Polycystic Ovary Syndrome or PCOS is a health problem that affects 1 out of every 10 women in their age of childbearing. Further, women with PCOS have a hormonal imbalance and metabolic issues that may affect their overall health and appearance. PCOS is a common but treatable cause of infertility.
What is Polycystic Ovary Syndrome?
Polycystic Ovary (or Ovarian) Syndrome is a common health problem caused by an imbalance of reproductive hormones. This hormonal imbalance creates problems in the ovaries.
The ovaries make the egg that is released each month as a part of a healthy menstrual cycle. However, with PCOS, the egg is unable to develop as it should, or it may not be released during ovulation.
PCOS causes missed or infrequent menstrual periods, and this further leads to:
- Growth of cysts in the ovaries.
Most women have menses every month, but women with PCOS can go long intervals without having it.
This is usually an indication that ovulation isn’t occurring. The ovary is unable to make one single mature egg to release, and thus many follicles containing immature eggs build up. Consequently, the eggs fail to expel at the time when ovulation would normally take place.
Further, the condition is associated with chronic anovulation (long-lasting failure to ovulate), and there is an overproduction of androgens, which are the male hormones, mainly testosterone and androstenedione. The absence of ovulation means there is no mature egg ready to be fertilized by a sperm which to infertility.
Risks Associated With PCOS
Unfortunately, there is more to PCOS than absent or irregular ovulation. Being a lifelong condition, PCOS not only causes infertility but also causes insulin resistance frequently. As a result, the body is capable of producing insulin but is unable to use it effectively, thus increasing the risk of Type 2 diabetes.
Besides, PCOS can lead to other serious health issues, especially in women who are overweight. These include:
- Gestational Diabetes: Diabetes that develops during pregnancy increases the risk of miscarriage. Further, it increases the risk of diabetes in both mother and child.
- High Blood Pressure: High BP can lead to damage to the kidneys, brain, and heart. The risk of heart diseases increases with age. Also, it is associated with high “LDL” (Bad Cholesterol) and low HDL (Good Cholesterol), which also increases the chances of heart diseases.
- Stroke: In this, cholesterol and white blood cells clog up the blood vessels leading to blood clots which in turn can cause a stroke.
What are the Causes of PCOS?
Doctors are uncertain about the exact causes of PCOS. Nevertheless, it is clear that the raised male hormone levels play a crucial role in preventing the ovaries from their normal functioning.
Here are some other well-known risk factors:
- Insulin Resistance: Insulin is the hormone produced by the pancreas for converting the sugar from food into energy; however, if the body is unable to utilize that insulin effectively, demand for the hormone increases, and more is produced by the pancreas to recompense. Consequently, this excess insulin triggers the production of more male hormones.
- Genetics: Studies have shown that PCOS runs in families, and women who have a sister or mother with PCOS or type 2 diabetes are more prone to exhibit PCOS than those with no family history.
- Inflammation: Women with PCOS have raised levels of inflammation in their bodies. Also, there have been studies that link excess inflammation results to increased androgen levels.
Symptoms of PCOS
If you experience irregular periods, very light periods, or complete loss of periods, it may be a sign of PCOS. Other common PCOS symptoms can include:
- Acne or oily skin and unusual hair growth, usually on the chest, face, or abdomen. This results from elevated androgen levels and can also include male-pattern baldness or thinning hair.
- Obesity along with difficulty to lose weight and maintaining weight loss and type 2 diabetes. These symptoms can be associated with anxiety, depression, and eating disorders.
- Difficulty in conceiving.
- Small pieces of extra skin on, or next to armpits, otherwise known as skin tags.
- Darker or thick skin patches in the armpits, back of the neck, and underneath the breasts.
One of the primary symptoms – cysts – isn’t one you can see yourself apart from signs of infertility. For this, you need to visit a doctor for diagnosis as well as tests.
How is PCOS Diagnosed?
There is no straightforward test for PCOS. However, when you pay a visit to the doctor, he/she will gather information by running a series of diagnostic tests.
Also, your doctor will take a detailed medical history and ask you about your menstrual cycle and other possible symptoms like acne, difficulty in losing weight, or unusual hair growth.
The physical tests will include the height and weight measurements for calculating your BMI (Body Mass Index). A transvaginal ultrasound scan enables the doctor to see whether the ovaries have typical PCOS features, which would normally show up as multiple immature follicles on the ovaries (Cysts).
Blood tests would be needed in order to help the doctor reach a final diagnosis, especially measuring the levels of specific hormones. FSH (Follicle Stimulating Hormone, AMH (Anti Mullerian Hormone), and LH (Luteinizing Hormone) have a part to play in signaling that ovulation is due. Further, knowing the levels of these hormones will help the doctor estimate the state of your fertility.
The most crucial hormone your doctor will be looking out for is AMH. Woman’s follicles release this hormone as they mature. Women with PCOS will have more follicles that are growing, although incompletely, at the same time. Consequently, their AMH levels will be higher than a woman without PCOS.
The blood tests will look at the levels of estrogen and testosterone as well as for insulin resistance screening.
Treatment for PCOS
Unfortunately, there is no cure for PCOS, but the symptoms can be managed. Treatment for PCOS generally starts with lifestyle changes like diet, weight loss, and exercise. Besides, losing just 5-10% of your total body weight can help regulate your menstrual cycle and improve PCOS symptoms. Moreover, weight loss can improve cholesterol levels, lower insulin and reduce diabetes risks and heart disease.
Birth control pills can help regulate the menstrual cycle and treat PCOS symptoms. Metformin, generally used to treat type 2 diabetes, can treat PCOS by improving insulin levels. Clomiphene is a fertility drug that can help women with PCOS to get pregnant. But there are complexities associated with twins and multiple birth when it comes to Clomiphene.
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PCOS can disturb the menstrual cycles of a woman and make it difficult to get pregnant. Also, higher levels of male hormones can lead to symptoms like unusual hair growth on the face and body.