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PCOS: A Common Hormonal Disorder In Women

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PCOS: A Common Hormonal Disorder In Women

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In polycystic ovary syndrome or disease, the ovaries develop many small follicles leading to hormonal imbalance. Read the article to learn more about it.

Medically reviewed by

iCliniq medical review team

Published At May 24, 2015
Reviewed AtDecember 28, 2022

What is PCOS?

PCOS means polycystic ovary syndrome. The ovaries develop many small follicles, also called cysts, of 4 to 10 mm. Poly means ‘many,’ and ‘cysts’ are small closed sacs filled with fluid. It often occurs in the general female population but is more prevalent in infertility populations. Its cause is unknown, although it is likely due to some genetic disorder.

It causes insulin resistance, a condition where the sugar-lowering hormone insulin fails in its action. This results in hormonal imbalance, causing the failure of follicles to mature and ovulate.

The immature follicles in PCOS produce more androgen (male hormone) than estrogen (female hormone). Oral contraceptive pills prevent the development of immature follicles but do not dissolve the existing follicles or cysts. The existing cysts dry up naturally over time.

In contrast, Clomiphene develops mature follicles of 17 to 18 mm or more in size. These produce more estrogen as well as ovulation. Clomiphene also does not dissolve the existing follicles or cysts.

What Causes PCOS?

The exact etiology of PCOS is unknown. However, most women portray insulin resistance. This signifies the inability of the body to use insulin and its functions well. The higher insulin levels lead to an increase in androgen levels. A high-sugar diet further causes a spike in insulin levels. Another cause to have increased insulin levels is obesity, which results in the worsening of PCOS symptoms. PCOS may also have a hereditary link. So, it is common for women of a family to have PCOS, like mothers, daughters, or sisters.

Who Can Get PCOS?

Any woman can get PCOS after attaining puberty and before menopause, that is, during the childbearing age. It is commonly diagnosed in the second or third decade of life when most women try to get pregnant.

A woman is most likely to suffer from PCOS if her mother or sister has it. Low insulin sensitivity, stress, and obesity also pose a predilection for PCOS. With adopting a sedentary lifestyle and fast life, stress is one of the leading risk factors.

What Are the Symptoms of PCOS?

The immature follicles, also called cysts, produce more androgen or testosterone, causing the following symptoms:

  • Infrequent, light (dysmenorrhea), or absent periods (amenorrhea) due to hormonal imbalance.

  • Infertility due to failure of ovulation.

  • Acne and oily skin.

  • Excess body hair (hirsutism), especially on the chest, stomach, chin, etc.

  • Weight gain, particularly abdominal and obesity, due to diminished insulin action.

  • Thinning of hair or male-pattern baldness.

  • Skin tags (small pieces of excess skin) on the neck or armpits.

  • Thick or dark skin patches at the back of the neck, under the breasts, and in the armpits.

How Is PCOS Diagnosed?

The doctor starts recording the patient’s medical history and symptoms to diagnose PCOS. A physical examination, including a pelvic examination, follows this. A pelvic examination is done to ensure the health of the reproductive organs.

To rule out other causes that may mimic the symptoms of PCOS, the following investigations are done:

  • Ultrasonography of the Pelvis: This test reveals the size, appearance, and health of the ovaries and other reproductive organs, like the uterus, fallopian tube, etc.

  • Blood Tests: Tests to check androgen and other hormone levels, blood glucose levels, cholesterol, and triglyceride levels are done.

How to Treat PCOS?

PCOS is not completely reversible, but several treatments can reduce its symptoms. Its treatment varies according to its contributing factors and the symptoms present in a woman. The following treatments are given for the below-mentioned symptoms:

  • Irregular Periods: If the main problem is irregular periods, the usual treatment is the oral contraceptive pill.

  • Infertility: Ovulation can be induced by Clomiphene and hence, treat infertility. However, it may predispose to some risks, like ovarian hyperstimulation and multiple births, causing abdominal bloating and pelvic pain.

  • Excessive and Abnormal Hair Growth: Suppression of male hormone production with tablets, such as the oral contraceptive pill or with an anti-male hormone drug, Cyproterone acetate, is used for at least 9 months.

  • Obesity: A change in lifestyle with a low-fat diet and exercise can reduce weight. Metformin, a drug used for diabetes, can also reduce weight and improve hormonal imbalance.

  • Acne: Oral contraceptive pills help in regulating androgen levels and treat acne.

A change in lifestyle and dietary patterns, with the inclusion of a healthy diet and more physical activity, can assist in losing weight and reducing the symptoms. They can also aid the body in using insulin more efficiently, decreasing blood glucose levels, and helping in ovulation.

To alleviate the physical signs of PCOS, like weight gain, abnormal hair growth, and acne, cosmetic treatments, such as electrolysis and laser hair removal, may aid women to feel better and confident about their appearance. A discussion with the healthcare provider is the best way to deal with such symptoms.

What Are the Complications of PCOS?

The most bothering complication of PCOS is infertility. Some critical health problems like type 2 diabetes, hypertension, heart and blood vessel issues, and uterine cancer may also develop in women with PCOS.

Conclusion:

PCOS is usually seen nowadays among women of reproductive age. The patient seeks medical attention due to missed or irregular menstrual periods, abnormal and excess hair growth, acne, infertility, or obesity. Though it cannot be treated completely, however, its manifestations can be controlled. Generally, the treatment is done according to the associated problems experienced by the patient. The treatment type for PCOS also depends on the decision of the woman to bear the child in the future or not. For women planning a future pregnancy, emphasis is laid on treating infertility by inducing ovulation. PCOS patients may also likely develop type 2 diabetes, hypertension, cardiac issues, and endometrial cancer.

Frequently Asked Questions

1.

What Is the Major Cause of Polycystic Ovary Syndrome?

PCOS is a common hormonal disorder that affects women's ovaries during the childbearing age and affects their hormone levels. The exact cause is unknown, but several factors like excess insulin and androgen, and hereditary (genes) play a significant role.

2.

What Are the Four Types of PCOS?

The four different types of PCOS are:
- Insulin-resistant PCOS - occurs due to the high insulin levels, which prevent ovulation, and trigger ovaries to create testosterone.
- Post-pill PCOS - occurs due to birth control pills.
Inflammatory PCOS - is caused by chronic immune activation to protect against stress or foreign particles.
- Adrenal PCOS - occurs when the androgen released during stress is converted to testosterone.

3.

How Do You Feel When You Have PCOS?

When you have PCOS, you may feel depressed, anxious, tired, impatient, fearful, have trouble managing weight, and sleep apnea.

4.

What Happens if You Have PCOS?

When you have PCOS, you will have irregular periods, unwanted and excessive hair growth (especially in the face, chest, buttocks, and back), acne, difficulty getting pregnant, and obesity. The elevated levels of male hormones may result in these physical signs. Physical examination and blood tests help diagnose this condition.

5.

Is PCOS a Severe Condition?

PCOS is a very severe condition because it can increase the risk of a range of health problems, including type 2 diabetes, high blood pressure, heart attack, stroke, and the risk of developing endometrial and breast cancer.

6.

Will PCOS Go Away on Its Own?

PCOS will never go away on its own, but the symptoms can be managed with the help of various treatment options. Meaning, it is an incurable but manageable disease. Even in menopausal women with PCOS, the levels of androgens are high along with insulin resistance, making them at risk for various complications associated with PCOS.

7.

What Happens if PCOS Is Not Treated?

If left untreated, PCOS may lead to serious, life-threatening illnesses, such as cardiovascular diseases, type 2 diabetes, stroke, uterine and endometrial cancers. It may also lead to reproductive complications, such as ovulation dysfunction and infertility.

8.

Can PCOS Make You Fat?

PCOS makes women gain weight more quickly than others. The more weight they gain, the more additional symptoms they will have. More than 50 % of women with PCOS are overweight, and they have a hard time controlling their weight.

9.

How to Reduce Your Belly if You Have PCOS?

Belly fat in PCOS patients can be reduced by:
- Consuming a high-fiber diet.
- Avoiding sugary foods and beverages.
- Eating four to six small meals in a day rather than three large meals.
- Exercising for at least 30 minutes a day.

10.

Can Weight Loss Cure PCOS?

Losing weight cannot cure PCOS, but it can significantly improve PCOS symptoms and reduce the risk of other health conditions. It also enhances reproductive aspects like regulating your menstrual cycle and helps with ovulation affected by PCOS.

11.

Can PCOS Be Treated Naturally?

The following natural remedies can manage PCOS:
- Support your gut health.
- Improve insulin sensitivity and blood sugar levels.
- Eat liver-friendly foods and herbs.
- Maintain the levels of cortisol by lowering stress.

12.

Is It Possible to Get Pregnant if You Have PCOS?

Untreated PCOS can make getting pregnant difficult. But if you maintain your body weight and BMI (body mass index), eat healthily, maintain blood sugar levels, and use an ovulation calendar to track your periods, you have chances to get pregnant naturally even with PCOS. Sometimes, in vitro fertilization (IVF) treatment and other assisted reproductive technology (ART) might be needed to help you get pregnant with PCOS.

13.

What Foods to be avoided in PCOS?

The foods to be avoided in PCOS are:
- Refined carbohydrates.
- Fried food items.
- Sugary beverages.
- Processed meats.
- Solid fats.
- Excess red meat.

14.

How Can Women With PCOS Conceive Naturally?

Women with PCOS can become pregnant naturally:
- By exercising more frequently.
- Managing their insulin levels with a healthy diet.
- Keeping stress levels down.
- Balancing hormonal levels.

15.

Can Miscarriages Be Prevented in PCOS?

Early loss of pregnancy or miscarriage is three times more common in women with PCOS. The continuous intake of Metformin until the first trimester of pregnancy reduces miscarriages in women with PCOS.

16.

Do Babies Born to Mothers With PCOS Have Congenital Disabilities?

Infants born to mothers with PCOS are prone to various complications that need treatment in the neonatal intensive care unit. They are also at risk of dying before, during, or right after birth. There is also increased risk of neonatal low blood glucose level, doubling of perinatal death rate, respiratory distress syndrome, fetal malformations, cardiovascular malformation, urinary and genital malformations, undescended testicles, and a patent ductus arteriosus in the infant.

17.

Does PCOS Get Cured After Pregnancy?

PCOS does not go away after pregnancy, and the symptoms might return eventually. The only permanent cure is getting the ovaries removed.
Dr. Purushottam Sah
Dr. Purushottam Sah

Obstetrics and Gynecology

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