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What is PCOS?

Polycystic ovary syndrome (PCOS) is an endocrine system disorder that affects women during their reproductive years. In this condition, small fluid-filled sacs develop on the ovaries.

According to an AIIMS study, about 20% to 25% of women in India of childbearing age suffer from PCOS. PCOS leads to an imbalance in hormonal levels among women and is the most common cause of infertility as it prevents ovulation. In addition, there is a higher incidence of miscarriage, gestational diabetes, pregnancy-induced high blood pressure, and premature delivery among women who do go on to conceive with PCOS.

What causes PCOS?

While the exact cause has still not been determined, the consensus is that PCOS results from a combination of several related factors. Many women with PCOS have insulin resistance, in which the body can’t use insulin efficiently. PCOS is a health disorder caused by metabolic and hormonal imbalance. This leads to high circulating blood levels of insulin, called hyperinsulinemia. It’s believed that hyperinsulinemia is related to increased androgen levels, as well as obesity and type 2 diabetes. In turn, obesity can increase insulin levels, causing worsening of PCOS.

How does PCOS affect ovulation?

Ovulation is a process in which a mature egg cell (also called an ovum), ready for fertilization by a sperm cell, is released from one of the ovaries (two female reproductive organs located in the pelvis). If the egg doesn’t become fertilized as it travels down the fallopian tube on its way to the uterus, the endometrium (lining of the uterus) is shed and passes through the vagina (the passageway through which fluid passes out of the body during menstrual periods; also called the birth canal), in a process called menstruation.

With an ovulatory problem, the woman’s reproductive system doesn’t produce the proper amounts of hormones necessary to develop, mature, and release a healthy egg.

When the ovaries don’t produce the hormones needed for ovulation and proper function of the menstrual cycle, the ovaries become enlarged and develop many small cysts which produce androgens.

Increased levels of androgens can also interfere with ovulation and normal menstrual cycles. Still, some women with polycystic ovaries have normal menstrual cycles.

Who gets PCOS?

PCOS can run in the family. It’s common for sisters or a mother and daughter to have PCOS, but a definite genetic link hasn’t been found.

What are the symptoms?

The symptoms of PCOS include:

• Weight gain
• Fatigue
• Unwanted hair growth
• Thinning hair
• Infertility
• Acne
• Pelvic pain
• Headache
• Insomnia
• Mood changes

Young girls with PCOS may have irregular periods or Amenorrhea, and heavy or scanty bleeding during menses. PCOS can also put women at risk of other health complications such as hypertension, high cholesterol, anxiety and depression.

Androgens and PCOS Symptoms

Androgens are often referred to as the “male” hormones, but these hormones are present and essential in both men and women. They are vital for the normal functioning of the reproductive system, emotional well-being, cognitive function, lean muscle function and growth and bone strength. In fact, you may be surprised to learn that women have more androgens than estrogens circulating in their body! That said, men overall produce more androgens than women.

Hyperandrogenism is when androgens are higher than they should be or there are clinical signs that androgens are higher than they should be

The majority of women with hyperandrogenism have PCOS. Having said that, there are other possible causes of hyperandrogenism that must be ruled out before a diagnosis of PCOS can be made.

Extra androgen in women leads to irregular menstrual cycles, excess body hair, weight gain, acne, and other PCOS symptoms.

Diagnosing PCOS

A person is suspected of suffering from PCOS upon meeting a minimum of two out of three conditions listed below.

• Irregular menstrual cycles
• Apparent excessive production of androgen manifested by excess body/facial hair or an increase in the presence of testosterone in the blood
• Having various cyst-like formations in the ovaries

If the doctors feel that there are chances of PCOS, they might want to find out the patient’s detailed health history including any surgeries, social and family background. Blood tests will be performed to find out the hormones and blood sugar levels. Finally, the doctor would conduct a pelvic ultrasound (sonogram) of the patient’s ovaries and uterus. The doctor may also examine other conditions such as diabetes and heart problems. This is because women with PCOS have double the risk of acquiring these health issues.

Long-term health effects of PCOS

Undetected PCOS might lead to the following.      

• Type 2 diabetes
• Infertility
• Cardiovascular disease
• Obesity
• Sleep apnea
• Depression
• Metabolism related problems

Treatment and management

PCOS cannot be treated. However, the symptoms can be managed by adhering to suggested medication and lifestyle changes. Some commonly prescribed medications for this condition include a combination of birth control pills and insulin-sensitizing drugs. Given that PCOS can also lead to diabetes or heart diseases over time, corrective action right at the outset becomes imperative.

Conclusion

PCOS is a commonly occurring health problem among women. It is important to diagnose and manage PCOS if symptoms are witnessed. If PCOS is not detected on time, it can result in a number of debilitating long-term health problems. Hence, early diagnosis and management of this condition are recommended!

As we mentioned, although PCOS cannot be cured, its symptoms can be managed better with certain changes to one’s lifestyle.

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