A Beginner’s Guide to PCOS

A Beginner’s Guide to PCOS

Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder condition that numerous women all over the world suffer from. Women who suffer from PCOS have a tendency to produce higher levels of male hormones in their bodies. This causes them to have irregular menstrual cycles and could even cause trouble in conceiving. From abnormal hair growth on the face to male-pattern baldness to the increased risk of diabetes and heart problems, the symptoms become more severe when the condition is aggravated.

PCOS affects women in their menstruating years, approximately ages between 15-44 years. The current stats stand at 2.2% to 26.7% of women affected by it within this age group. 

Each month, the ovaries release an egg as part of its cycle. This process is known as ovulation. The pituitary gland overlooks the ovulation process by producing Follicle-Stimulating hormone (FSH) and luteinizing hormone (LH). The FSH prompts the ovaries to make a follicle, a sac containing the egg. LH’s job is to trigger the ovary into releasing a mature egg. When there is an imbalance in this process, PCOS is triggered.

As the complete form suggests, PCOS is a ‘syndrome’. PCOS mainly targets the ovaries and ovulation, and its three distinct features are:

  • A surge in male hormone production
  • Formation of cysts in the ovaries
  • Irregular menstruation cycles

PCOS is a polycystic syndrome where multiple sacs are filled with fluid inside the ovaries. These sacs are follicles containing eggs that never mature enough to set off ovulation. The surge in the production of male hormones hinders the menstrual cycle. This causes women to have less frequent periods or none at all.

Causes of PCOS

  1. Genetic Predisposition: Amongst the most common causes of PCOS are genes. A lot of the time, it goes undetected since some women assume that their cycle has “always been irregular”. This is why it’s easier to be normalized. It’s also probable that multiple other genes can be responsible for this condition.
  2. Insulin resistance and obesity: The pancreas secretes a hormone called ‘insulin’ that helps in converting sugar into energy. A large portion of women suffering from PCOS have insulin resistance. Insulin resistance means that the body is unable to use insulin properly. Since the insulin demand increases, the pancreas secretes more insulin to make up for it. This, in turn, causes the ovaries to secrete more male hormones, which then causes PCOS - making it into a vicious cycle. Insulin resistance is also closely linked with obesity. This is also why most women with PCOS have severe weight gain issues. Insulin resistance also puts patients of PCOS at a very high risk of developing type 2 diabetes. 
  3. Inflammation: Studies have suggested that increased inflammation leads to increased androgen production in women with PCOS. Inflammation is also caused due to being overweight. So the symptoms of PCOS feed into each other, making the condition worse. This might seem scary but try and think of it this way: if you can tackle just one of these causes properly, you will have a positive effect on the whole cycle, which can help reduce the other symptoms as well. Good news, right? 

Symptoms of PCOS

More often than not, PCOS symptoms are not triggered in the initial days of menstruation. The symptoms, in most cases, are triggered when a lot of unhealthy weight is suddenly gained due to poor lifestyle choices. 

Symptoms of PCOS include:

  1. Irregular periods: Irregular periods are the most common symptom of PCOS. Due to the lack of ovulation, the body cannot trigger a menstrual cycle. Women with PCOS either have very irregular periods or even none at all.
  2. Profuse bleeding: Another symptom of PCOS is very heavy bleeding. Prolonged durations of not bleeding causes the uterine lining to build up. Hence, when women get their menstrual cycle after prolonged periods, they are cumbersome and painful. 
  3. Weight gain: Women suffering from PCOS are highly likely to be overweight or obese. The stats show that 80% of women who suffer from PCOS are overweight or obese.
  4. Acne: The surge in male hormone production can make the skin oilier than usual. Hence, this becomes a cause of severe acne breakout on the face and all over the body.
  5. Male pattern baldness: Women suffering from PCOS are also prone to experiencing hair thinning and losing hair strands.
  6. Headaches: The hormonal imbalance in the body can trigger severe headaches in PCOS patients.
  7. Abnormal hair growth: Women suffering from PCOS face abnormal hair growth on their face, belly, back, and chest. This condition is called hirsutism. More than 70% of PCOS patients face this abnormal hair growth, making it one of the most common symptoms.
  8. Darkened skin: Skin darkening tends to occur under the skin folds like the neck, breasts, etc. 

Complications with PCOS

PCOS is a condition that not only affects your physical health but also impacts your mental health as well. Mentioned below are some of the complications faced when suffering from PCOS:

  1. Infertility: When the ovulation cycle is so heavily interrupted, it is bound to have an effect on fertility. If enough eggs won’t be released to get fertilized, it becomes tougher to conceive. PCOS, unfortunately, is one of the major causes of infertility in women.
  2. Sleep apnea: Women suffering from PCOS are at a higher risk of sleep apnea, especially the ones who are overweight. Sleep apnea is a condition where breathing is interrupted multiple times during sleep. This causes the person to have disturbed sleep. Studies have shown that women who suffer from obesity and PCOS are 5-10 times likelier to have sleep apnea. And poor sleep is directly linked with poor mental health. 
  3. Metabolic syndrome: As stated earlier, the stats of women who are obese and have PCOS stand at 80%. PCOS and obesity put these women at a very high risk of: High blood pressure levels; high blood sugar levels; higher levels of ‘LDL’, i.e., bad cholesterol and lower levels of ‘HDL’, i.e., good cholesterol

Together, these complications can cause much more significant problems like heart diseases, diabetes, and even a stroke!

  1. Fluctuating insulin levels and diabetes: As discussed earlier, PCOS risks developing insulin resistance in women. This insulin resistance results in increased production of androgens. The sugar isn’t absorbed very well by the cells. Hence, insulin resistance creates a need in the body to produce more insulin for compensation. As a result, more sugar is in your blood than the average. Such a state creates a condition for diabetes. This can also impact your cardiovascular function and the nervous system. 
  2. Uterine/endometrial cancer: Since the process of ovulation never really completes, the uterine lining builds up over time. This puts women suffering from PCOS at a very high risk of developing endometrial cancer.
  3. Non-alcoholic steatohepatitis: Also known as the non-alcoholic fatty liver disease, this is a liver inflammation disease. Fat accumulates in the liver, which causes inflammation, and can even lead to scarring of the liver.
  4. Other complications of PCOS include:
  • Depression
  • Anxiety
  • Abnormal uterine bleeding
  • Eating disorders

How is PCOS diagnosed?

There isn’t a particular test that can diagnose PCOS. Usually, the doctors start by ticking two of three symptoms:

  • Irregular periods
  • High androgen levels
  • Ovarian cysts

Additionally, the doctor asks if you’re having any other symptoms such as acne, hair growth, weight gain, hair thinning, etc. Besides this, the doctor conducts a pelvic exam, where they identify the problem areas of the ovaries and reproductive tract. 

You might be asked to get blood tests to check your hormone levels, blood sugar, and cholesterol. An ultrasound is conducted to check for cysts and tumors in the ovaries and measure the uterus lining. 

Treatment for PCOS

Treatment of PCOS depends on the condition, whether you are trying to conceive a pregnancy or not.

In the former case, the best option is to make better lifestyle choices and changes. There exists no ‘cure’ as such for PCOS. The only way to deal with the ailment is to exercise regularly and eat healthier. There are a lot of alternative foods that help in easing the symptoms of PCOS significantly. Besides this, the doctor can prescribe medicines for hormonal balance, insulin-sensitizing, and blocking androgen production. However, the best course of action is to make lifestyle changes because not only is that healthier and sustainable.

The treatment for the latter case is a little more elaborate. The doctor can put you on medication to induce ovulation. Many women suffering from PCOS also opt for in vitro fertilization (IVF) to get pregnant. There is also a surgical procedure known as ovarian drilling. This process can prevent ovulation by removing the androgen-producing tissues in the body. However, doctors do not go for this procedure nowadays, given the availability of newer, better medicines.

Final thoughts

PCOS is an ailment that affects a lot of women all over the world. The stats suggest that PCOS goes undiagnosed in about 70% of women who have it. Staggering figures, aren’t they? But PCOS doesn't have to be scary. The condition can be reversed, given that the proper steps are taken. Please visit your gynecologist if you’re currently experiencing these symptoms