PCOS (Polycystic Ovary Syndrome)

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder in women of reproductive age in which women have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. Women can have enlarged ovaries containing many small cysts which interfere with regular menstruation and fertility. Excess androgens due to PCOS can lead to excess hair growth, weight gain, and acne.

The common symptoms of PCOS

The most common symptoms of PCOS include:

  • Irregular menstrual cycles: The absence of regular ovulation prevents the shedding of the uterine lining every month leading to irregular periods.
  • Excessive hair and acne: Women with PCOS often have excessive hair on their faces and body. They also have hormonal breakouts due to excessive androgens.
  • Weight gain: Insulin resistance often leads to faster weight gain and difficulty in losing that weight.
  • Painful periods: Extremely painful periods, along with nausea, lower back pain, diarrhoea, dizziness and fatigue can be possible symptoms of PCOS.
  • Skin darkening: PCOS leads to the darkening of the skin around the neck, armpits, groin and other folds of the body. This condition is acanthosis nigricans.

What causes PCOS?

Although the exact cause of PCOS is not known, doctors speculate that high levels of male hormones in the female body disrupt the normal process of making eggs by the ovaries. Genetic factors, insulin resistance, and the presence of inflammation can lead to excess production of androgens. Obesity is a major cause of both insulin resistance and increased levels of inflammation in the body.

How is PCOS diagnosed?

Diagnosis involves a physical pelvic examination by the doctor after discussing the medical history and symptoms of the patient. Doctors may often require other tests for diagnosis, including:

  • Ultrasound/USG: This is an imaging test that shows the size of the ovaries and also shows if the ovaries have cysts.
  • Blood tests: These tests provide information about the levels of androgens and other hormones. The doctor may also check the levels of blood glucose, cholesterol, and triglycerides.

Remedies/Treatment

The symptoms of PCOS can be managed quite effectively. Lifestyle interventions are often the first line of treatment recommended by doctors for PCOS. The doctors may also suggest hormonal birth control pills, anti-androgen medications, or metformin. However, the exact treatment depends on the age, severity of the symptoms, and overall health of the patient. The most common treatment options include one or more of the following options:

  • Lifestyle modification: A healthy diet and an active lifestyle can aid in weight loss and keep the body weight under control. This can improve insulin resistance and keep the symptoms under control.
  • Ovulatory medications: These medications can help the ovaries to release eggs normally.
  • Birth control pills: They help in regulating the menstrual cycles by lowering androgens and also help in reducing hormonal acne.
  • Diabetes medication: They help in managing lower insulin resistance in PCOS. It may be prescribed to reduce androgen levels, regularise ovulation, and control excessive hair growth.

When to see a doctor?

Consult a doctor in case of:

  • Missed periods in the absence of pregnancy
  • Presence of symptoms of PCOS, such as excessive hair growth and acne
  • Not being able to get pregnant for more than 12 months
  • Having symptoms of diabetes such as excessive thirst or hunger, or unexplained weight loss

PCOS is a common problem in women of reproductive age and although it can not be cured, it can be effectively managed by simple lifestyle modifications. The key to effective management is to diagnose the symptoms early and discuss them with the doctor to obtain a comprehensive management plan.

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Apollo Fertility, Varanasi

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1. I have PCOS. What kind of foods should I eat to keep my hormones under control?

Protein, fibre and healthy fats are your best friend. It is best to choose carbohydrates that are digested slowly like beans, chickpeas, or lentils, whole grains (brown or red rice, quinoa or whole oats) and sweet vegetables. Always combine carbohydrates with protein, healthy fats and fibre. Eat frequently but avoid constant snacking.

2. Why have I been prescribed a birth control pill for treating PCOS?

Doctors prescribe birth control pills to restore normal hormonal balance, regulate ovulation, relieve symptoms like excess hair growth or acne, and protect against endometrial cancer.

3. I have PCOS. Will this make it harder for me to become pregnant?

PCOS causes irregularities in the menstrual cycle and makes it harder to get pregnant. However, women with PCOS can easily get pregnant using fertility treatments which help in improving ovulation. Losing as little as 10% of the overall body weight and lowering blood sugar levels can also improve the chances of conception.

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