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By Dr. Ambika Shankar (MBBS, MS Obstetrics and Gynecology), Senior Consultant (Obstetrics and Gynecology).
What is Polycystic Ovarian Syndrome (PCOS)/PCOD
Have you ever had trouble losing weight or suffer from anxiety or depression? Have you experienced chronic acne, put up with troublesome periods, or even experienced infertility?
If you are facing a combination of these symptoms, you may be suffering from PCOS (Polycystic Ovarian Syndrome). Every other woman coming to a gynecologist nowadays has PCOS.
Polycystic Ovarian Syndrome (PCOS) is a problem with hormones that happens during the reproductive years. Polycystic ovarian syndrome is the most common endocrinopathy affecting 4-12% of the reproductive age group women. It not only has an adverse effect on fertility but also on the quality of life. In fact, South Asian women are more predisposed. In India, the prevalence is ~ 4 – 22%.
What is PCOS?
PCOS or polycystic ovarian syndrome is a disorder where the ovaries fail to release an egg every 28-35 days i.e., there is no ovulation causing accumulation of unruptured follicles giving its characteristic appearance – polycystic. As a result, the ovaries produce an excess of only certain hormones estrogen and androgens causing menstrual irregularities and a plethora of other symptoms, which we’ll talk about in the post.
It is mainly caused due to imbalance in the hormones in the hormonal axis involving our hypothalamus, pituitary, and ovaries; these are the organs producing the hormones needed to maintain a normal menstrual cycle.
Are PCOS and PCOD different?
- Polycystic Ovarian Syndrome (PCOS) or Polycystic ovarian disease (PCOD). People confuse these two conditions to be different. However, PCOS was earlier referred to as PCOD.
- In 1935 Irving Stein and Michael Leventhal discovered the polycystic ovary as a frequent cause of irregular cycles in women seeking fertility treatment. Initially, this disorder was known as a polycystic ovarian disease (PCOD). A significant percentage of the female population showed symptoms of androgen excess, such as hirsutism, acne, and oily skin. Many women also had associated insulin resistance, excess insulin levels in the blood, and excess levels of cholesterol. Given this condition had multi-systemic involvement, it was re-termed as Polycystic Ovarian Syndrome (PCOS)
What causes PCOS in women?
Causes of PCOS
Polycystic Ovarian Syndrome is caused by a hormonal imbalance that affects various processes in the body. At this point, we do not fully understand what initially contributes to the imbalance. However, certain factors predispose a woman to develop PCOS.
- Family history-polygenic genetic predisposition.
- Insulin resistance – when the cells in your muscle and liver don’t respond to the hormone insulin secreted by your pancreas, it leads to high levels of unused sugar in the blood and can be a risk factor for developing PCOS.
- Obesity or higher than normal body weight also predisposes to PCOS
- Stress affects the hypothalamic-pituitary-ovarian axis and disrupts the normal menstrual cycle.
You may have the genetic predisposition but it’s your lifestyle that precipitates it.
So, how do you know that you have PCOS?
Symptoms of PCOS
- Long prolonged periods or missed periods followed by heavy bleeding or scantly bleeding
- Unusual gain in weight. And the difficulty in losing weight
- Sudden periods of intense craving for food
- Excessive growth of hair on the face, back, belly, and chest. While the hair on your scalp gets thinner and falls out. This is due to the high level of male hormones secreted by the ovaries affected by PCOS
- Difficulty in conception or getting pregnant
- Acne or pimples on the face, chest, and upper back
- Cysts: if your doctor suspects you have PCOS he/she may order an ultrasound to look out for cysts on the ovaries. The cyst alone does not necessarily indicate a PCOS diagnosis though – signs of extra androgen and menstrual abnormalities must be present as well. Some women with PCOS do not have cystic ovaries at all.
Complications of PCOS
Higher than normal levels of estrogen and androgens (male hormones) for long associated with PCOS can lead to complications like:
- Abnormal uterine bleeding – bleeding that lasts longer than usual
- Infertility or inability to conceive despite carefully timed unprotected sex for a year or longer
- Repeated miscarriages
- Increased risk for high blood pressure, high blood sugar, and heart diseases
- Sleeping disorder where breathing starts and stops repeatedly while you are in bed, known as sleep apnea
- Depression, persistent feelings of sadness and loss of interest in life and other activities, which seriously impairs day-to-day life
- Endometrial cancer – cancer affecting the inner lining of the womb
Pregnancy & PCOS
PCOS is one of the common reasons for difficulty in conception by women. That’s because ovaries are not releasing eggs every cycle due to hormonal imbalance. when there is no egg, how can you get pregnant?
However, with the right treatment, women with PCOS can get pregnant and deliver a healthy baby. A study revealed a 44.6 % success rate in pregnancy with PCOS.
How do you treat PCOS?
Though there is no permanent cure for PCOS, there are various ways to manage the symptoms and control the complications. Lifestyle changes remain the mainstay of treatment as mentioned below. If you are obese or overweight maintaining a healthy weight through food and exercise is crucial even a 5 – 10% weight reduction can make a major impact
- Regular exercise for 30-40 minutes every day can manage weight and mood issues associated with hormonal imbalances in PCOS. Choose exercises of your choice like yoga, Pilates, brisk walking, etc.
- 8 hours of sleep.
- Eat a diet rich in whole grains, fruits, and vegetables, and low in processed products can help keep your blood sugar low.
- Include lots of fruits like oranges, cherries, blueberries, and green vegetables in your diet. Nuts like almonds and pistachios are also healthy sources of fiber
- Opt for whole grains to regulate your blood sugar and get healthy carbs
- Consume fish high in Omega-3 fatty acids like salmon, mackerel, and sardines
- Avoid foods rich in refined carbohydrates like white bread and muffins, sugar-laden food and drinks, processed and red meat, and foods made with white flour
- Always read your food labels while buying them and beware of sugar’s various names like fructose, sucrose, dextrose, and high fructose corn syrup. Avoid buying such food items.
Adopting a disciplined and healthy lifestyle is the way to control PCOS. It needs a lot of determination, but the devil called PCOS can be controlled when we control our vices.
The right diagnosis and the right treatment are needed with consistency and PCOS has both short-term and long-term effects.
What should you do if you suspect you have PCOS?
You may make an appointment with your doctor and discuss the symptoms and the challenges being faced. Your doctor may like to order some blood tests to assess your hormone levels. PCOS may sometimes need short-term implementation of hormonal supplements. with proper treatment, women can usually manage their symptoms, and many are able to get pregnant if they decide to do so.
Book an appointment for a virtual consultation with our experienced gynecologists at CareFirst for understanding and manage your menstrual problems.
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