PCOS is a common health condition among women of reproductive age thats affects 10 million women in the world. Between 12 to 18 percent of women between late adolescence and menopause have this syndrome which leads to an increasing possibility of infertility. Despite its frequency, near 70 percent of these cases remain undiagnosed.
Polycystic Ovary Syndrome, abbreviated as PCOS, is a complex hormonal condition that affects women’s hormone levels. It is a condition affecting the way a woman’s ovaries function. ‘Polycystic’ simply means ‘many cysts’.
Women are born with the all the egg cells in their ovaries that they will have in their lifetime. These egg cells are located in small pockets on the ovary called follicles. With PCOS, there are multiple partially formed follicles which rarely grow into maturity or are able to produce eggs that can be fertilized. Polycystic ovaries also contain a large number of follicles that are harmless. These follicles are underdeveloped sacs where the eggs that develop can be up to 8mm in size. The follicles are often unable to release the egg which means ovulation cannot take place.
Women with PCOS produce high levels of insulin. PCOS also affects hormone levels causing an excessive production of male hormones also known as androgens. The reason for this is unclear, however insulin resistance is considered to be the major key driving this syndrome.
What causes polycystic ovary syndrome (PCOS)?
What causes PCOS in women is uncertain, however it is considered to be related to abnormal hormone levels.
Genetics and environmental factors are believed to be involved in the development of PCOS. It's a leading cause of female infertility and is responsible for a number of symptoms that can affect the body physically and emotionally.
Common causes of PCOS
Produced by the pancreas to regulate the sugar levels in the blood, insulin helps to move glucose from blood to cells where they are broken down to energy. When the adipose (fat) tissues are resistant to insulin, it will actually cause the body to produce even more insulin to compensate. This high level of insulin therefore affects the ovaries causing them to produce more testosterone than normal which interferes in the development of the follicles which leads to no ovulation. Insulin resistance also leads to weight gain which makes the symptoms of PCOS worse since having excess fat causes the body to produce more insulin.
Many women with PCOS are found to have different types of hormonal imbalances which can include:
Increased levels of Luteinizing hormone (LH) – a hormone that stimulates ovulation. It can have an adverse effect on the ovaries when the levels are too high.
Increased levels of Prolactin – This hormone stimulates the breast glands for milk production during pregnancy.
Reduced levels of sex hormone-binding globulin (SHBG) – This is a protein found in the blood which binds to testosterone to reduce its effect.
Increased levels of testosterone – this is referred to as the male hormone. Biologically, women are supposed to only produce small amounts of it.
Sometimes, PCOS runs in families. Although specific genes associated with this condition are yet to be identified, some women with PCOS inherited it from their family. In some cases, PCOS may occur due to a weight gain or being overweight.
Symptoms of PCOS
Most signs and symptoms of PCOS are exhibited when a woman who has it is in her late teens or early twenties. Symptoms include;
Excessive hair growth – Women who has PCOS normally grows excess facial hair, chest, back or buttocks.
Weight Gain – Due to the increase in insulin, women with PCOS end up gaining weight easily.
Oily Skin or Acne.
Difficulty in getting Pregnant – As a result of irregular ovulation, or absence of ovulation, women with Polycystic Ovary Syndrome find it difficult to get pregnant.
Hair Loss or Baldness – Women with PCOS go through loss of hair on their heads.
Irregular Period – This is one of the most common symptoms of PCOS. However, there are many other factors that can cause irregular period; it’s advisable you visit your doctor to confirm what the cause may be before making conclusions.
7. Heavy bleeding – Since the uterine walls build up for a longer period of time before period sets in, the bleeding becomes heavier than normal whenever menstrual bleeding occurs.
8. Darkened Skin – Women with PCOS tend to have dark patches formed on their skin around the neck, in the groin area and under the breast.
PCOS has also been linked with increased risk of development of health problems like high cholesterol levels, and high blood pressure later in life. Also women with PCOS can easily develop type 2 diabetes.
Does polycystic ovary syndrome (PCOS) affect conception?
Yes, it can increase the risk of infertility affecting chances of conception. To get pregnant, one has to ovulate. Women who don’t go through ovulation regularly rarely release enough eggs to be fertilized. Because PCOS inhibits ovulation, it is one of the leading causes of infertility in women of reproductive age.
How PCOS is diagnosed?
Typically, doctors diagnose for PCOS in women when they find at least two of the following symptoms:
Cysts on the ovaries
High androgen levels
Irregular menstrual cycles
For further diagnosis, your doctor might ask you if you’ve had other symptoms like weight gain, hair growth, etc. A pelvic examination to check your ovaries and other parts of the reproductive tract might be conducted. During this, the doctor might have to insert gloved fingers into your vagina to check for growths in your ovaries or uterus. A blood test may be conducted to check for high levels of male hormones as well as other hormonal imbalance. Blood tests may also be conducted to check insulin levels, cholesterol and triglyceride levels to evaluate risk for related conditions like heart disease or diabetes.
An ultrasound scan might also be carried out to check for abnormal follicles and other issues they might be present in your ovaries and uterus
Treatment through lifestyle
You may be able to treat PCOS through making some lifestyle changes. Because PCOS can cause weight gain, it may be helpful to try to lose that weight through appropriate diet and exercise changes. This should positively affect your menstrual cycle and aid in its regulation. This will in turn improve PCOS symptoms and raise the chances of proper ovulation. Weight loss may also improve your cholesterol level, and it may help lower insulin levels to normal rate and reduce the risk of heart diseases and diabetes.
When it comes to diet, studies have confirmed that low-carbohydrate diets can be effective for both weight loss and lowering insulin levels in the body. A diet low in its glycemic index (low-GI) obtains most of its carbohydrates from whole grains, fruits and vegetables which can help regulate your menstrual cycle. If you are not already participating in sports or regular exercise, try to work in 30 minutes of moderate-intensity exercise at least three times a week into your schedule. A balanced diet combined with exercise can improve your health by lowering the risk of developing diabetes and heart diseases. If you find that these options do not work for you, then seeking a medical treatment with your doctor may be a better option
PCOS has no particular cure; however the symptoms can be treated. Daily use of Birth control pills containing estrogen and progestin can help to eradicate hormonal imbalance thereby regulating ovulation. It can also relieve symptoms like excessive hair growth and offer protection against endometrial cancer. You can get these hormones in form of a patch, pill or a vaginal ring.
Metformin is another drug that can be used to treat PCOS by improving insulin levels. Also known as Glucophage or Fortamet, this drug was originally used for treating type 2 diabetes.
Clomiphene (Clomid) is a drug used to treat infertility in women. It can be used to help women with PCOS get pregnant. However, it can increase the risk for twins and other multiple births.
To tackle the excessive hair growth symptoms, you can engage the use of hair removal methods to get rid of unwanted hair or stop it from growing. For example, eflornithine (Vaniqa) cream slows down hair growth. Laser hair removal and electrolysis can also be used to remove unwanted hairs on the face or any part of the body.
Surgery can also be conducted to improve fertility especially when other treatments fail to work. During this process which is called Laparoscopic ovarian drilling (LOD), tiny holes are created in the ovary with a laser or thin heated needle to restore normal ovulation. If you are interested in this method, speak to your doctor to see if it could work for you
Signs you should see your doctor
Most women might not even know when they have Polycystic Ovary Syndrome since not all the symptoms appear in all cases.
If you’ve been trying to get pregnant for over 12 months without success, you should see your doctor.
If you are having symptoms of diabetes like excess thirst or hunger, blurred vision or unexplained weight loss, please see your doctor.
If you’ve missed 1 or more periods, and either had a negative pregnancy test or haven’t had hetersexual intercourse, see your doctor.
If you are experiencing symptoms of PCOS such as facial hair growth as well as excessive hair growth on some other parts of your body, see your doctor.
If you’ve been diagnosed of PCOS, visit your primary care doctor regularly to continually check for diabetes, high blood pressure and other health problems that might accompany PCOS.