Patient's Complete Guide to Polycystic Ovary Syndrome (PCOS)

Overview of Polycystic Ovary Syndrome (PCOS)

PCOS or Polycystic Ovary Syndrome (پولی سسٹک اوریز سنڈروم) is a hormonal disorder that affects females of reproductive age (between adolescence and menopause). PCOS is a complex condition that is characterized by ovarian cysts, menstrual difficulties, and increased levels of male hormones.

PCOS literally translates as multiple cysts. It is a heterogeneous condition i.e., involving several environmental and genetic causes. The condition is further associated with an increased risk of type-2 diabetes, cardiac illnesses, and endometrial cancer.

PCOS occurs due to dysregulated hormones that alter ovulation resulting in menstrual abnormalities and affecting female fertility in the longer run.

PCOS Prevalence

Talking about PCOS prevalence, the condition affects 6-26% of the female population globally. In the Pakistani population, the condition is more prevalent affecting 52% of the female population.

Signs and Symptoms of Polycystic Ovary Syndrome (PCOS)

PCOS symptoms can vary from woman to woman. Some of the most common symptoms of PCOS are:

  • Periods abnormalities (irregular periods, missed periods, heavy or low blood flow)
  • Increased androgen levels (indicated as excessive facial or body hair growth, male pattern baldness, hair thinning, severe acne)
  • Cyst in your ovaries

If a woman exhibits at least two of these signs, then she is considered to suffer from PCOS. Other than these, PCOS can be associated with the symptoms like:

 

  • Excessive weight gain (especially around the belly area)
  • Skin tags (excess pieces of skin on neck and armpits)
  • Darker skin patches (neck, armpits, and under the breast)
  • Fertility issues

Types of Polycystic Ovary Syndrome (PCOS)

PCOS is a complex hormonal disorder that comes from several different causes. There are four different types of PCOS depending upon the cause:

Insulin Resistance PCOS

This is the most common type of PCOS that arises due to increased insulin resistance in the body. In this case, body cells don’t respond to produced insulin in your body that signals your body to produce more insulin. Excess insulin means there will be insulin in your body.

Pill Induced PCOS

Sometimes taking contraceptive pills (birth control pills) can also result in the onset of PCOS. In this type of PCOS, these hormonal birth control pills suppress the ovulation that brings along an increase in male hormones.

Inflammatory PCOS

Inflammatory PCOS is the type of PCOS that is associated with low-grade inflammation in the body. There could be several triggers of inflammation in the body including dietary stimuli. In case of inflammation, your body produces excess male hormones that are linked to the onset of PCOS.

Adrenal PCOS

 

In this fourth type of PCOS, the female body produces excessive androgen aka male hormones. Adrenal PCOS is basically related to stress and is characterized by increased DHEA levels in the blood.

Causes of Polycystic Ovary Syndrome (PCOS)

The exact cause of PCOS is unknown. There are multiple factors that can play a role in causing PCOS. These include:

  • Increased levels of Male Hormones: Male hormone excessive production affects ovulation in females that cause menstrual abnormalities.
  • Insulin Resistance: Insulin resistance is the inability of body cells to utilize the produced insulin. Due to this resistance, there is an increase in insulin levels in the body that makes your body produce more male hormones.
  • Low-Grade Inflammation: Inflammation in your body can be another factor contributing to the onset of PCOS. C-reactive protein test is used to indicate the level of inflammation in the body.

Risk Factors of Polycystic Ovary Syndrome (PCOS)

Given below are certain risk factors that are associated with PCOS onset in females.

  • Genetics: PCOS doesn’t have a clear pattern of inheritance but is present in close family members. Several gene loci are linked to PCOS development but further research is required to establish a clear link between genetics and PCOS.
  • Body Weight: Being overweight and obese is one of the prominent risk factors for PCOS. The association between body weight and PCOS onset comes from the impact of body weight on insulin resistance.
  • Diabetes: Suffering from diabetes can increase your chances of suffering from PCOS due to being linked to insulin resistance in the body.
  • Lifestyle Choices: Your lifestyle choices can play a huge role in increasing your risk of PCOS. These can include your dietary choices, sedentary lifestyle and consumption of alcohol etc.
  • Stress: Stress is another risk factor for PCOS as it affects your reproductive hormones levels directly.
  • Medication: Certain medications such as hormonal birth control pills significantly increase your chances of suffering from PCOS.

Complications of PCOS

Some of the common complications associated with PCOS include:

 

  • Trouble getting pregnant
  • Pregnancy complications such as pregnancy-induced diabetes and hypertension
  • Birth complications (premature birth and miscarriages)
  • Diabetes or prediabetes
  • Cardiac problems
  • Sleep apnea
  • Anxiety and depression
  • Endometrial cancer
  • Non-alcoholic fatty liver disease

Prevention

PCOS is a complex disease that involves multiple causes so there is no evident way to prevent PCOS. However, you can delay the onset of the disease and reduce symptoms severity with the following tips:

  • Management of body weight
  • Making wise-food choices (foods that don’t trigger inflammation or affect your body weight)
  • Working out regularly
  • Keeping an eye on the warning signs

Diagnosis

PCOS diagnosis can be quite complicated as no single test can confirm the disease. Here are the steps for the confirmation of PCOS.

  • Medical History: Your doctor can take your medical history into account and determine your risk of suffering from PCOS.
  • Family History: By looking at your family history for PCOS and associated conditions your physician can proceed with the diagnosis further.
  • Physical Examination: Next step in PCOS diagnosis is the physical examination. This includes tracking your body weight and highlighting any physical changes such as body hair appearance, acne, hair growth changes etc.
  • Blood Tests: Blood tests, especially hormonal tests, help your physician to analyze the level of reproductive hormones in your body that is a key indicator of PCOS.
  • Ultrasound: Ultrasound scans specifically pelvic area scans are the next step towards the confirmation of PCOS. Through ultrasound, your doctor can visualize the presence of cysts in your ovaries alongside uterine lining changes.

By keeping all of these screening outcomes in mind, your physician can confirm PCOS.

Treatment of Polycystic Ovary Syndrome (PCOS) | When to Consult a Doctor

Unfortunately, there is no cure for PCOS. However, there are several ways that can help you with the management of PCOS symptoms. Some of the possible treatment options for PCOS include:

Medications

Different medications can help you with the management of PCOS symptoms. Some of the commonly prescribed medications for PCOS include:

  • Androgen Blockers: These medications can hinder the effect of male hormones on your body ultimately reducing the symptoms associated with these hormones.
  • Insulin Sensitizers: Other medications that can help with PCOS management are the ones that increase the insulin sensitivity in your body thus controlling your symptoms.
  • Birth Control Pills: For menstrual cycle regulation, birth control pills work pretty well and are commonly prescribed for PCOS treatment.
  • Ovarian Stimulating Drugs: These are the medicines that are generally prescribed to improve ovulation among women suffering from fertility troubles with PCOS.

Note: Consult your doctor before taking any medications

Complementary Therapies

Depending upon individual requirements, there are certain therapies that can result in better management of PCOS. These therapies include:

  • Body Weight Management: Losing a certain amount of body weight can help women to minimize the complications associated with PCOS.
  • Stress Management: Stress management therapies are somehow effective for the treatment of stress-induced PCOS or adrenal PCOS.
  • Nutrient Therapy: Nutrient therapy is basically the management of PCOS symptoms by adjusting the presence of certain nutrients in your diet. This is one of the most effective treatment options for PCOS.

IVF or In Vitro Fertilization

This treatment option for PCOS is for females who are struggling with fertility troubles. This artificial fertilization procedure assists the females with pregnancy and increases their chances of successful childbirth.

Surgical Treatments

There are two different types of ovarian surgeries that can help to cure PCOS. These include:

  • Laparoscopic Ovarian Surgery: This is the surgical procedure for the removal of a cyst from your ovaries. This surgery is performed using laser or heat sources to destroy the parts of the ovary which ultimately promotes ovulation.
  • Ovarian Block Resection: This type of surgical procedure removes the part of the ovary to overcome menstrual dysfunction. Though this is not a recommended option as it can increase the chances of ovary scarring.

Healthcare Providers

Consult with Best Doctors for Polycystic Ovary Syndrome (PCOS)

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Dr. Nargis Waqar

Speciality for Polycystic Ovary Syndrome (PCOS)

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