PCOS, popularly known as Polycystic Ovarian Syndrome, is a multisystem disorder which generally affects women in the age group of 15-45 years (reproductive age). In this syndrome, there are various metabolic disturbances and a wide variety of clinical features. It is a hormonal disorder that causes the enlargement of ovaries with small cysts of the outer edges.
The cause of PCOS is not well understood. It may involve a combination of genetic and environmental factors.
The core region that is affected by PCOS is the women’s ovaries. Ovary is a reproductive organ that is responsible for producing important hormones like estrogen and progesterone, which help in the regulation of the menstrual cycle. It also produces androgen, a male hormone, in minute amounts.
It is now easier to understand how the unbalanced secretion of these hormones is the reason behind menstrual disturbances and masculine hair growth on the body in the case of PCOS.
The main job of the ovaries is to release eggs. They release a single mature egg from alternate ovaries every month. When this egg is fertilized by the male sperm, pregnancy occurs. The most common and sensitive issue in PCOS, is infertility.
Listed below are some of the major PCOS symptoms :
- Ovarian Cysts: Ovarian cysts are fluid-filled sacs or pockets in an ovary or on its surface. Most of the women have ovarian cysts at some time in their life. Most of these cysts cause very little or no discomfort, thus they are harmless. But there can be serious implications in the case of an ovarian cyst rupture. Ovarian cysts can cause pelvic pain, heaviness in abdomen and bloating.
- Androgen Excess: Androgen is a male hormone which is also produced in very small amounts in females. Androgen excess is the most common endocrine disorder in the women during their reproductive age. It causes various clinical features such as acne, hirsutism and reproductive dysfunction.
- Irregular menstrual cycle: Irregular menses can be caused due to hormonal imbalances in the body. It can also be due to excessive stress, hyperthyroidism and of course due to PCOS.
Insulin resistance is very commonly seen in PCOS. It is mostly because the cells are unable to use insulin properly, due to which there is an increase in the body’s demand for Insulin. Due to this extra insulin produced in the body, the ovaries get triggered to produce more amount of androgen. The main reason for insulin resistance is obesity. Diabetes too occurs due to insulin resistance and obesity.
Why is it called PCOS?
In this condition, many fluid-filled sacs grow inside of the ovaries. These sacs are follicles that contain small immature eggs in each of them. These eggs never become mature enough to go through ovulation. Thus, they keep increasing inside the ovaries situated peripherally to them. When seen from an ultrasound, it looks like a queen’s necklace. This is the most important diagnostic feature of PCOS.
What is the cause of PCOS?
The cause of PCOS are still not found but there are several other factors that may trigger it.
- Heredity:PCOS sometimes runs in families. If any relatives, such as your mother, sister or aunt, have PCOS, the risk of you developing it is often increased. This suggests there may be a genetic link to PCOS, although specific genes associated with the condition have not yet been identified.
- Stress: Stress is also one of the major factors for occurrence of PCOS. High levels of stress may lead to hormonal imbalance which may then trigger PCOS
- Unhealthy Eating Habits: Consumption of junk, unhealthy and nutrition deficient food may take you closer to PCOS.
- Obesity: The probability of contraction of PCOS in cases of overweight and obesity and vice versa.
- Diabetes: Girls/Women having uncontrolled diabetes may contract PCOS due to the insulin resistance.
- Depression/Anxiety: If you are suffering from depression, it will surely lead to unhealthy food habits and thus there is a good chance of contracting disease in such women.
PCOS Symptoms and Signs
- Irregular menses: Irregular or absence of periods is common
- Heavy menses: Heavy menses happen due to the thickening of the inner layer of the uterus.
- Hirsutism: Excessive growth of facial hair, hair on chin, breasts and thigh, due to the increase in level of androgen.
- Acne/Pimple: Due to the excessive level of androgen, the skin becomes oily which leads to formation of the acne and pimples.
- Infertility: Perhaps the most sensitive issue for a woman. It is more common with PCOS due to anovulation due to which, fertilization is not possible.
- No Dysmenorrhea: In PCOS, ovulation doesn’t happen, so there’s no pain while menses.
- Skin Pigmentation: Thick pigmented skin over the nape of neck, inner thigh and armpit.
- Pattern Baldness: Scalp hair becomes thinner and hair falls out more easily.
- Disturbed Sleep: Breathing difficulty while sleeping and erratic sleep.
- Endometrial Cancer: Generally, in menses, there is a shedding of the uterine linings. But in PCOS, anovulation is common. So, there is a thickening of uterine linings which may lead to endometrial cancer.
- X Syndrome: In PCOS, diabetes, hypertension along with hyperlipidaemia, & cardiovascular disease can be common. This cluster of disorders is called as X syndrome.
Diagnosis of PCOS
In most cases, PCOS goes unnoticed until it causes some major impact on the body like excessive hair growth, weight gain or when the women face infertility after marriage.
When you consult a gynaecologist, first they ask you for detailed medical history as well as family history. Along with that:
- Blood Tests: They are conducted to rule out the chances of diabetes, high cholesterol and insulin resistance.
- Ultrasound: Confirmatory test to find polycystic ovary. Along with the ovarian size, abnormal follicles and their size can be found.
- Hormonal Assay: To check the disturbance of reproductive hormones like oestrogen, progesterone, androgen and other hormones like Thyroid and prolactin level.
Consequences of PCOS on pregnancy?
The main consequences of PCOS is that it mainly leads to infertility. You can overcome this with the help of a Gynaecologist. After you manage to get pregnant, your problems don’t end as women with PCOS have a higher chance of
- Abortion/Miscarriage
- Gestational Diabetes
- Premature Delivery
- Hypertension (high BP) in Pregnancy
- Disturbance in Cholesterol/lipids
- PCOS in subsequent life
By adopting a holistic and healthy lifestyle for your PCOS reversal and with with proper medical care and advice of the gynaecologist and other health experts, you can carry out your pregnancy smoothly.