCOS, which stimulates polycystic ovaries to produce androgens. 

Symptoms of PCOS

Symptoms of PCOS may appear at different stages of a woman’s life. Some women start seeing symptoms around the time of their first period. Others only discover them when they have gained a lot of weight or have difficulty getting pregnant. Not all women with PCOS will have all of the symptoms, and each symptom can vary from mild to severe. 

Symptoms of PCOS may include:

  • Missed, irregular or very light periods
  • Abnormally heavy periods
  • Ovaries that are large or have many cysts
  • Difficulty getting pregnant (infertility)
  • Excess body hair, including on the chest, stomach and back
  • Weight gain, especially around the abdomen
  • Acne or oily skin
  • Male-pattern baldness or thinning hair
  • 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

Getting it checked

If you suspect that you may have PCOS, fix an appointment with your gynaecologist or endocrinologist to get it checked. Most cases can be diagnosed with a thorough evaluation of your medical history and symptoms, as well as a physical examination.

A blood test may be required to check the levels of various hormones, including androgen. In some cases, an ultrasound of the ovaries to check for cysts may help with diagnosis. 

Treatment of PCOS

Treatment of PCOS is highly dependent on your goals and symptoms.

If you are trying to become pregnant, oral or injected fertility medications may be needed. Those who don’t want to become pregnant, may consider birth control pills or progesterone supplementation to regulate periods. 

There is also a non-hormonal treatment option, which is a medication usually used for diabetes. This medication may help restore fertility and assist weight loss.

Other medications are available to manage unwanted hair growth and acne. 

Surgery can be an option to improve fertility if other treatments don’t work. A procedure called ovarian drilling makes tiny holes in the ovary to restore normal ovulation. 

Lifestyle changes

Making certain changes to your lifestyle can also help relieve some of the symptoms of PCOS and prevent further complications. These may include:

  • A change in diet. Eating a low-calorie, nutritious diet can help if you need to lose weight and lower blood glucose levels. Limit starchy or sugary foods and increase your fibre intake. Losing just 5 to 10 percent of your body weight can help regulate your menstrual cycle and improve PCOS symptoms. 
  • Exercise. Regular physical activity will also help with weight loss and blood glucose regulation. Try to engage in 30 minutes of moderate-intensity exercise at least 3 days a week. 
  • Maintain a healthy weight. Weight loss can reduce insulin and androgen levels and may restore ovulation. Work with your doctor and dietitian to develop a weight-loss plan to reach a healthy weight and maintain it. There are also medications that can help with weight loss if needed.

PCOS is a common yet underdiagnosed condition among women. Lifestyle interventions and medications are available to treat the condition. With proper management, symptoms of PCOS can be alleviated and normal menstrual cycles restored, making pregnancy a possibility.

 

References:

  1. Johns Hopkins Medicine. Polycystic Ovary Syndrome (PCOS). Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos Accessed 3 September 2021.
  2. Healthline. Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment. Available at: https://www.healthline.com/health/polycystic-ovary-disease#causes Accessed 3 September 2021. 
  3. NHS. Polycystic ovary syndrome. Available at: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/ Accessed 3 September 2021.
  4. WebMD. Polycystic Ovary Syndrome (PCOS). Available at: https://www.webmd.com/women/what-is-pcos Accessed 3 September 2021.

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