Polycystic ovary syndrome, in short, called PCOS is a health condition associated with hormonal imbalance. It is common among women of reproductive age. PCOS can impact your fertility ie ability to have a child. PCOS can cause irregular, missed, or more extended menstrual periods. It can also lead to excess androgen levels (male hormone), excessive hair growth in the areas where it is not generally found, acne, infertility, and weight gain. The ovaries may have numerous small collections of immature ovarian follicles- which can appear as cysts on medical imaging. Although in many cases women with PCOS do not have cysts.
Usually, ovarian follicles contain egg cells, which are released during ovulation. ( Ovulation is the process in which a mature egg is released from the ovary. After its release the egg moves down the fallopian tube and stays there for 12 to 24 hours, where it can be fertilized) In polycystic ovary syndrome – due to abnormal hormonal levels – follicles remain immature to release eggs. Which may lead to infertility. These immature follicles get accumulated in the ovaries and generally fade away as the age progresses.
What causes PCOS?
The exact cause of PCOS is not clear. The following factors may have a role.
- Excess insulin- Insulin hormone is released by the pancreas to utilize sugar in the blood for the formation of energy for different body activities. But if your cells become resistant to the action of insulin- then sugar in your blood remains unutilized and there is an increase in the sugar levels in your blood. As a result, your body might produce more insulin. The excess insulin levels may increase the androgen levels- which may impact the ovulation process resulting in PCOS.
- Excess androgen levels – The ovaries may produce an excess amount of androgen hormones like- testosterone. This can lead to an irregular menstrual cycle, hirsutism ( growth of hair on unusual areas like- chest, back, or belly), and acne.
- Heredity– PCOS can run in families. Research suggests that certain genes might be responsible for PCOS. It’s common for sisters or a mother and daughter to have PCOS.
- Low-grade inflammation- Studies have shown that women with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens. This can further increase the risk of heart and blood vessels related issues.
What are symptoms of PCOS?
The symptoms of PCOS generally develop during the onset of the first period. But sometimes it may develop in later stages in response to substantial weight gain. Symptoms may include:
- Irregular menstrual cycle- missed periods, irregular periods, or very light periods.
- Large ovaries with cysts.
- Hirsutism- excess hair on the chest, stomach, and back.
- Gain in weight- mainly around the belly.
- Acne or oily skin
- Thinning of hair or baldness like males
- Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts.
- Pelvic pain
- Mood swings
In the case of obese women, symptoms are more severe.
What health complications are involved with Polyctstic ovary syndrome?
The health complications involved with PCOS vary from patient to patient. If you have PCOS and high levels of androgens, you are at increased risk of complications. Following are a few complications:-
Problems in getting pregnant– The ovulation process gets impacted due to cysts in the ovaries. As a result, a healthy egg is not available for fertilization by sperm. There is a problem in getting you pregnant. But chances are still there- seek the help of your gynecologist or Ayurveda specialist, which can guide you and prescribe you certain medicines to make it happen.
Higher insulin levels– Higher insulin levels in the blood may result in diabetes– which is the risk factor for cardiovascular diseases. Moreover, due to higher levels of sugar – more glucose is available to the liver to convert it into fats- which may result in fatty liver disease.
Other complications associated with PCOS may be:-
- Miscarriage or premature birth
- Gestational diabetes (gestation period is the period between conception and birth during which- an embryo or fetus gets developed in the uterus) or pregnancy-induced hypertension (high blood pressure).
- Non-alcoholic steatohepatitis- Inflammation in the liver with the accumulation of fats in the liver.
- Metabolic syndrome- a cluster of conditions, which includes high blood pressure, high blood glucose levels, and high cholesterol levels- that increase the risk of cardiovascular diseases.
- Sleep apnea
- Depression and anxiety
- Type-2 diabetes
- Abnormal uterine bleeding
- Endometrial cancer- cancer of the uterine lining
Which hormones are associated with PCOS?
The body makes different hormones to carry out various functions in your body. In case you have PCOS – your reproductive hormones are not in balance or are not being produced in optimum quantity. This may hamper the normal functioning of your ovaries as a result you may have missed or irregular periods, affecting your ability to conceive. The hormones associated with PCOS are:
- Androgen– These are male hormones but are present in small quantities in females also. In women with PCOS, there is an increase in androgen levels.
- Insulin– Insulin hormone is responsible for the utilization of blood glucose for the formation of energy by body cells for various body activities. If you have PCOS your body may not react to insulin in the normal way.
- Progesterone– In women with PCOS progesterone levels gets disturbed. Which results in abnormal menstrual periods or menopause symptoms. Progesterone is also responsible for the implantation of the fertilized egg in the uterus and for maintaining pregnancy.
When to consult a healthcare provider?
Consult your healthcare provider if you have problems related to your periods if you are unable to conceive, or have excess androgen-related issues like- hirsutism, acne, or male pattern baldness. Diagnosis of PCOS is made if you have at least two of the following signs:-
- Irregular periods– One of the most common signs of PCOS includes- irregular or prolonged periods. Consult your healthcare provider if you have fewer than 9 periods in a year, a lapse of more than 35 days in between periods, or have abnormally heavy periods.
- Excess androgen- In women with PCOS, generally have higher levels of androgen hormones, which may cause hirsutism ( excess facial and body hair), and severe acne or male pattern baldness.
- Polycystic ovaries– In case- you have PCOS. Your ovaries may get enlarged and contain follicles around the eggs. Normal functioning of ovaries gets hampered.
You should also consult your doctor if you have issues like- unexplained weight gain, mood changes, or changes in your hair or skin. They may or may not be related to PCOS. But may indicate- other serious health issues.
Diagnosis of PCOS
Based on your family and medical history and your symptoms- your doctor will do your physical examination. You may be advised to undergo some blood tests to measure your hormonal levels, blood glucose, and cholesterol levels. An ultrasound may be advised to look for cysts or tumors and to measure the lining of your uterus.
How PCOS is treated?
Treatment of PCOS is done by medications, Which help in reducing symptoms and further complications. Mainly treatment depends upon your symptoms, your age, and your willingness to get pregnant or not. If you are overweight- shedding even 5% to 10% of body weight can make feel better and may help the medications work better on you and may also improve your childbearing capabilities.
If you want to become pregnant, your treatment may include:-
Healthy lifestyle and healthy eating habits– Adopting a healthy lifestyle and healthy eating habits, and engaging yourself in physical activities can help you reduce your weight. This can help your body to utilize insulin in a better way and optimize your blood glucose levels. A healthy lifestyle and eating habits may help you ovulate.
Medications to cause ovulation- Medications prescribed by your healthcare provider may help your ovaries to release eggs normally. This sometimes may increase the chances of multiple births (twins or more). They may also overstimulate your ovaries. Which can cause abdominal bloating or pelvic pain.
If you do not want to be pregnant, your treatment may include:-
A healthy lifestyle and healthy eating habits– A healthy lifestyle with healthy eating habits helps to maintain a healthy BMI (body mass index). It also helps in better utilization of blood glucose levels- thus helping to normalize your ovulation cycle.
Birth control pills– Birth control pills under instructions by your healthcare provider may help to lower androgen levels, regularize periods, and reduce acne.
Antidiabetic medications– Antidiabetic medications as prescribed by your doctor may help in lowering insulin resistance in women with PCOS. It can also be useful in reducing increased androgen levels, hirsutism, and regularising ovulation periods.
Lastly- the key points:-
- PCOS is one of the most common hormonal problems in women of childbearing age.
- PCOS may cause irregular or missed periods, infertility, obesity, acne, and excess hair growth in women on body parts- where they are normally not found like- the face, belly, or back.
- Women having PCOS may not be able to ovulate, have higher androgen (male hormone) levels, and generally have many small cysts on their ovaries. ( in many cases women with PCOS do not have cysts).
- Women with PCOS are generally at increased risk of type- 2 diabetes, high blood pressure, heart-related diseases, and endometrial cancer.
- PCOS treatment depends upon – your willingness to get pregnant or not. Accordingly, the treatment is given.
For awareness purposes only.
For treatment- consult your healthcare provider.
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