What is Polycystic ovary syndrome?
Polycystic ovary syndrome (PCOS) is a common hormonal system disorder seen in women of reproductive age. Women suffering from PCOS may have enlarged ovaries that contain follicles (collections of fluid) as seen during an ultrasound exam.
PCOS affects a women’s:
- Menstrual periods
- Blood vessels and heart
PCOS, if left untreated can lead to heart disease and diabetes. Women with PCOS have numerous fluids-filled sacs known as cysts in their ovaries. Therefore, this condition is called polycystic ovary syndrome. These cysts aren’t harmful by themselves but are responsible for the associated hormonal imbalances. The most common cause of infertility in women is PCOS.
The prevalence of PCOS is projected at 10% of the general female population worldwide. Among the Indian adolescent girls, the prevalence of PCOS is 9.13%. Hence, early diagnosis in adolescent girls is a matter of importance.
Causes and risk factors
The exact cause of PCOS is not yet known. However, if it runs in your family, you would be at a greater risk of having it. If the other women in the family have irregular periods, diabetes, etc., then you are more likely to be at risk of having PCOS. The genetic factor makes it inheritable in nature.
The key issue of PCOS is the hormonal imbalance. The ovaries produce more of the male hormone “androgen” than the normal. This hormonal imbalance leads to another imbalance, which leads to another and thus the chain continues. High levels of insulin in women too has been linked with PCOS, which is thought to be responsible for the androgen production.
Symptoms and signs
The general symptoms of PCOS include
- Acne and oily skin
- Presence of extra hair on the body and face (hirsutism)
- Weight gain
- Fertility issues
- Irregular or absence of periods
- Cysts in ovaries
Diagnosis of PCOS will include:
- Medical History: The doctor will enquire about your periods, changes in weight, etc.
- Physical Examination: The doctor will look for signs of PCOS like the presence of extra hair on the body, check the weight and height to know if you have a healthy Body Mass Index (BMI).
- Pelvic Exam: The doctor may examine you for any signs of enlargement of ovaries due to the cysts.
- Vaginal Sonogram: An ultrasound may be needed to check the endometrial lining and the presence of cysts in the ovaries.
- Blood tests: Blood test is performed to test the levels of various hormones, insulin and sugar in the blood.
Treatment and prevention
There is no definitive cure for PCOS and it needs to be managed to prevent further problems and risks of infertility, miscarriages, uterine cancer, heart disease and diabetes.
The usual treatment of PCOS includes:
- Birth Control Pills: For correcting the menstrual cycle, birth control pills are prescribed that prevent the formation of endometrial lining for long and help in preventing cancer of the uterus.
- Medications: Medication for managing diabetes like metformin is used for type 2 diabetes treatment. Nursing mothers must consult their doctor as metformin can pass to your baby through the breastmilk.
- Lifestyle changes: Usually, women with PCOS are obese and overweight. PCOS can be managed by regular exercise and by maintaining healthy levels of weight. Reduction in 10% of your weight can help you to regain regular periods.
One may prevent the complications associated with PCOS with
- Regular exercise
- Healthy diet
- Regular medical checkup
Following conditions are more likely in case you suffer from polycystic ovary syndrome and obesity as well:
- High blood pressure
- Type 2 diabetes
- Anomalies in cholesterol and lipid levels with low high-density lipoprotein (HDL) and higher triglyceride levels
- Nonalcoholic steatohepatitis — an acute inflammation of the liver owing to fat buildup in the liver
- Metabolic syndrome — a bunch of symptoms and signs that point to a notably higher risk of cardiovascular diseases.
- Sleep apnea
- Anxiety and depression
- Anomalous bleeding of the uterus
- Cancer of the endometrium (uterine lining) due to higher oestrogen exposure
- Pregnancy-linked high blood pressure
- Gestational diabetes
Visit your doctor if you notice hirsutism, experience infertility or concerns with your periods.
Seek immediate medical attention if you notice
- Severe bleeding from the vagina
- Sudden appearance of dark patches on the neck
- Depression for long
- Difficulty in getting pregnant
- Rapid hair growth on the face and body
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- Women’s Health Research, National Institute of Child Health and Human Development (NICHD), NIH,http://www.nichd.nih. gov/womenshealth
- Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol. 2011 Aug;24(4):223-7.