Polycystic Ovary Syndrome (PCOS) is a common hormonal and endocrine disorder that affects women of childbearing age. As the name suggests, it is a syndrome, not a disease. It affects the ovaries that are female reproductive organs responsible for producing eggs and hormones such as estrogen and progesterone.
PCOS is caused by an imbalance of reproductive hormones. It affects ovulation, and hence leads to fertility-related problems. Understanding the causes, symptoms, diagnosis, and treatment of PCOS is important to manage the condition effectively and improve the quality of life. According to a June 2023 update by World Health Organization, PCOS impacts an estimated 8–13 percent women in the reproductive age. Due to lack of awareness about the signs of PCOS, around 70 percent of affected women remain undiagnosed worldwide.
Some of its common symptoms include irregular periods, excess levels of androgen or the male sex hormone, ovarian cysts or enlarged ovaries. Due to its severe impact on menstrual health, PCOS has earned notoriety for being one of the leading causes of infertility.
A multidisciplinary approach, including lifestyle changes, medications and personalized treatment plans, can significantly improve the quality of life for those living with PCOS. It is essential for individuals experiencing symptoms of PCOS to consult with a healthcare professional for proper evaluation and guidance on managing this condition effectively.
Causes of Polycystic Ovary Syndrome (PCOS)
When it comes to causes of PCOS, experts are unable to pinpoint at one common factor. A combination of genetic and environmental factors are at play. As per studies, some potential factors contributing to PCOS include insulin resistance and obesity.
Insulin Resistance: When the cells become resistant to insulin, the body compensates by producing more insulin. This can lead to hormonal imbalances that give rise to PCOS.
Hormonal imbalances: PCOS involves an increase in the levels of male hormones androgens, as well as luteinizing hormone (LH), and decrease in follicle-stimulating hormone (FSH) and progesterone. These complicate menstrual regularity.
Genetics: Having a family member with a history of PCOS has been discussed as one of the causes of PCOS. But as per the European Journal of Endrocrinology, the genetic basis of PCOS is unknown and the mode of inheritance is uncertain.
Inflammation: There are several studies that haved linked to PCOS with chronic inflammation. Inflammation reportedly causes the ovaries to produce testosterone in excess in women, impacting metabolism and ovarian dysfunction.
Environmental factors: A person’s dietary and lifestyle choices have led PCOS to be referred to as a lifestyle disorder. Lack of physical inactivity, exposure to toxins may also be blamed in certain cases.
Key Facts About Polycystic Ovary Syndrome (PCOS)
Usually Seen In
Women of childbearing age
Women of normal weight may also have lean PCOS
Irregular menstrual periods
Excess production of androgens or male sex hormones
Thick uterine lining
Necessary Health Tests
Improve your diet
Adopt healthy lifestyle changes
Birth Control Pills
Medication for improving fertility
Symptoms of Polycystic Ovary Syndrome (PCOS)
PCOS can show in different people differently. Not all women will experience a the same set of symptoms. But it is important to know the symptoms of PCOS to be able to recognise it and go for early diagnosis.
Irregular menstrual periods: Irregular periods are often one of the first alarms for women. Anyone with PCOS may often experience delayed periods, early periods or even prolonged menstrual cycles.
Excess production of male sex hormones: A common occurence in women with PCOS, is the increased levels of male hormones or androgens. This can lead to symptoms such as acne, excessive hair growth on the face, chest, and back (also known as hirsutism) or even male-pattern baldness in some women.
Weight gain: PCOS may lead to increased accumulation of abdominal fat. It is linked to weight gain and women with PCOS may often find it tougher to lose weight.
Diabetes risk: Insulin resistance is already a key factor in PCOS. Since this condition involves ineffective response of body cells to insulin, it may lead women to experience high blood sugar levels and an increased risk of type 2 diabetes.
Infertility: This is one of the most menacing symptoms of PCOS. Due to hormonal imbalances and irregular ovulation, conceiving a child can become challenging for women. This not just takes a physical toll on them, but mental too.
Skin problems: PCOS may also give rise to acne, skin tags, skin darkening and even skin patches.
Ovarian cysts: While this may not be a visible symptom of PCOS, an ultrasound suggested by a medical expert, can detect small cysts on ovaries. But this may not be the case with every woman.
Thick uterine lining: Endometrial thickness may be part and parcel of PCOS, causing the fertility process to be more complicated. There is also a higher risk of miscarriage and pre-term delivery for some women.
Diagnosis of Polycystic Ovary Syndrome (PCOS)
If you are showing any signs and symptoms of PCOS, you must meet a gynaecologist or an endocrinologist who specialises in hormonal disorders. The medical expert will evaluate your medical history, conduct a physical examination and ask you to go for specific tests. You may be recommended the following:
1. Blood tests: Taking a blood test will help the expert measure your hormone levels. In case the cause of your menstrual issues and excessive androgen production is not PCOS, these blood tests may be able to pinpoint it. The doctor may even suggest tests for your cholesterol and glucose levels.
2. Pelvic exam: A physical exam of the pelvic region may help the medical expert to assess the health of your reproductive prgans. Any unusual growth may be a sign for more attention.
3. Ultrasound: Most medical experts may suggest you to undergo an ultrasound in case you showcase PCOS symptoms. It helps to detect ovarian cysts, any unusual thickening of the uterus lining or any other growth. This may be recommended from case to case.
4. Any other tests: PCOS also affects mental health in many people. It can lead to increased stress and likelihood of depression due to the symptoms. Depending on your line of thought, your healthcare provider may or may not recommend you to consult a mental health expert.
Treatment of Polycystic Ovary Syndrome (PCOS)
PCOS can be managed. It cannot be cured. This can depend on the symptoms, fertility plans and overall health of a person.
Improve your diet: Focus on including whole foods such as fruits, vegetables, whole grains, legumes, seeds, pulses and nuts in your diet. An ideal PCOS diet will include reduced consumption of refined carbohydrates such as sugars, white bread, white rice and all purpose flour that can impact sugar levels and raise insulin levels. Foods with anti-inflammatory properties – ranging from tomatoes, leafy veggies and greens, fatty fish and olive oil – may be good for you.
Adopt healthy lifestyle changes: Give up your sedentary lifestyle and adopt regular exercise, a balanced diet and weight management techniques. The Physical Activity Guidelines for Americans notes that an average adult requires a minimum of 150 minutes of moderate-intensity physical activity and 2 days of muscle strengthening activity. This can help to mitigate stress and manage weight. Check out: PCOS Guidelines 2023: 10 highlights by PCOS expert Dr Duru Shah
Birth Control Pills: A lot of medical experts may assign you oral contraceptives as a means to regulate menstrual cycles and reduce androgen levels. You may be given combination birth control pills that contain estrogen and progestin or progestin therapy. The hormonal pills may also help you solve issues such as acne and excess hair growth. But take these only under supervision and proper diagnosis by a doctor. Do not self-treat your PCOS with birth control pills as excess intake may affect you in the long run.
Medication for improving fertility: Many women may find out their PCOS diagnosis only after failed attempts at pregnancy. Improving their chancer of fertility often becomes their sole motive to manage PCOS. For women trying to conceive, there are a certain set of medications prescribed to stimulate ovulation. Check with your doctor about these medicines.
Surgery: In some severe cases, doctors may recommend laparoscopic ovarian drilling, a surgical procedure to reduce androgen production. It involves a doctor making a small cut in the lower tummy and passing a laparoscope (a long and thin microscope) to surgically treat the ovarian cysts or tissues that cause excessive production of androgens.Also read:7 expert-recommended tips to manage PCOS at home
Related Stories to Polycystic Ovary Syndrome (PCOS)
PCOS is a chronic condition, and there is no cure. However, with proper management and lifestyle changes, the symptoms can be effectively controlled.
Does PCOS only affect fertility?
No, PCOS can have broader health implications. It is associated with metabolic issues such as insulin resistance, which can further increase the risk of type 2 diabetes and cardiovascular diseases.
Does every woman with PCOS have ovarian cysts?
No, not all women with PCOS have ovarian cysts. The presence of cysts on the ovaries is just one of the diagnostic criteria.
Can PCOS be prevented?
Since the exact cause of PCOS is not fully understood, there are no specific preventive measures. However, maintaining a healthy lifestyle, including a balanced diet and regular exercise, may help reduce the risk of developing PCOS or manage its symptoms.