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.
About 20% to 25% of women in India of childbearing age suffer from PCOS, according to an AIIMS study. 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. 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, headaches, sleep problems, and 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, to name a few.
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 to normal reproductive function, 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. Even though men have naturally higher levels of androgens, hyperandrogenism can occur in both men and women.
The majority of women with hyperandrogenism have PCOS. That said, 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.
Although PCOS cannot be cured, its symptoms can be managed better with certain changes to one’s lifestyle. And if you are looking for an easy and convenient product to help you alleviate PCOS symptoms, do try &Me’s PCOS drink, which comes in your favourite Cranberry flavour!
Until next time...
Department of Endocrinology and Metabolism, AIIMS