What is PCOS ?

November 18, 2019

What is PCOS?

 PCOS is a gynecological syndrome characterized by irregular levels of hormones that are responsible for ovulation and preparing secondary physical symptoms in gals.

Ovaries are the main organ in the female reproductive system. Ovaries perform several functions in the female body including the creation of eggs and hormone secretion. The hormones secreted by the ovaries include estrogen, progesterone and a small quantity of testosterone.

Ovulation is the method of relief of an egg from the ovaries every month. The creation and maturation of the egg are managed by the hypothalamus of the brain and the hormones secreted by the pituitary gland. These hormones are Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH).

For efficient ovulation, a specific area of LH to FSH ratio is required. In PCOS, the LH to FSH ratio gets confused and this disruption is sufficient to create a problem in ovulation. Further, there is an enlarged surge of testosterone that also scores up the complexity.

PCOS is a very common endocrine disorder in the female of childbearing age and is also one of the most prominent factors for female infertility. It is expected that roughly 10% of women in the childbearing age may be affected by PCOS in India.

PCOS means Poly Cystic Ovary Syndrome. The nomenclature of this condition shows that several cysts or fluid-filled sacs containing immature eggs are seen in the ovary (polycystic condition) due to disruptive ovulation.

The gals suffering from PCOS usually experience symptoms such as ovarian cysts, dominating level of male hormones and menstrual irregularity or heavy menstrual bleeding.

What are the causes of PCOS?

Although the specific cause of the PCOS remains unknown, some of the factors that contribute to the growth of PCOS are:

Genetics: The connection between the genes and the development of PCOS is a complex phenomenon. To date, the studies in this arena indicate that it is a multigenic disorder with a high level of complexity. The immediate family such as sister or daughter, of the women suffering from PCOS is significantly at higher risk of developing this disease. Further, families with a high incidence of PCOS are also at increased risk of developing type 2 diabetes. Gals between the age group of 15-30 years are usually diagnosed with PCOS.

Insulin resistance: The hormone Insulin is required to sustain an optimum level of sugar in the blood. However, if the body becomes insulin resistant i.e the cells of the body stop responding adequately to insulin, the body is not able to support the blood sugar level. Due to this, increased insulin is secreted leading to a condition known as hyperinsulinemia which is also an important contributor to the development of PCOS. An increased blood level of insulin leads to increased synthesis of androgens such as testosterone. Insulin resistance is seen in approximately 80% of ladies suffering from PCOS. Lifestyle also plays an important role in insulin resistance. Women with lacking physical activity and bad eating habits are at improved risk of altered insulin levels.

Sedentary lifestyle and Obesity: Low levels of activity and being overweight also results in the growth of PCOS. Scientific studies report that the signs of PCOS start appearing once the women gain weight. Obesity is strongly linked to hyperinsulinemia and increased risk of type 2 diabetes

What are the symptoms of PCOS?

Some of the basic signs experienced in PCOS are:

  • Menstrual irregularity or heavy bleeding
  • Improved production of oil and sebum in the skin leading to acne
  • Improved hair growth in the face, back, belly, and chest.
  • The appearance of male pattern baldness
  • Overweight or obesity
  • Darkening of the skin of the neck and encircling area of the breast.
  • Headaches
  • Psychological effects such as depression and anxiety
  • Reduced fertility

 What are the effects of PCOS on the body?

Common hormonal level, especially in females, is one of the prerequisites for sound health. PCOS disrupts the physiology of the body in the following manner:

Infertility: Preparation of the egg with the sperm is an essential phenomenon for reproduction. In PCOS, the ovulation method is disturbed and there is no release of the egg from the ovary which leads to infertility PCOS is considered to be one of the important causes of infertility.

Sleep apnea: Women with PCOS may improve sleep apnea or interruption in sleep. The situation is described by obstruction of the upper respiratory system while sleeping followed by bouts of pauses in breathing. This may partially be due to the excessive thickening of the neck due to the deposition of fatty tissue in obese people.

Psychological condition issues: More than 50% of PCOS ladies suffer from anxiety and depression. This is due to small confidence, decreased self-image, and low esteem while coping with the symptoms of PCOS such as hirsutism (excessive facial hair), alopecia, moderate to severe acne and obesity.

Metabolic effects: Gals suffering from PCOS are at raised risk of developing type 2 diabetes, dyslipidemia, cardiovascular disorders, and stroke.

Endometrial cancer: The endometrial lining which is the lining of cells in the uterus, should be shed through each menstrual cycle and a new lining is formed in the next cycle. Due to the unusual period, the previous lining remains unshed leading to the build-up of the endometrial lining. This increases the risk of endometrial cancer.

Acanthosis nigricans: Darkening of the skin is seen in these women and the area most affected is the neck, groin, and tissue surrounding breasts.

How is PCOS diagnosed?

 The gynaecologists can diagnose PCOS by undertaking a detailed medical history of the person followed by:

Physical examination: During the physical examination, the gynaecologist assesses the physical signs such as alopecia, hirsutism and PCOS acne. The doctor may also ask the family records of the patient and new changes in the body such as recent weight gain or menstrual irregularity.

Pelvic examination: Manual inspection and assessment of the reproductive organs are done for identifying any abnormal mass or tissue growth.

Blood tests: The total hormonal panel test is recommended by the gynaecologist to decide the level of hormones. The hormones of main importance are estrogen, testosterone, FSH, LH and the ratio of LH to FSH.

Imaging technique: PCOS is described by the cysts in the ovary which can often be visualized in the ultrasound of ovary.

 

How do polycystic ovaries affect pregnancy?

 

Female infertility is the major consequence of PCOS. About 70-80% of the gals suffering from PCOS are unable to conceive. But this connection of PCOS and infertility is not a big cause of concern because, through the advanced treatment strategies, most women are now able to conceive.

PCOS also significantly High risk of pregnancy complications. There is an improved risk of miscarriage and an increase of gestational diabetes which may lead to large babies. Also increased is the risk of preeclampsia, premature delivery and an increased chance of C-section.

Through proper medical care, medical nutrition, vitamins, and mineral supplementation and a sufficient level of antenatal care, the risk of such complications are minimized.

 

Diet and lifestyle tips to manage PCOS

 

Lifestyle changes are considered the first-line treatment strategy for PCOS patients. These lifestyle tips are helpful if one wants to know how to increase fertility with PCOS.

 

  • Maintaining a healthy weight and reducing weight helps in regularizing the menstrual periods and ovulation. Decreasing weight also helps to decrease the risk of metabolic disorder such as diabetes and dyslipidemia and also reduce cardiovascular risks.

 

  • Diet should be a low glycemic index diet in which carbohydrate consumption is restricted, and a significant portion of carbohydrate should be obtained from fruits and grains.

 

  • Moderate intensity exercise should be performed at least thrice a week to maintain regular menstrual periods and ovulation.