PCOS- Polycystic Ovarian Syndrome

What is Polycystic Ovarian Syndrome?

Poly Cystic Ovarian Disease or Poly Cystic Ovarian Syndrome is a disease of the ovaries which causes hormonal imbalances in females of reproductive age group. PCOS affects around 5-10 percent of women of reproductive age, and it is the most common cause of subfertility among women in the reproductive age group.

Your ovaries produce eggs that are needed to get pregnant. At the same time, ovaries produce hormones such as estrogen, progesterone, and androgens. They are responsible for maintaining the female reproductive cycle. In PCOS, ovaries excessively produce hormones called Androgens leading to PCOS symptoms. Androgens are essential for regulating menstruation and aiding pregnancy, but in excess, they can cause various ill effects mentioned below.

Causes of PCOS

Causes for PCOS are not clear. But it is a disease that has been found to run in families. If your mother or a sister is suffering from PCOS, it is better to get yourself checked with a doctor. In addition to that, some environmental factors can increase the prevalence of the disease. Industrial endocrine disruptors can change your body’s hormonal responses, triggering or exacerbating PCOS and its related symptoms.

PCOS symptoms

A considerable number of women face irregularities regarding periods. You may have missed a period or two or had delayed periods sometimes, which is normal. But did you know that missing periods for a long time is a PCOS symptom?

What is the main sign of PCOS?

Menstrual disturbances: Can either be a complete absence of periods for three or more consecutive months or oligomenorrhoea, which means noticeably light periods.

Associated PCOS symptoms include,

1. Weight gain: Most women with PCOS are overweight or obese but remember that lean women can go undiagnosed for years if they are not concerned about other PCOS symptoms.
2. Excessive hair growth on the face, chest, and back (Hirsutism)
3. Acne
4. Hyperpigmentation of skin in some body parts, such as axillae and other flexures: This is a feature of insulin resistance that could alarm you about developing diabetes.
5. Low chances of getting pregnant.
6. Recurrent miscarriages

When to see a doctor?

Do not hesitate to visit your doctor if you keep suffering from the PCOS symptoms mentioned above. If you miss periods often or have irregular periods for a considerable time and experience unexplained weight gain and breakout of pimples, always check with a doctor.

PCOS Diagnosis

Your health care provider will take a detailed and thorough medical history, including your menstrual history. The doctor will conduct a pelvic examination to assess the health of your reproductive organs. The definitive diagnosis of PCOS will be based on several checkups.

1. USS (Ultrasound Scan)

This can visualize your ovaries, and by the appearance of its polycystic ovaries can be diagnosed. In a normal menstrual cycle, there are many primary follicles inside an ovary, and one develops into a giant follicle that contains the egg. The egg is released on the 14th day of the menstrual cycle, and it can combine with a sperm resulting in a pregnancy. But in Poly Cystic Ovaries, there are numerous small follicles, but none of them develop into a large follicle and do not result in the release of an egg. Therefore, in an Ultrasound scan, many small follicles can be visualized in the periphery of the ovary.

2. Blood tests

Elevated androgen hormone levels in your blood can be used to diagnose PCOS. A Glucose Tolerance Test will be performed to diagnose diabetes associated with PCOS.

In addition, a lipid profile will assess the cholesterol and triglyceride levels in your blood which can be used to determine the severity of PCOS symptoms and complications.

Complications

PCOS affects many organs, and not managing PCOS properly could lead to devastating long-term complications. Females with PCOS have an increased risk of developing the following conditions.

1. Type 2 Diabetes mellitus
2. Cardiovascular diseases
3. Endometrial cancer
4. Subfertility

1. Diabetes and PCOS

Insulin is the hormone that regulates the glucose levels in your blood. PCOS leads to Insulin resistance, which means your body’s cells stop responding to Insulin. 50-70% of females with PCOS have insulin resistance. This leads to elevated sugar levels in your blood since the cells are unable to uptake glucose into cells and cannot utilize it for the body’s functions.

2. Cardiovascular diseases

Diabetes itself is a risk for heart diseases. In addition to that, elevated cholesterol and triglyceride levels in the blood cause lipid plaques to form inside the blood vessels (atherosclerosis). This leads to a reduced blood supply to the heart, and eventually, the heart will not receive the adequate volume of blood to meet its demands.

3. Endometrial cancer

As you know, after puberty, in females, the reproductive organs, including the uterus, undergo cyclic changes. This happens under the influence of hormones produced by the ovaries and pituitary. Your uterus will prepare itself to bear a baby inside in a regular menstrual cycle. But if you do not get pregnant in that menstrual cycle, the inner lining of the uterus(endometrium) will shed off following bleeding for 3-5 days. That is what we call periods.

In women with PCOS, periods are not regular. That means they do not undergo the shedding of the inner lining of the uterus cyclically, and it exposes them to higher levels of hormones. This causes the endometrium to grow thicker than usual, which causes an increased risk for endometrial cancer.

4. Subfertility

Women with PCOS often have problems with getting pregnant. But having PCOS does not mean that you can never get pregnant because PCOS is treatable. Mostly it is due to the irregularity of your periods which reduces the frequency of releasing eggs by your ovaries. If you are a known patient with PCOS and trying to get pregnant, do not worry; your doctor will refer you to a fertility clinic and will treat you appropriately. The treatments are there to induce ovulation, making your ovaries release eggs more frequently. That will increase the chances of getting pregnant.

PCOS and Pregnancy

Women with PCOS are at higher risk of developing complications following pregnancy.

1. Miscarriage or an early loss of pregnancy: PCOS patients carry a three times higher risk than women who do not have PCOS to face a miscarriage in early pregnancy.
2. Pregnancy-induced hypertension (elevated blood pressure): This is not preexisting hypertension that we talk about. If hypertension develops after 20 weeks of pregnancy only, we call it pregnancy-induced hypertension. Women with PCOS have an increased risk of developing pregnancy-induced hypertension, which also can progress to severe forms like pre-eclampsia.
3. Gestational diabetes: This is the type of diabetes that only pregnant mothers would develop. Usually, this resolves after the delivery of the baby.
4. Higher chances to get a C-section: Due to early complications following pregnancy, most pregnant mothers with PCOS have to undergo C-sections to make it a safe delivery for both the mother and the baby.

It is better to understand that all these complications are not only faced by PCOS patients. These are the complications associated with pregnancy, and all of them can be successfully managed under the proper guidance of your consultant and your compliance with treatment.

PCOS Treatments

Do not be afraid because PCOS is treatable, and you can have a normal life like any other with proper treatment guidance.

Treatments for PCOS depend on numerous factors. Your health care provider will discuss the treatment plan with you. It will be decided according to your age, the severity of your symptoms, and your personal needs.

Your physician will prescribe medications according to the symptoms of the disease. Most of the time, you will be given COCP (Combined Oral Contraceptive Pills) or, in simple terms, birth control pills to regulate your menstruation. Regulation of menstrual cycles holds the most important target of PCOS management.

Medicines used for diabetes, such as Metformin, will be prescribed if you have diabetic symptoms.

As necessary, other complications such as excessive hair growth, acne, and subfertility should be managed by your doctor.

If you have a low chance of getting pregnant, you will be referred to a fertility clinic and be given medications to induce ovulation. It will help your ovaries to release eggs more frequently.

Weight loss and PCOS

Most women with PCOS suffer from being overweight following abnormal hormonal changes in PCOS. Weight reduction is the first thing of PCOS management. Even a moderate level of weight loss can reduce PCOS symptoms and the chances of developing long-term complications.

But an important thing to realize is that weight loss is never easy, and for a woman with PCOS, it is more difficult due to the hormonal imbalances she faces. Hence the support of a nutritionist or a dietician and a fitness expert is beneficial to following an appropriate diet and an exercise plan to reduce weight.

Always remember that there is no straightforward way to reduce weight quickly. You must sacrifice some of your interests if you need to lose weight. Eat less and work more is the golden statement we have heard from our childhood days to reduce weight. Isn’t it? But it is never easy as it sounds. Do you know why? Most of us know the pathway that we should follow to reduce weight, but we lack the commitment, dedication, and strength of mind to follow that pathway.

1. Proper diet: Reducing carbs, sugar, and fats in your meal is essential to losing weight. Adding more vegetables and fruits is essential. Be aware of the amount of food that you consume every day. Stop having foods with empty calories with no nutritional value. Stimulating your taste buds with food is not essential because most of the junk food you love to have, you have eaten plenty for years now.
2. Regular exercise: All the exercises will not work out for everyone. You need to figure out what type of exercise you love and which will work for you. Aerobics, Zumba, Yoga, hourly training at the gym, the type of exercise does not matter. What is important is that you follow your exercise routine consistently. At least engage in exercise 4-5 days per week.
3. Measure your weight: Have a bathroom scale to measure your weight frequently. Try to reduce 3-5 kilograms per month. Always check it with your target weight to achieve a normal BMI.
4. Manage your cravings: Remember that weight loss is a long process, and you need to be patient throughout. You will have the urge to have an ice cream or enjoy a piece of cake or any of your favorite dishes. It is ok to have something you like once a week but be aware of the portion you eat and always get back to your diet from the next day itself.
5. Have a supportive group: Always have a supportive group of people who encourage you to follow your goal. Be away from the toxic people that let you down every day and get to know other people who have PCOS or suffer from the same problems as you. Discuss your experiences and improve your lifestyle, which will improve your symptoms.
6. Adequate sleep and rest: Have a good sleep at night and manage your stress as it will give satisfactory results with any disease.

You need to understand the bottom line that you are not the only one with PCOS. If you have PCOS symptoms, meet a doctor and follow the proper treatment plan. And there are lots of people to help you to improve your condition.