Women of reproductive age may suffer from polycystic ovarian syndrome (PCOS), which is characterized by irregular menstrual cycles, excess androgen levels, and polycystic ovaries. This blog post discusses the causes, symptoms, diagnosis, treatment, and prevention of PCOS, as well as the health problems associated with PCOS, such as infertility, acne, hirsutism, obesity, diabetes, and cardiovascular disease.
The exact cause of PCOS is unknown, but it is believed to involve a combination of genetic and environmental factors. Some of the possible causes are:
Insulin resistance: Insulin is a hormone that helps the cells use glucose (sugar) for energy. When the cells become resistant to insulin, the blood glucose levels rise, and the body produces more insulin. High insulin levels can stimulate the ovaries to produce more androgens, which are male hormones that can interfere with ovulation and cause acne and hirsutism.
Inflammation: Inflammation is a response of the immune system to fight infections or injuries. Women with PCOS tend to have higher levels of inflammation in their body, which can also trigger the ovaries to produce more androgens and affect the quality of the eggs.
Genetics: PCOS tends to run in families, which suggests that genes play a role in its development. Researchers have identified several genes that are associated with PCOS, but the exact mechanisms are not fully understood.
Environmental factors: Some environmental factors, such as exposure to endocrine-disrupting chemicals, obesity, stress, and poor diet, may also contribute to the development of PCOS by affecting the hormonal balance and the function of the ovaries.
The symptoms of PCOS vary from person to person, depending on the severity of the condition and the individual characteristics. Some of the common symptoms are:
Irregular periods: Women with PCOS may have fewer than nine periods a year, or more than 35 days between periods, or periods that last longer than usual. Some women may also experience heavy bleeding, spotting, or no periods at all.
Excess androgen: Women with PCOS may have high levels of androgen in their blood, which can cause physical signs such as acne, oily skin, excess facial and body hair, and male-pattern hair loss.
Polycystic ovaries: Women with PCOS may have enlarged ovaries that contain multiple small cysts (fluid-filled sacs) along the edge. These cysts are actually immature follicles that fail to release eggs. The presence of polycystic ovaries does not necessarily mean that a woman has PCOS, as some women may have normal ovarian function despite having cysts.
Infertility: Women with PCOS may have difficulty getting pregnant, as they may not ovulate regularly or at all. PCOS is one of the leading causes of infertility in women.
Other symptoms: Women with PCOS may also experience other symptoms, such as weight gain, difficulty losing weight, insulin resistance, diabetes, high blood pressure, high cholesterol, mood swings, depression, anxiety, sleep apnea, and pelvic pain.
As PCOS manifests differently in different women, there is no single test for diagnosing it. A woman is diagnosed with PCOS if she meets at least two of the following criteria. The diagnosis is based on a combination of medical history, physical examination, blood tests, and ultrasound.
Irregular periods: Having fewer than nine periods a year, or more than 35 days between periods, or periods that last longer than usual.
Excess androgen: Having high levels of androgen in the blood, or physical signs of excess androgen, such as acne, hirsutism, or male-pattern hair loss.
Polycystic ovaries: Having enlarged ovaries that contain multiple small cysts, as seen on an ultrasound.
The diagnosis of PCOS may also require ruling out other possible causes of the symptoms, such as thyroid disorders, adrenal disorders, pituitary tumors, or medications.
The treatment of PCOS depends on the goals and preferences of the individual woman, as well as the severity of the symptoms and the presence of any complications. The treatment of PCOS may include:
Changes in lifestyle: Women with PCOS can reduce their symptoms and improve their overall health by adopting a healthy lifestyle. It includes eating a balanced diet, exercising regularly, maintaining a healthy weight, coping with stress, and quitting smoking. Women with PCOS are more likely to suffer from diabetes and cardiovascular disease if they make lifestyle changes.
Medications: Various medications can be used to treat the symptoms and complications of PCOS, such as:
Hormonal contraceptives: Birth control pills, patches, rings, injections, or implants that contain estrogen and progestin can help regulate menstrual cycles, lower androgen levels, and prevent endometrial cancer. As well as improving acne and hirsutism, hormonal contraceptives can cause weight gain, mood changes, or blood clots as side effects.
An anti-androgen drug such as spironolactone, finasteride, or flutamide can help reduce excess hair growth and acne caused by PCOS. It is important to avoid these medications while pregnant or planning to become pregnant, since they may cause birth defects. They may also cause other side effects, including irregular periods, breast tenderness, or liver problems.
Among women with PCOS, metformin can help restore ovulation, regulate periods, and prevent diabetes by improving insulin sensitivity and lowering blood glucose levels. Weight loss can also be achieved with metformin, but side effects include nausea, diarrhea, and vitamin B12 deficiency.
A drug that stimulates ovulation, clomiphene citrate can help women with PCOS become pregnant. A woman with clomiphene citrate can increase her chances of having twins or triplets by taking it for five days at the beginning of her menstrual cycle. Side effects include hot flashes, headaches, and ovarian cysts when taking clomiphene citrate.
Depending on the specific symptoms and complications of PCOS, other medications may be prescribed, such as antidepressants, antianxiety drugs, statins, blood pressure medications, or anti-inflammatory medications.
Surgery: In some cases, surgery may be an option to treat PCOS, such as:
In some women with PCOS, ovarian drilling is a minimally invasive procedure that involves drilling small holes in the ovaries with an electric current or laser to lower androgen levels and restore ovulation. It is also possible to damage the ovaries, scar the ovaries, or decrease the ovarian reserve with ovarian drilling.
A surgical procedure that involves removing a part of the ovary, ovarian wedge resection is also effective in lowering androgen levels and restoring ovulation in some PCOS patients. Although ovarian wedge resections can cause serious complications, such as bleeding, infection, and adhesions, they are rarely performed nowadays.
There is no definitive way to prevent PCOS, as the exact cause of the condition is unknown. However, some of the possible ways to reduce the risk or delay the onset of PCOS are:
It is important to maintain a healthy weight: Being overweight or obese can increase insulin resistance and androgen levels, which may worsen PCOS symptoms and complications. Diabetes and cardiovascular disease can be reduced by losing weight, which improves hormonal balance and ovarian function.
Dietary balance: Eating a balanced diet with fruits, vegetables, whole grains, lean proteins, and healthy fats can help regulate blood glucose levels, reduce inflammation, and provide the body with essential nutrients. PCOS can also be prevented or managed by avoiding processed foods, added sugars, refined carbohydrates, and trans fats.
Moderate to vigorous physical activity for at least 150 minutes per week is recommended for women with PCOS to burn calories, improve insulin sensitivity, lower androgen levels, and improve mood and self-esteem.
PCOS can be aggravated by stress, which can cause cortisol to be released, a hormone that can increase blood glucose levels, insulin resistance, and inflammation. Meditation, yoga, breathing exercises, relaxation techniques, hobbies, or counseling are some of the ways that can help reduce stress and improve mental and emotional well-being.
A health care provider should be consulted as soon as possible if you have any signs or symptoms of PCOS, or if you have a family history of PCOS. By early diagnosis and treatment, PCOS complications such as infertility, diabetes, and cardiovascular disease can be prevented or delayed.
In addition to causing physical, emotional, and social challenges, PCOS can also be managed with proper care and support. It is a complex and chronic condition that affects millions of women worldwide. Understanding the causes, symptoms, diagnosis, treatment, and prevention of PCOS can help you live a fulfilling life and be more healthy.
