Girls as young as 14 years of age are facing hormonal imbalance in their bodies. PCOS is a common term being bandied about every day. If you or someone you know is experiencing unpredictable weight gain, acne, or irregular periods, it may be time for you to ask ‘What is PCOS?’ Let’s understand its basics and how to effectively manage this condition.
- What is Polycystic Ovary Syndrome (PCOS)?
- PCOD vs PCOS: Is There a Difference Between the Two?
- PCOS: Causes
- PCOS: Symptoms
- PCOS: Diagnosis
- PCOS: Treatment
- PCOS: Complications
- Don’t Have Time To Read?
What is Polycystic Ovary Syndrome (PCOS)?
Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. In individuals with PCOS, the ovaries produce more than the normal amount of male hormones called androgens, which are usually present in a smaller amount in females.
As a result of this hormonal imbalance, the ovaries are unable to release eggs (ovulation), which causes irregular menstrual cycles. Irregular ovulation can also cause numerous small, fluid-filled sacs to develop on the ovaries. These sacs are called cysts and give the condition PCOS its name.
PCOD vs PCOS: Is There a Difference Between the Two?
Now we know that “PCOS” stands for Polycystic Ovarian Syndrome. But what is PCOD? What is the difference between PCOD and PCOS?
“PCOD” stands for Polycystic Ovarian Disease. “PCOS” and “PCOD” are the same condition and there is no difference between the two. “PCOD” is an older terminology, which is now being replaced by “PCOS” in most instances.
The exact cause of PCOS is not known. However, there are some significant factors that play a role in causing PCOS. These factors include
Many individuals with PCOS have insulin resistance. When your body becomes resistant to insulin, your cells lose the ability to take up the glucose (sugar) required to produce energy, which causes increased blood sugar levels. This, in turn, triggers the pancreas to produce more insulin to stabilise the blood sugar levels.
The excess insulin now in your blood, in turn, may lead to excess production of male hormones (androgens) in the body, causing difficulties in ovulation.
Excess Androgen Levels
Your ovaries may produce excess amounts of androgens and cause the symptoms of PCOS. High androgen levels prevent the ovaries from releasing eggs, which causes small, fluid-filled sacs to develop on the ovaries and leads to irregular menstrual cycles and other symptoms of PCOS.
According to studies, women with PCOS have low-grade inflammation. If you are obese and have abdominal fat, the adipose tissue (fat tissue) shows an increased secretion and release of proinflammatory cytokines. This can cause low-grade inflammation in your body, which stimulates the ovaries (polycystic) to produce androgens and may lead to heart and blood vessel problems.
Research shows that PCOS runs in families. Many women who have a family history of PCOS develop the condition.
The signs and symptoms of PCOS vary from person to person. You may have PCOS and none of its associated symptoms and you may have several of the PCOS symptoms.
You may observe the first signs of PCOS around the time of your first menstrual cycle or only experience it in the later stages.
- Cysts: As one of the most telling symptoms of PCOS, your ovaries may develop cysts, sac-like pockets filled with fluid, which are visible on ultrasound.
- Irregular periods: Irregular, infrequent, prolonged or missed periods are the most common symptom of PCOS. You may have fewer than 9 periods a year, more than 35 days between periods, or not have periods at all.
- Heavy bleeding: Your uterine wall lining may keep building up for a long period of time due to the hormonal imbalance and cause heavy bleeding during your periods.
- Abnormal hair growth: This condition is also called hirsutism. Most women develop unwanted hair on their face, and excessive hair growth on their arms, back, abdomen, and chest.
- Acne: Excess androgens can cause acne, especially on the back, chest, and face. You may continue to develop them past your teenage years.
- Skin darkening: Dark patches may develop on your skin, especially on the neck, armpits, groin and under the breast. This condition is known as acanthosis nigricans.
- Skin tags: You may also develop little flaps of extra skin on your neck and armpits.
- Obesity: About 80% of women with PCOS gain weight and may experience difficulty in losing it. The weight gain is most prominently around the abdomen.
- Male pattern baldness: The hair on your scalp may get thinner and you may lose patches of hair.
- Headache: You may experience headaches due to the hormonal imbalance in PCOS.
- Infertility: PCOS is the most common cause of infertility due to the decreased frequency or complete lack of ovulation.
If you think you are experiencing the symptoms of PCOS, consult your doctor without any further delay.
Your doctor may use the following steps for the diagnosis of PCOS:
- Discuss your symptoms, medical history, family history, menstrual cycle, and any changes in your weight.
- Perform a physical examination for hair growth, discolouration of the skin, skin tags, and acne.
- Undertake a pelvic exam to inspect for any masses, growth, swollen ovaries, or abnormalities in your reproductive organs.
- Order blood tests to check for higher than normal levels of male hormones in your body. Tests for glucose tolerance and cholesterol and triglyceride levels may also be prescribed. These tests will help to rule out other possible causes that mimic the symptoms of PCOS.
- Finally, the doctor may perform a pelvic ultrasound to check the size of the ovaries, cysts in your ovaries, and the thickness of the lining of your uterus (endometrium).
You need to meet at least 2 of these 3 criteria to be diagnosed with PCOS:
- Irregular or missed periods
- Signs of excess androgen such as acne or excessive hair growth or blood test results confirm high androgen levels.
- Cysts on one or both ovaries.
PCOS symptoms and treatment are related. Treatment options for PCOS may vary because some individuals with PCOS may experience a range of symptoms, and others may deal with just 1 symptom.
Since PCOS is the most common cause of infertility, the treatment for PCOS depends on whether or not the individual wants to get pregnant. The treatment for PCOS also varies based on the symptoms, medical history, and other health conditions of the individual.
Treatment if You Do Not Want to Get Pregnant
Hormonal Birth Control: It can be in the form of pills, patches, shots, vaginal rings, or intrauterine devices (IUDs). This treatment modality can help to regulate your menstrual cycle, and improve PCOS symptoms such as excess hair growth and acne. The modality uses a combination of oestrogen and progestin to decrease androgen production and regulate oestrogen levels in the body.
Insulin-Sensitising Medication: Metformin, a drug used to treat diabetes, is also used as a part of the treatment process for PCOS. It works by reducing insulin resistance in PCOS. Once insulin is controlled, some individuals with PCOS may see improvements in their menstrual cycles.
Lifestyle Changes: The treatment of PCOS starts with lifestyle changes. Eating a balanced diet, regular physical activity, and the resultant weight loss can result in the improvement of several PCOS symptoms.
Treatment if You Want to Get Pregnant Immediately or in The Future
Medications to Induce Ovulation: Your doctor may prescribe medications to induce ovulation. These medications can help the ovaries release eggs normally. Drugs such as metformin, clomiphene, and letrozole are taken orally, while gonadotropins are given by injection to induce ovulation.
In Vitro Fertilisation (IVF): When the medications do not help with ovulation, matured eggs are retrieved from your ovaries and fertilised with your partner's sperm in a lab. The fertilised eggs are then transferred into your uterus where they may grow into a healthy pregnancy. This process is known as In Vitro Fertilisation or IVF.
Along with these modalities, lifestyle changes, including a balanced diet and regular physical activity are advised for those trying to get pregnant with PCOS. A healthy diet and increased physical activity can promote weight loss, help your body use insulin and lower blood glucose levels, and may help you ovulate.
If you have PCOS and it goes undiagnosed and untreated for long, you are prone to develop complications such as: