PCOS

PCOS

What is Polycystic ovarian syndrome (PCOS)?

Polycystic ovarian syndrome (PCOS) is a hormonal disorder. This hormonal imbalance is caused by the reproductive organs ovaries that produce and release eggs. Ovaries produce estrogen and progesterone hormones and these hormones regulate the menstrual cycle. In PCOS conditions, ovaries produce excess male hormones called androgens. This situation makes reproductive hormones become imbalanced.


Females with obesity or family history have higher chances to get affected by PCOS. PCOS is one of the most common causes of female infertility. Women with PCOS may experience irregular or skipped menstrual periods and unpredictable ovulation. Small cysts may develop on ovaries due to unpredictable ovulation (anovulation). PCOS may also cause hair growth on the face and body and even baldness.


As per the reports, nearly 10% of women are affected with PCOS between puberty and menopause periods. Despite many women being affected by PCOS, this condition is often undiagnosed. This situation increases the chances of developing other PCOS associated conditions like diabetes or metabolic syndrome.


Causes of Polycystic ovarian syndrome (PCOS)

Medical experts don’t know the exact cause of PCOS. Medical science believes that the higher androgen hormone levels can impact female fertility and menstrual cycles. Even genetics plays a crucial role in the cause of PCOS. Nearly 10% of women are affected with PCOS between puberty and menopause periods. Many factors play a role in the cause of PCOS. For some of these factors, it’s unclear whether they develop PCOS or these factors are caused by PCOS. Some of the main factors to cause PCOS are:


Genetics:   Research suggests that several genes contribute to PCOS. Having a family history of PCOS may increase chances for developing it.

Excess levels of androgen hormones:   Ovaries produce estrogen and progesterone hormones and these hormones regulate the menstrual cycle. In PCOS conditions, ovaries produce excess male hormones called androgens. Excessive androgen hormones interfere with ovulation and thus eggs do not develop on a regular basis and aren't released from the follicles where they develop. This situation makes reproductive hormones become imbalanced. High androgen hormones may also cause acne and excess hair growth in women.

Insulin resistance:   Insulin hormone is made by the pancreas. Insulin controls the way the human body processes glucose and uses it for energy. When the human body doesn't process insulin correctly, resulting in high glucose levels in blood. This may cause the human body to make more insulin to try to bring down the blood sugar level. Increased insulin levels may cause the ovaries to make and release male hormones androgens. Increased male hormones suppress ovulation. Obesity can also develop insulin resistance. Insulin resistance can lead to diabetes. Approx 65% of women with PCOS have insulin resistance.

Low-grade inflammation:   This condition is where white blood cells make substances in response to infection or injury. People with PCOS tend to have a long-term and low-grade inflammation that leads to PCOS. White blood cells levels can be measured using blood tests. Low-grade inflammation conditions may lead to heart and blood vessel problems.

Obesity:   Overweightness is mainly associated with insulin resistance and excessive male hormones androgen. They can increase risk for type 2 diabetes.


Types of Endometriosis

There are mainly four types of endometriosis based on the abdominal area they affect and they are as below:


Superficial peritoneal lesion (pelvic endometriosis) -   This is the most common type of endometriosis. A person with this condition can have lesions on the peritoneum (a thin film that lines the pelvic cavity).

Androgenic Alopecia:   This is a genetic condition where both men and women can be affected by this condition. Men with this condition may start losing hair even in their teenage years. This is known as male-pattern baldness. It is marked by gradual hair loss from the frontal scalp and the crown and the hairline receding. Women with this condition have hair thinning after their forties from the frontal scalp and the crown. It is known as female-pattern baldness.

Endometrioma (ovarian lesion) -   This type is also known as chocolate cysts as they are dark, fluid-filled cysts. These cysts are present deep in an ovary. This type doesn’t respond well to treatments and can damage surrounding healthy tissues.

Deeply infiltrating endometriosis -   This type of endometriosis grows under the peritoneum and might affect organs near the uterus such as bowels or bladder. Nearly 1 to 5% of endometriosis cases in women are of this type.

Abdominal wall endometriosis -   This type of endometriosis develops due to a surgical incision and wound caused during a cesarean section. The uterus lining-like tissue grows on the abdominal wall.


Symptoms of Polycystic ovarian syndrome (PCOS)

As per the reports, nearly 10% of women are affected with PCOS between puberty and menopause periods. The symptoms of PCOS may vary from woman to woman. The severity of pain doesn’t indicate the extent of the condition. Some of common signs and symptoms are listed below:


  Fluid-filled cysts in or around the ovary

  Irregular menstrual periods

  Excessive bleeding during menstrual periods

  Infertility

  Excess and dark hair growth at unwanted places like face (hirsutism)

  Male-pattern hair loss.

  Infertility

  Weight gain and obesity

  Acne especially on the back, chest and face

  Headaches

  Obesity

  Darker patches of skin where skin creases such as around the neck, armpits, groin, under the breasts, etc.


How is Polycystic ovarian syndrome (PCOS) diagnosed?

There are no direct tests available to diagnose PCOS conditions, thus oftenly it takes longer to diagnose a PCOS. First, healthcare providers will rule out other possible medical conditions before diagnosing PCOS properly. Healthcare providers gather useful information about a person's medical condition by examining and knowing the following things:


  By knowing about the patient's symptoms & possible triggers.

  By knowing about the medical history of the person.

  By knowing about the family history of the person.

  By examining a person's pelvic.

  By examining a person's ovarian cysts.

  By examining excess hair growth on the body, male-apttren baldness, weight gain, discolored skin and skin tags.


Two of the following three criteria must be present to be diagnosed with PCOS:


Polycystic ovaries:   Women with PCOS have cysts or fluid-filled sacs in the ovaries.

Irregular menstrual cycle:   Women with PCOS have a long menstrual cycle with more than 35 days between ovulation. They may have missed menstrual cycles. They may also have heavy bleeding during a period.

Androgen hormones level:   Women with PCOS have excess levels of male hormones androgen.


There are several tests that help doctors diagnose the condition. Some of them are as follows:


Blood Test:   Generally healthcare providers conduct blood tests to assess hormone level, insulin level, blood sugar level, triglyceride level, cholesterol etc. to evaluate risk of heart disease and diabetes.

Pelvic Exam:   Healthcare providers will perform a physical examination and manually feel pelvis for any abnormalities such as cysts on reproductive organs or scars behind the uterus.

Ultrasound:   Healthcare providers use high-frequency sound waves to create images inside the body. A device called a transducer captures the images when it is pressed against the abdomen or inserted inside vagina. These imaging will tell the healthcare provider about the cysts in ovaries, the thickness of the lining of the uterus, abnormal follicles and other problems with ovaries and uterus.


Treatment of Polycystic ovarian syndrome (PCOS)

Unfortunately, there is no universal cure for PCOS. However, there are a number of options available for treating and managing the disease after diagnosis. Medications and Medical surgery as well as diet and lifestyle management help to manage symptoms.


Medications:  

These medications help to improve insulin resistance and lower insulin levels.

   Metformin ( Riomet )

These ovarian-stimulating medications may help women with PCOS become pregnant.

   Clomiphene ( Clomid )

   Letrozole ( Femara )

These medications may help to lower androgen levels and thus are sometimes used to help with excess hair growth and acne. These medications should not be taken in pregnancy.

   Spironolactone ( Aldactone )

These birth control medications are a combination of estrogen and progesterone hormones and help to regulate a woman's menstrual cycle and prevent complications like endometrial hyperplasia.

These facial cream medications may slow hair growth on the face.

   Vaniqa

Medical Surgery:  

Medical Surgery:   Ovarian surgery is helpful with fertility and regulating menstrual cycles. But it is only recommended when other medical treatment options have been unsuccessful.


Diet:   There is no particular diet that will help with PCOS and its symptoms. Still a proper diet will help with insulin resistance, maintain a healthy weight and manage other symptoms.

  Take fiber-rich foods like fruits, vegetables, whole grains, legumes, oats

  Take protein-rich foods like beans, nuts, seeds

  Lower carbohydrates foods

  Lower sugar intakes


Lifestyle management:   Person should take the following steps to reduce symptoms:

  Take prescribed medications regularly.

  Do regular exercises to manage healthy weight.

  Do regular meditation and yoga to manage stress.

  Get enough vitamin-D exposure regularly.


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