What is PCOS?
PCOS stands for polycystic ovary syndrome. PCOS is a common endocrine system disorder and hormone disorder. It occurs mostly in the reproductive years and affects the fertility of women. It is characterized by excess production of male hormones (androgens), and prolonged or infrequent menstrual periods. PCOS has no cure and can lead to endometrial cancer, heart diseases, and diabetes if left unmanaged.
Signs and symptoms of PCOS might be hard to detect as PCOS is a complex disorder that occurs in various forms. Women affected by PCOS generally develop numerous follicles in the ovaries (small collections of fluid), which make the regular release of eggs difficult.
Even though the exact causes of PCOS are unknown, early diagnosis and timely treatment is known to reduce complications and painful PCOS symptoms. PCOS is generally treated by a gynecologist or a reproductive endocrinologist.
What are the symptoms of PCOS?
Symptoms of PCOS vary in most cases and can occur at any age between puberty and menopause. Ovarian cyst symptoms usually surface around puberty when menstrual cycles start to occur. However, in some cases, symptoms of PCOS may occur later in life due to various reasons including weight gain, metabolic abnormalities, and family history.
Some studies have shown that PCOS symptoms are more severe in women with higher body mass index. However, a diagnosis of polycystic ovarian disease is conducted when at least two of these following signs become apparent.
Early symptoms of PCOS
Irregular or prolonged menstrual cycles is among the most common PCOS symptoms. In some cases, women might have fewer than nine periods, or abnormally heavy periods annually.
Excessive production of androgen:
Excess body and facial hair (Hirsutism) can result from high levels of male hormone production. It also causes acute acne and male-pattern baldness. Androgen, the male hormone is present in both men and women. Its role in women and their fertility is also vital. However, excess androgens in women result in a host of PCOS symptoms. Hyperandrogenism or having excess androgen in women leads to excess facial hair, more follicles in the ovaries, and lack of ovulation (anovulation).
Women’s ovaries show signs of enlargement and contain follicles surrounding the eggs — the ovaries might become incapable to function regularly as a result of this.
Other PCOS symptoms:
- Unmanageable weight gain
- Fatigue and low energy levels
- Hair thinning on the head
- Unable to conceive naturally due to infertility
- Mood swings due to depression and anxiety
- Pelvic pain because of heavy bleeding during periods
- Frequent headaches
- Sleep apnea
Factors that influence polycystic ovarian syndrome and excess androgens
Overabundance of insulin
Insulin produced in the pancreas allows the cells to use sugar. However, if the cells become resistant to the action of insulin (insulin resistance), then blood sugar levels rise. As a compensatory mechanism, the body might produce more insulin. This excessive insulin production can cause an increase in the production of ‘androgen’ hormone that leads to difficulty ovulating.
Research suggests that the effects of inflammation in the body are linked to excess production of androgens. In inflammatory conditions, white blood cells produce certain substances that tend to stimulate the production of androgens.
Studies show that there is a genetic link to PCOS. A woman whose mother or sister has PCOS is more likely to develop it.
Complications of Polycystic ovarian syndrome
Unmanaged or improperly managed PCOS can leads to numerous complications aside from painful PCOS symptoms. Thus it is important to recognize the early signs of PCOS and get a thorough evaluation with an endocrinologist.
- Premature birth or miscarriage
- Nonalcoholic fatty liver disease
- Metabolic syndrome — a cluster of medical problems including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increases the risk of cardiovascular disease
- Type 2 diabetes
- Sleep apnea
- Depression, eating disorder, anxiety
- Abnormal uterine bleeding
- Endometrial cancer (cancer of the uterine lining)
PCOS has no cure; however, the goal of treatment is to reduce the risk of type 2 diabetes, heart diseases, and other metabolic disorders. Treatment is also targeted to manage individual concerns such as infertility, obesity, Hirsutism and acne. Therefore, specific treatment might involve medication or lifestyle changes.
If the concern is about infertility, a weight loss treatment is recommended with the help of a low calorie diet along with moderate exercise activities. Even losing a 5 percent body weight helps improve PCOS symptoms.
If the concern is to regulate monthly menstrual cycle then the recommended treatment include:
Birth control pills for PCOS
A combination pill that contains estrogen and progestin helps to decrease the production of androgen and regulates estrogen. Regulating hormones can lower the risk of endometrial cancer and rectify abnormal bleeding, excess hair growth and acne. An alternate medication to pills is a skin patch or vaginal ring containing a combination of estrogen and progestin.
Fertility and PCOS treatments
To help ovulation the recommended treatment includes the use of medications like gonadotropins, diabetes medications, hormonal medications, and in-vitro fertilization.
Hirsutism treatment in PCOS
In order to treat women with excess body hair in PCOS, medications like antiandrogens are prescribed. Antiandrogens are androgen receptor blockers and are highly effective in moderate to severe presence of excess hair in PCOS. Medications like estrogen progestin compounds known as EPs are prescribed. However, it is known that antiandrogens are more effective in women with higher body mass index. Other medications include metformin, and combination of antiandrogens and EPs.
Coping with PCOS symptoms can be frustrating; however, taking proactive steps can help reduce the symptoms. Creating a food list of good/bad and sticking to it is probably one of the best ways to effectively lose weight. It can treat PCOS symptoms and improve the odds of getting pregnant.
Needless to say, if lifestyle changes aren’t effective then medication is an option. Birth control pills and metformin can both aid to bring back normal menstrual cycles and alleviate PCOS symptoms.