All you need to know about PCOS, its symptoms, causes and treatment
Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects women of reproductive age. It can affect menstruation and fertility; luckily, there are treatments for it.
Being diagnosed of PCOS can be frustrating and scary for many. People usually get diagnosed with this syndrome around their early twenties, and at such point, it can be so confusing trying to make out what it all means.
Because, this condition can affect fertility, some fear that they will never be able to give birth again. However, there have been cases of people who gave birth even though they were diagnosed of PCOS.
While PCOS can affect fertility, it doesn't mean being diagnosed with it means absolute infertility. With the right treatment and management plan, you still have your chances at childbirth and motherhood.
What is polycystic ovarian syndrome (PCOS)?
Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that mostly affects women of reproductive age. PCOS diagnosis can be complicated.
However, women with this condition typically experience no or infrequent menstrual cycles and excess of the male androgen, which can affect fertility.
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PCOS is a disorder of the hormones (hormonal imbalance) which affects women between 22 to 44 years. Many women don't even know they have this condition as it is not life-threatening.
The prevalence of PCOS has been reported to be highly variable; it ranges from 2.2% to 26.7% A study shows that up to 70% of women with PCOS haven't been diagnosed.
PCOS affects a woman's ovaries (the organ responsible for releasing the female eggs and produces the hormones estrogen and progesterone). It affects the ovaries to cause the following:
- Formation of cysts in the ovaries
- high levels of male hormones
- irregular or skipped periods
Understanding PCOS and fertility (hormonal imbalance)
PCOS affects the ovaries, and ovulation thus can mostly affecting fertility. With Polycystic Ovarian Syndrome, fluid-filled sacs grow inside the ovaries. The word "Polycystic" actually means "many cysts" in the ovaries.
The sacs are follicles. The follicles, in this case, contain immature eggs and the eggs seldom mature enough to trigger ovulation. This means a woman with PCOS is likely to be missing out on ovulation even if she menstruates.
Since there is no ovulation, matured eggs will not be released into the infundibulum in readiness for fertilisation from the male sperm cell.
Also, with no ovulation, the levels of the hormones- progesterone, estrogen, follicle-stimulating hormone and the luteinizing hormone is typically altered.
Progesterone and Estrogen hormones become lower than usual while androgen hormones become higher. Androgen hormone is a male hormone which women also have (in minimal level). However, in the case of PCOS, it is released in a large amount.
High level of the male hormone, androgen disrupts the menstrual cycle; thus, women with PCOS usually experience irregular or fewer periods than usual.
PCOS is a hormonal condition that can affect fertility. However, with the right treatment, management, lifestyle and dietary changes, women with this condition conceive.
Causes of polycystic ovarian syndrome (PCOS)
Health experts can't tell the exact causes of PCOS. The general idea has been that high levels of male hormones prevent the ovaries from making eggs and producing hormones normally.
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However, certain factors have been associated with it. Studies have shown that the following factors might play a role in Polycystic ovary syndrome.
With PCOS, there is excess production of androgen, which can result in acne and hirsutism (excess hairs on the body).
Research works have shown that polycystic ovarian syndrome can be hereditary, i.e. certain genes might be linked to PCOS.
Insulin is the hormone produced by the pancreas, which allows cells to use sugar (glucose) which is the primary energy supply to cells.
Diabetes is typically caused by the resistance of cells to insulin which causes blood sugar level to increase and further triggers more production of insulin.
Up to 70 per cent of women with PCOS experience insulin resistance. Excess insulin might cause an increase in androgen production which could cause difficulty with ovulation.
Women with PCOS typically experience increased levels of inflammation in the body. Obesity has been linked with inflammation, and studies have linked inflammation to higher levels of androgens.
Common PCOS symptoms
For most women, they start experiencing symptoms of PCOS around the time of their first period. Others, however, notice much later, years after they have gained much weight, battled acne and have trouble getting pregnant.
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Some of the most common PCOS symptoms include:
- Irregular periods: This is a very common symptom of PCOS because when there is no ovulation, the uterine lining is most likely not going to shed every month. In such a case, the woman might see her period for less than eight times in a year.
- Heavy bleeding: Women with PCOS also experience heavy menstrual flow. This is because the uterine lining doesn't shed regularly and can build up for an extended period, thus causing heavy bleeding when it finally sheds.
- Weight gain: Studies have linked PCOS with weight gain. Up to 80 per cent of women diagnosed with PCOS are obese or overweight.
- Acne: Acne is another common symptom of PCOS. Women with PCOS have higher than normal level of the male hormone in their blood, and the male hormones make the skin oilier and can cause breakouts on areas of the body like chest, face and upper back.
- Excess growth of hair: Excessive hair growth on parts of the body (called hirsutism) is one of the PCOS symptoms. About 70 per cent of women with PCOS have excess hair on their body as well as facial hair.
- Darkening of the skin: Sometimes, PCOS also presents with the formation of dark patches in body creases such as creases in the groin, on the neck and underneath the breast.
The treatment of PCOS focuses mostly on managing individual PCOS symptoms. For instance, while some PCOS patients battle with acne and hirsutism, others might be battling with obesity and difficulty getting pregnant.
Treatment usually targets specific symptoms as concerns an individual, and treatment here typically involves the use of medication and lifestyle changes.
PCOS treatment using medications
Doctors most times, prescribe medications to PCOS patients either to help regulate the menstrual cycle or to assist in ovulation. In some other cases, medicines may be prescribed to reduce excessive hair growth, and acne break out.
Here are some types of medications that may be prescribed for PCOS patients:
Combination birth control pills
These pills contain progestin and estrogen and are meant to regulate the oestrogen hormone and decrease the production of androgen. In regulating hormones, they also control the menstrual cycle.
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Another good effect of hormone regulation is a reduction in the risk of endometrial cancer, excess hair growth, acne and correction of abnormal bleeding.
Metformin is one of the common drugs usually prescribed for women with PCOS as it helps induce ovulation.
Metformin is actually a medication for type 2 diabetes. It helps to lower insulin level by improving insulin resistance.
If you also have diabetes (which is commonly linked with PCOS patients), this drug will help in managing the condition while at the same time helping with weight loss.
Clomiphene is an oral anti-oestrogen medication which is taken during the first part of the menstrual cycle. It works to help with ovulation.
Spironolactone is mostly a treatment that targets excessive hair growth as it blocks the effects of androgen on the skin. However, just like other medications, it has its side effects.
One of the side effects is that it can cause congenital disabilities. Thus, spironolactone might not be prescribed for a pregnant woman or a woman who is planning to get pregnant.
While taking progestin for 10-14 days every one to two months can help regulate the menstrual cycle and protect against endometrial cancer, it doesn't improve androgen level. Also, it won't prevent pregnancy like the combination birth control pills.
If you wish to prevent pregnancy as well, your doctor might prescribe the progestin-only minipill or the progestin-containing intrauterine device.
The medications listed here are only for educational and informative purpose. Get medications prescribed by a doctor if you are diagnosed with PCOS. Do not self-medicate!
Lifestyle changes for treating PCOS
Another helpful treatment plan that doctors usually prescribe for women with PCOS is lifestyle changes. This change typically starts with your diet.
Your doctor will most likely recommend that stick to low-calorie diet combined with regular exercising activities. Studies have shown that weight loss might improve PCOS symptoms for women with PCOS.
Eat healthy foods. Limit the intake of high-carb foods
Diet is crucial to the management of health conditions like PCOS. Foods that contain high carbohydrate tends to increase insulin levels.
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Also, avoid foods that contain refined sugar; sticking with complex carbs might be better as they don't raise blood sugar levels fast. Talk to your doctor to help you draft the best dietary plan.
Maintain a healthy weight
With PCOS, you must have to watch your weight. Excessive weight gain and obesity are one of the most common symptoms that women with PCOS battle with.
When you lose weight, it can help reduce the levels of androgen and insulin hormones, thereby increasing the chances of ovulation.
Subscribe to weight loss and weight control programs. A dietician might also help you attain weight loss goals.
Be active. Avoid a sedentary lifestyle
Exercise can help a lot, especially in lowering blood sugar levels. If you have been diagnosed with PCOS, you mustn't take exercising lightly.
Having an exercise routine may be helpful in treating or even preventing insulin resistance which will prevent the development of diabetes and keeps weight under control as well.