What is PCOS?

Polycystic Ovarian Syndrome

PCOS or polycystic ovarian syndrome is a common endocrine disorder that is caused due to hormonal imbalances. It is a condition that leads to excess production of male hormones (androgen) in women.  It is characterized by irregular or no menstrual cycles in women of childbearing ages and is known to cause infertility.

Polycystic Ovarian Syndrome – An Endocrine Disorder

Polycystic ovarian syndrome is a complex disorder with various manifestations. That is why PCOS symptoms are varied. They appear in the form of acne, facial hair, irregular periods, infertility, and weight gain.

Polycystic ovarian syndrome is a very common endocrine disease in India and the world over. However, it is also the most misunderstood illness due to its various manifestations. Known to occur in 8 to 11% of women in their reproductive and childbearing ages, it is steadily on the rise in India due to changing lifestyles and obesity.

Starting in women as early as their adolescence, PCOS can even affect them immediately after puberty. It leads to a condition called anovulation, which means that there is no ovulation. This is a major cause for infertility in women.

Though there isn’t complete understanding of the underlying factors behind what causes PCOS, it is known to be an endocrine disorder. PCOS comes in various forms with many different symptoms. However, it is known that imbalances in luteinizing hormone (LH), insulin, and synthesis of androgen (male hormones that are produced in the ovaries) are the major causes of PCOS.

Undiagnosed PCOS

It is a fact that many women (up to 70%) suffer with undiagnosed PCOS. In a painful and complex condition like PCOS, due to the presence of multiple symptoms and the action of many factors, diagnosis is generally late.

Though symptoms of polycystic ovarian syndrome may appear shortly after puberty, there is delay in diagnosis due to common nature of symptoms. Symptoms of polycystic ovarian syndrome can range from acne, weight gain, mood changes, pelvic pain, and even headaches among others. Symptoms like PCOS pain, acne, and others are generally associated with other conditions and this makes the diagnosis of PCOS difficult.

Criteria for PCOS Diagnosis

PCOS is generally characterized with the presence of a dysfunction in the process of ovulation, presence of multiple cysts in the ovaries, and an excess of androgen secretion. However, for medical practitioners to diagnose PCOS, there is need for the presence of at least two of these characteristics. Since PCOS presents with many metabolic and reproductive abnormalities, a widely accepted criteria for diagnosis of PCOS is Rotterdam criteria.

Rotterdam criteria takes into consideration:

  • Presence of at least two characteristics of PCOS
  • Number of days of menstrual cycles along with luteal progesterone to measure ovulation
  • Free testosterone, Free Androgen Index, and bioavailable testosterone in order to assess hyperandrogenism (excess of male hormones)
  • Presence of cysts on both sides of the ovaries
  • In younger women, entering the third year after menarche with irregular cycles may be a sign and should be tested
  • Before diagnosis of PCOS, thyroid function tests, prolactin, and follicle stimulating hormone levels should be checked

Management of PCOS and its symptoms needs a holistic approach taking into consideration physical symptoms, emotional aspects, and improving chances of fertility.