Polycystic Ovarian syndrome

Polycystic ovarian syndrome (PCOS)

 

Lately, the diagnosis of this condition especially among young women is becoming more common.I have a lot of women tell me that they have been told they have PCOS, I am not sure all of them actually do!

The American statistics show that 1 in 25 to 1 in 10 women may be having PCOS. But maybe many women are also being over diagnosed.

The data also shows that 1 in 5 women have ovaries with polycystic appearance. So what is the difference?

What is this condition? How can you suspect you have it?

What does it mean for your health? What are the long term implications for this? Can it be treated or controlled?

These are some of the many questions that may be going through your head if u have recently been told you have this condition. There are many myths associated with this condition and I will try and answer and resolve as many of them as I can.

What is PCOS?

PCOS stands for Polycystic ovarian syndrome. It is a condition of hormonal disturbance in females resulting in any or all of the following: irregular periods, weight gain, difficulty in conceiving, acne and some other long term complications.

Polycystic ovaries are a part of this syndrome. Ovaries with a large number of follicles, with a typical appearance on ultrasound are called polycystic ovaries. Not all women with polycystic ovaries have the syndrome.

What are the common symptoms?

The most common symptom of PCOS is irregular periods. The periods usually come at irregular and prolonged intervals, sometimes being absent for 2-3 months also. This may be associated with weight gain, increased facial hair, acne and difficulty in getting pregnant.

How can the diagnosis be confirmed?

The diagnosis is confirmed based on your symptoms, Ultrasound for your ovaries and some blood tests for hormones. It is best to have these tests and ultrasound done on the second or third day of your period.

According to the Rotterdam criteria for diagnosis of PCOS two out of the three criteria should be present.

These are :

  1. Irregular prolonged periods
  2. Signs of increased androgens (male hormones) like excessive hair/ acne OR blood reports suggestive of the same
  3. Ultrasound showing polycystic ovaries : Ovaries which are larger than normal ovaries and have more than double the number of eggs, as seen on ultrasound.

What causes PCOS?

The exact cause behind PCOS is not clearly defined. It is believed to be an imbalance between male and female hormones in the body leading to excessive male hormones which leads to the manifestations of PCOS. The excess of male hormones makes it difficult for the ovary to produce and release an egg every month, resulting in irregular periods and subsequently difficulty in conceiving.

The development of PCOS may also be liked to Insulin resistance and this may be the factor linking it to diabetes in the long run.

What does it mean once I have been diagnosed with PCOS?

PCOS is not a disease. It is a collection of symptoms. But it also has short and long term implications for your health if it is not corrected.

Short term Health concerns:

Weight gain and acne

Excessive hair on face and chest, also called hirsutism

Irregular periods which may be associated with heavy periods also

Inability or difficulty to conceive

Miscarriage in early pregnancy

Long term concerns:

Long standing PCOS, especially if periods remain irregular or less frequent than 3 times a year, can lead to Diabetes, high blood pressure, Obesity, cardiac problems, cancer of the womb, depression, snoring and daytime sleepiness.

What is the treatment for PCOS?

As PCOS is not a disease there is no definite treatment for it. However, there are some lifestyle changes and medications that can help reduce the chances of your having symptoms and any complications of PCOS.

Lifestyle modifications

A healthy diet

Eating a balanced diet with plenty of fruits and vegetables has been associated with improvement in this condition.

Losing weight with diet and exercise also improves the hormonal imbalance. It has been shown that losing even 5 % of your weight might be enough to improve your symptoms. BMI or body mass index is a good way to monitor your health. The BMI depends on a person’s weight and height. It is best to maintain your BMI between 19 and 25.

Regular routine. Sleeping on time i.e. not very late and trying to get up early also helps improve PCOS.

Stress management. Techniques to reduce stress like meditation, music therapy, exercise etc also help reduce the severity of PCOS.

Medications:

Cyclical hormonal pills: Sometime you may be given hormonal pills like the contraceptive pills to regularize the period. These do not treat he condition but while you are taking the medicines your periods will come on time and the other symptoms like acne and hirsutism may also improve. However they are likely to come back once you stop the pills.

Metformin: Medications that reduce insulin resistance can help reduce the imbalance between male and female hormones and hence improve the symptoms.

But the most important and effective method of dealing with PCOS remains weight loss and lifestyle management.

The take home message is that PCOS is a very common condition among young women and although it may seem difficult in the beginning, can be kept under control with a disciplined lifestyle and a little help from medications.

 

 

 

 

 

 

 

Author: drnehagami

M.B.,B.S
M.D. ( Obs and Gyne)
D.N.B. ( Obs and Gyne )
M.R.C.O.G ( United Kingdom )
F.C.L.S ( India )

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