Practical Guide to Polycystic Ovarian Syndrome

Polycystic ovarian syndrome or simply known as PCOS is a hormonal condition widely prevalent among women. Most women are well versed with the common signs and symptoms that point towards a possible diagnosis of PCOS. However, the intricacies of the condition are vital in identifying and treating the condition efficiently.

What is the hormonal imbalance present with PCOS?

Women who have polycystic ovarian syndrome usually have an increased presence of male hormones circulating in their body. It is observed to affect women primarily during their reproductive years.

In addition, women are also observed to have an imbalance in insulin. A study highlighted an estimated prevalence of PCOS ranging from 2.2% to 26% among 18 to 45-year-old women in India. While being one of the most common causes of infertility, PCOS can also be diagnosed even after women have had successful deliveries.

What are the possible causes of polycystic ovarian syndrome?

Even though plenty of research has been conducted on the subject, there is no exact cause that is linked to the development of PCOS. A combination of possible risk factors are generally considered responsible for a woman developing PCOS.

#1. Genetics

Hormonal imbalance can run in families. Families that have an increased likelihood of other hormonal conditions such as diabetes or thyroid related conditions can also have genes that are linked to causing PCOS.

#2. Imbalance of hormones

PCOS is a condition that develops due to the ill effects of an imbalance of hormones. What initially causes the imbalance is not known. However, the imbalance and the surge of male hormones is responsible for the symptoms associated with PCOS.

#3. Inflammation

Women with PCOS have been discovered to have low-grade inflammation that is responsible for their ovaries increased production of androgens (male hormones).

#4. Lifestyle changes

Women who follow an unhealthy diet on most days of the week, do not add adequate exercise to their routine are at an increased risk of developing PCOS.

#5. Stress

While not a direct cause, increased incidence of stress, coupled with other risk factors are likely to increase inflammation in the body that can contribute to the development of PCOS.

What are the common symptoms of PCOS?

Women who have polycystic ovarian syndrome do not display only a single set of symptoms. Women with PCOS can present in versatile ways during a doctor’s examination. The most common symptoms related to PCOS include:

• Irregular periods or no periods for an extended period of time
• Sudden weight gain
• Excess hair growth, often on the face and other parts of the body
• Acne
• Hair loss
• Prominent changes in mood
• Darkening and thickening of the skin in certain areas (particularly the armpits and neck)

Some women might only have irregular periods that lead to a diagnosis of PCOS. A diagnosis of PCOS is commonly made when two of the three are present:

• Irregular periods or amenorrhea (which is a lack of periods)
• Increases in the levels of male hormones (detected on tests as well as presented with characteristics such as increased hair growth, acne, and weight gain)
• Presence of cysts on ultrasound

How would a doctor diagnose PCOS?

There is no definitive or single test that can be used to confirm the diagnosis of PCOS. A physician would suspect PCOS whenever a patient has a history of the aforementioned symptoms.

Common tests that usually conducted:

• A thorough physical exam which checks the patient’s weight, excess hair growth and signs of hormone imbalance (darkening of the skin)
• Routine blood tests, as well as ones that check for an imbalance in hormones, is vital. Hormonal conditions such as thyroid dysfunction can also cause irregular menses.
• An ultrasound is usually conducted to detect cysts in the ovary and eliminate other possible causes of irregular menses.

What are the possible complications I can experience with PCOS?

PCOS is among the most common causes for infertility among women. Since women with PCOS have dysfunctional ovaries, there is a decreased likelihood that they are ovulating on a regular basis.

Due to the obesity and imbalance in the hormones women are likely to develop diabetes, increased cholesterol and also an increased probability of developing heart disease. This primarily occurs as the imbalance in hormones tends to wreak havoc on the internal functioning of the basic metabolic system.

Women with lifelong PCOS symptoms are also at an increased risk of developing endometrial cancer.

How is PCOS treated?

Once diagnosed it is important to remember that PCOS is a condition with no cure. Symptoms can wax and wane over time but they will never go away completely.  The two main ways to manage PCOS symptoms is through medications and lifestyle changes.

#1. Medications

These are NOT a lifelong alternative to treat PCOS. Many women are under the assumption that PCOS, like other medical conditions, can be treated or corrected with a set of pills. However, this is far from the truth. Medications are given just to help modulate symptoms and assist women on their journey towards a more healthier lifestyle.

The most commonly prescribed medications are metformin and oral contraceptive pills. Metformin has been primarily used to treat diabetes. However, in women with PCOS, it helps with modulating insulin levels. While on metformin women have also been observed to lose weight and also have their cholesterol levels subside.

OCPs are initially given to regularize menstrual cycles. Women who lose sufficient weight and keep it off, usually start getting regular menstrual cycles themselves.

In some cases, medications to lower and block the effects of male hormones in the body have also been prescribed.

#2. Lifestyle management

Women with PCOS who opt to make strict changes to their daily routine reap the most benefits. The most vital aspects of this change in routine involve following a strict and healthy diet and including exercise into one’s daily routine.

Women are free to experiment with any diet they feel might help them lose weight. However, a diet that is low in carbohydrates has been proven to be most beneficial. This essentially includes cutting out veggies, rice and baked items that might be high on the glycemic index. Carbohydrates break down to sugars. And women with PCOS already have a disturbance with insulin and their ability to moderate these sugars. So cutting back essentially reduces the burden and also helps improve the metabolism.

Most women who have PCOS are observed to be overweight. A healthy diet and medications are not enough to lose excess weight. Women are advised to participate in some form of physical activity for a minimum of five days a week. Shedding off those excess pounds, and working on keeping it off, helps with regulating menstruation. Women who have been at a healthy weight for a few months have often observed that regular periods start on their own. Signs such as acne, excess hair growth and even darkening of the skin can go away with time once the male hormones subside in the body.

Is conception a struggle for women with PCOS?

One of the primary causes of infertility is polycystic ovarian syndrome. Women who reduce their weight, exercise regularly and also follow a healthy diet have been known to successfully conceive without requiring any external treatment. Blood sugar levels should also be brought down to a close to normal range.

While it is difficult to conceive with PCOS, it is not impossible.

Most women are aware of the basics of what polycystic ovarian syndrome entails. It is primarily related to an irregular period and difficulty with conceiving. While the cause of developing PCOS is uncertain, there are ways in which symptoms can be treated and women can continue living relatively normal lives.

Yes, it is often a struggle and quite disheartening, but owning your condition helps to prevent long term complications of PCOS. It is true, that it is more difficult for women who have PCOS to lose weight and to maintain a normal weight. But making exercise and healthy living a routine is a must for everybody.

When in doubt never hesitate to consult a physician. Eliminating other possible causes of hormone dysfunction is vital. Only a physician can recommend whether medications are required or not. Periods that continue to remain irregular, or women who experience severe pain or excessive bleeding should ideally consult with a physician. PCOS is a treatable condition. It doesn’t have to be a lifelong hindrance.

The right steps often enables women to lead a relatively normal life with PCOS.