The Polycystic Ovarian Syndrome (PCOS) is a very common health problem affecting most of the women of childbearing age. But, to acquire this disease, there is no age barrier, women of all age groups who have attained puberty can get this. It is estimated that approximately every 1 in 10 women suffers from this disease. PCOS affects the function of a woman’s ovary and occurs due to the imbalance of certain hormones. It affects the menstrual cycle, fertility, the appearance of a woman, insulin production and level of the male hormones in the female body.
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It is estimated that approximately every 1 in 10 women suffers from this disease. PCOS affects the function of a woman’s ovary and occurs due to the imbalance of certain hormones. It affects the menstrual cycle, fertility, the appearance of a woman, insulin production and level of the male hormones in the female body.
This disorder cannot be treated but can be managed through proper diet and exercise regime. It is vital to get PCOS diagnosed and maintained in time, or it may lead to serious long-term health issues such as diabetes, heart diseases and blood pressure.
What is PCOS Disease?
The full form of PCOS is Poly Cystic Ovarian Syndrome. PCOS is also known as Stein-Leventhal syndrome. It is caused due to hormonal imbalance in general. It results in enlarged ovaries along with small cysts on the outer edges of the ovaries. The PCOS results in a variety of symptoms. It affects about 10 to 18 percent of the females worldwide and is the most common cause of infertility in the women of reproductive age. It can occur at any age after puberty, but many women find this only when they find it difficult to get pregnant and meets a doctor. Women of all ethnicities may be affected by this disorder.
What are the causes of polycystic ovarian disease
The exact cause the leads to PCOS is unknown, but several factors are considered to play a significant role in its occurrence. These are as follows:
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1. Insulin resistance
Insulin is a hormone that is secreted by the pancreas and is known to control the level of blood sugar. Its main action is to move the glucose from the blood into the cells whenever the level of glucose rises in the blood. In the cells, the glucose breakdowns to produce energy. One more act of the insulin is to exhibit action over the ovaries and trigger the production of progesterone.
In a woman suffering from PCOS, we can notice the insulin resistance. It means that to the effect of the average level of the insulin, the body cells become resistant. To control normal blood sugar level, and to compensate this change the production of insulin increases.
It, in turn, triggers the ovaries to produce more testosterone. The high standard of both insulin and testosterone hormone causes interference in the normal development of the follicles. Thus, there is a formation of many follicles in the ovaries, but none of them develops fully. So, there will be a delay in the ovulation process. Also, high level of testosterone is responsible for hirsutism and male patterned baldness. On the other hand, increased the level of insulin causes weight gain and increases the risk of future prediabetes and type 2 diabetes.
2. Luteinising hormone
The pituitary gland releases a hormone which is known as Luteinizing hormone. The pituitary is present at the base of the brain. LH hormone stimulates the ovaries to ovulate and also triggers the ovaries to produce testosterone. Test reports say that every four women among ten suffering from PCOS show increase in the standard level of Leutinizing Hormone. In the case, a test report shows an increase in both LH and insulin hormone it means that the ovaries of that patient are producing a very high amount of testosterone.
3. Low level of Sex hormone-binding globulin (SHBG)
It is a protein. By binding with testosterone, it reduces the of effect of testosterone.
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4. High level of prolactin
Prolactin hormone triggers the breast to secrete milk during pregnancy. Although occurring only a few women suffering from PCOS, still the raised level of prolactin hormone may cause PCOS.
The exact reason why such changes of hormones occur are unknown. But it is considered that the problem that results in hormonal imbalance either begins from the ovaries or other glands responsible for producing the particular hormone or in the part of the brain that is responsible for the production of these hormones.
Other causes of PCOS are:
The excess of fat worsens the insulin resistance and contributes to raising the level of insulin in the blood. It, in turn, contributes to more weight gain. Therefore, most of the physician’s advice women to reduce their weight to get relief from PCOS symptoms.
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Research shows that PCOS may run in the families. If any of your relatives, such as sister, mother or aunts suffer from PCOS than the risk of developing it increases. However, till date, the researchers are not sure about the specific genes that are responsible for PCOS
What happens in PCOS?
As said earlier, Hormonal changes are responsible for this disorder. A normal ovary (a pair of large marble sized glands lying on either side of the female womb) makes the egg (ovum). The ovum is released into the Fallopian tube every month as a part of a regular menstrual cycle, and this process is known as ovulation, and the Fallopian tube takes the egg into the uterus. Before being released the ovum develops within the follicle (A little swelling of the ovary that is like a tiny cyst). Several follicles grow each month, but only one develops fully and ovulates.
But if a woman is suffering from PCOS, due to hormonal imbalance the egg is not prepared and is not released in time during ovulation. This results in irregular periods, infertility, fluid-filled sacs in the ovaries, known as cysts (this is the reason why it is called as polycystic ovarian syndrome) and unwanted changes in your appearance.
The ovaries of the female body make a subtle amount of male hormone known as androgens. But in the case of PCOS, The production of male hormones by the ovaries increases slightly. It stops ovulation and in turn cause acne problems, hirsutism. Also, there is an increase in insulin resistance. It is the condition where the body is unable to use insulin efficiently. It, in turn, leads to the sugar level in the blood go high. With time this condition may progress and your chances of getting diabetes increases.
The various conditions seen in PCOS are
Thus, Polycystic ovarian syndrome may be defined as, a disorder where 2 to 3 of the conditions discussed below occurs:
1. At least 12 follicles develop in the ovaries. However, some women may also suffer from PCOS without having multiple cysts in their ovaries.
2. The ovaries produce more than normal male hormone testosterone.
3. The balance of the estrogen and progesterone hormone is altered.
4. Delayed or absence of ovulation. It, in turn, causes delayed or absence of periods.
The major sign and the symptoms of PCOS depend on at the elevated level of male hormones and menstrual disturbance.
The symptoms of menstrual disturbance include:
1. Delayed menses
2. The absence of menses more than three months.
3. Fewer than normal menses also known as Oligomenorrhea.
About 7 in every ten women who suffers from PCOS have menstrual problems. However, in some cases, the menstrual cycle may not be related to ovulation (anovulatory cycle). Here there may be heavy bleeding.
Fertility problems- It is very clear that to get pregnant women needs to ovulate. In PCOS, there is either delay or absence of ovulation. Thus a woman finds it difficult to get pregnant.
PCOS Symptoms associated with elevated levels of male hormone include
Hirsutism- Hirsutism is defined as an excess of hair growth on the body. Mostly this condition affects the face, chest and lower abdomen. But this does not happen in all the cases of PCOS.
Acne- Acne is common in teenagers, but in those suffering from PCOS Acne may persist even after average teenage years.
Male pattern baldness and thinning of the scalp hair.
Other symptoms of PCOS include:
- Obesity- Women suffering from PCOS are more at the risk of gaining weight and become obese.
- Elevated insulin levels and insulin resistance
- Oily skin
- Skin discolorations
- High cholesterol levels
- High blood pressure
- Multiple small cysts in the ovaries.
- PCOS may also result in low self-esteem and depression.
The above-mentioned symptoms of PCOS vary from mild to severe form. Also, symptoms may change over the years. Its symptoms typically start in early 20’s or late teenage. Also, one point to note is that women suffering from PCOS may not show all the symptoms discussed above.
What are the Long-term complications of PCOS
Women suffering PCOS are at the risk of developing following long-term complications:
- Type 2 diabetes.
- Diabetes, high blood pressure, and preeclampsia in the pregnancy.
- High cholesterol level.
- High blood pressure.
- Obesity and overweight. Your tummy may have more amounts of fat than in any other area of your body.
As said earlier, these health issues, in turn, increases the risk of developing the cardiac disease and stroke.
Sleep problems are also common in PCOS woman.
Females whose periods are infrequent or suffers from the absence of menses are at the higher risk of developing cancer of the uterus.
Also, due to the lack of ovulation, the secretion of the progesterone hormone diminishes, and there is unopposed long-term estrogen stimulation that acts as a risk factor for developing endometrial cancer and endometrial hyperplasia.
Diagnosis of PCOS
If you are suffering from irregularities or the absence of periods along with any other symptoms of PCOS discussed above in this article, do consult your health care provider.
Your doctor may ask you questions related to your periods, lifestyle, family history of PCOS, how long you are trying to get pregnant and any medicine if you are taking.
Doctor will also examine your skin, pelvis, breast, thyroid and hair growth.
To clarify your condition and to rule out the hormonal disturbances your doctor may advise you the following tests
1. Blood Test- To check the level of insulin, testosterone, and LH hormone.
2. Ultrasound- This is done to detect to reveal enlarged ovaries with multiple cysts.
Also, a regular check up is advised to check blood pressure, blood sugar, and blood cholesterol to rule out other risk conditions such as heart disease and diabetes type-2.
Treatment of polycystic ovarian syndrome
There is no specific treatment of PCOS. The Treatment option for the PCOS varies according to the symptoms experienced by the patient. Some of the treatment options we have are
- Changes in the lifestyle and diet- The first line of treatment for PCOS includes changes in lifestyle and diet.
- It helps you to control your conditions and also reduce the risk of heart disease, diabetes, and uterine cancer.
- If a woman is overweight, she is advised to reduce weight as this significantly improves her condition.
- Regular exercises
- To lose weight practice regular exercise such as brisk walking, cycling, swimming or aerobics at least for 30 minutes 5 days in a week.
- Besides following an exercise regime switch on to a healthy eating habit. Include fruits, vegetables, low glycemic index carbohydrates such as brown rice, oats or whole grains and sources of proteins in your diet.
- Avoid refined sugar and food with a high glycemic index such as candies, pastries, squash and white flour pasta. Avoid saturated fats, trans-fats, and cholesterol-rich foods such as butter and mayonnaise.
- Include healthy fat options that are rich in omega-6 and omega-3 fatty acids such as olive oil, flaxseeds, sunflower, seafood, walnuts and avocado. Also, avoid sweetened or canned juices and carbonated drinks. Stop smoking, drinking.
- Limit the intake of soy products because they are responsible for delaying the ovulation and also reduce the quantity of the dairy products as they restrict the processing of testosterone and increases their level.
- Prefer eating the meat of grass-fed animals and also include foods rich in chromium in your diet, such as wheat germs, orange, tomato, black pepper, onion, potato and beans.
Poly Cystic Ovarian Syndrome Treatment
Medications to treat PCOS
Your doctor may recommend certain medication to ease the symptoms of PCOS, regulate the production of hormones and regularize the periods such as contraceptive pills. In the case, it is not suitable a progesterone hormone may be given for a few days in every few months. But still, if both of them do not work ultrasound is done to detect any issues related to the uterus.
Treating fertility issues
By proper treatment, the pregnancy chances of women suffering from PCOS increases up to 80 percent. The chances of getting pregnant depend on how often women ovulate. Your doctor may prescribe you medications such as clomifene to cause ovulation. If the clomifene is not successful in treatment, then the physician may recommend the Metformin. Women suffering from PCOs are usually will have a high level of insulin in their blood. So, the doctor can prescribe the metformin which is a drug useful to treat type 2 diabetes.
It helps to decrease the level of insulin in the blood and to treat PCOS. It encourages monthly periods, stimulates ovulation and lowers the risk of miscarriage. Metformin also has other long-term benefits such as reducing the risk of heart disease and lowering levels of cholesterol.
According to your condition, your doctor may also prescribe you a short course of other tablets. If these treatments are not successful IVF treatment is advised.
Treatment of unwanted hair growth
There are certain medicines to control hirsutism such as cyproterone acetate, spironolactone, flutamide, finasteride and combined oral contraceptives (this also improves acne). Your doctor may also prescribe a cream known as eflornithine to slow down the growth of facial hair. You can use this cream with other hair removal products. Other options for treating unwanted growth are
- Hair removing
- Laser treatments
If you are suffering from PCOS, do not lose your heart and self-esteem. Although this disorder has no cure, there are certain medications, regular exercises, and a healthy diet regime you can gain back your fertility and reduce long-term health risks.