POLYCYSTIC OVARY SYNDROME (PCOS)

Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels. This hormone imbalance causes their body to have irregular periods, ovarian cysts hair on the face and body, etc.

WHAT HAPPENS EXACTLY

• Polycystic ovary syndrome (PCOS) is a hormonal imbalance that occurs when your ovaries(the organ that produces and releases eggs) create excess hormones.
• If you have PCOS, your ovaries produce unusually high levels of hormones called androgens.
• This causes your reproductive hormones to become imbalanced.
• As a result, people with PCOS often have irregular menstrual cycles, missed periods, and unpredictable ovulation( the process where eggs are released from the ovary)
• Small follicle cysts (fluid-filled sacs with immature eggs) may be visible on your ovaries on ultrasound due to lack of ovulation (anovulation).
• PCOS is one of the most common causes of infertility in women and people assigned female at birth (AFAB).
• It can also increase your risk of other health conditions.

AGE GROUP

Women can get PCOS at any time after puberty. Most people are diagnosed in their 20s or 30s when they’re trying to get pregnant. If you are obese or have PCOS in your biological family, your risk of developing it may be increased.

CAUSES

The exact cause of PCOS isn’t known. Factors that might play a role include:

• Insulin resistance. People with PCOS have insulin resistance(Insulin resistance is when cells in your muscles, fat, and liver don’t respond well to insulin and can’t use glucose from your blood for energy). To make up for it, your pancreas makes more insulin. There will be the production of hormone androgen as a result of high insulin levels in the body.

One sign of insulin resistance is dark, velvety patches of skin on the lower part of the neck, armpits, groin, or under the breasts. A bigger appetite and weight gain may be other signs.

• Research suggests that certain genes might be linked to PCOS. Having a family history of PCOS may play a role in developing the condition.
• Excess androgen. With PCOS, the ovaries may produce high levels of androgen. Having too much androgen interferes with ovulation. This means that eggs don’t develop on a regular basis and aren’t released from the follicles where they develop. Excess androgen also can result in hirsutism ( the excessive growth of terminal hair in a typical male pattern in a female) and acne.

SYMPTOMS

• Missed periods, irregular periods, or very light periods.
• Ovaries that are large or have many cysts.
• Excess body hair, including the chest, stomach, and back (hirsutism)
• Weight gain, especially around the belly (abdomen)
• Acne or oily skin
• Male-pattern baldness or thinning hair
• Infertility
• Small pieces of excess skin on the neck or armpits (skin tags)
• Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts

COMPLICATIONS

Complications of PCOS can include:

• Infertility
• Gestational diabetes or pregnancy-induced high blood pressure
• Miscarriage or premature birth
• Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat buildup in the liver.
• Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and unhealthy cholesterol or triglyceride levels that significantly increase your risk of heart and blood vessel (cardiovascular) disease.
• Type 2 diabetes or prediabetes
• Sleep apnoea
• Depression, anxiety, and eating disorders.
• Cancer of the uterine lining (endometrial cancer).

Obesity commonly occurs with PCOS and can worsen complications of the disorder.

DIAGNOSIS

Your healthcare provider will ask about your medical history and your symptoms. You will also have a physical exam. This will likely include a pelvic exam. This exam checks the health of your reproductive organs, both inside and outside your body.Some of the symptoms of PCOS are like those caused by other health problems. Because of this, you may also have tests such as:

• An ultrasound Scan is used to look at the size of the ovaries and see if they have cysts. The test can also look at the thickness of the lining of the uterus (endometrium).

 

• Blood tests. These look for high levels of androgens and other hormones. Your health care provider may also check your blood glucose levels. And you may have your cholesterol and triglyceride levels checked.

TREATMENT

Treatment for PCOS depends on several factors. These may include your age, how severe your symptoms are, and your overall health. The type of treatment may also depend on whether you want to become pregnant in the future.If you do plan to become pregnant, your treatment may include:

• A change in diet and activity.A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.

 

• Medications to cause ovulation. Medications can help the ovaries to release eggs normally (eg ; Clomiphene ). These medications also have certain risks. They can increase the chance for multiple birth (twins or more). And they can cause ovarian hyperstimulation. This is when the ovaries release too many hormones. It can cause symptoms such as abdominal bloating and pelvic pain.

If you do not plan to become pregnant, your treatment may include:

• Birth control pills.These help to control menstrual cycles, lower androgen levels, and reduce acne.
• Diabetes medication. This is often used to lower insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help you ovulate more regularly.
• A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.
• Medications to treat other symptoms. Some medications can help reduce hair growth or acne. A few treatments can help get rid of unwanted hair or stop it from growing. There are creams available that slow hair growth. Laser hair removal and electrolysis can get rid of unwanted hair on your face and body.
• Surgery can be an option to improve fertility if other treatments don’t work. Ovarian drilling is a procedure that makes tiny holes in the ovary with a laser or thin heated needle to restore normal ovulation.

OUTLOOK

• PCOS is a common condition that affects your menstrual cycle and causes other symptoms. The initial PCOS therapies that doctors advise are lifestyle modifications, and they frequently have positive results.
• Weight loss can reduce PCOS symptoms and increase the likelihood of conception. To reduce weight, combine aerobic activity with a healthy diet.
• Talk to your healthcare provider about your symptoms if you suspect you have PCOS.