Polycystic Ovarian syndrome (PCOS)

 Polycysticovarian syndrome (PCOS) is a health problem that affects 1 in 10 woman of child bearing age. Woman with PCOS have a hormonal imbalance and metabolic problem that may affect their overall health and appearance. PCOS is a common and treatable cause of infertility. The hormonal imbalance creates problems in the ovaries. The ovaries form multiple fluid filled sacs called follicles in its outer edge which fail to mature and ovulate.  The egg may not develop as it should or it may not be released during ovulation as it should be.

CAUSE- Exact cause is still not known but genetic and environmental factos both plays a role.

Genes – Studies show that POCS run in families. It is likely that many genes contribute to this condition.

High levels of androgens - All women make small amounts of androgens or male hormones. Androgens control the development of male traits like male pattern baldness. Women with PCOS have more androgens than normal. Higher than normal androgen levels in woman can prevent the ovaries from releasing an egg (Ovulation) during each menstrual cycle and can cause extra hair growth, acne.

High level of insulin – Insulin is a hormone produced by pancrease to help body use sugar from foods for energy. When cells cannot use insulin properly, the body’s demand for insulin increases. The pancrease makes more insulin to compensate. Extra insulin trigger the ovaries to produce more male hormones. Insulin resistance occurs and Insulin blood levels become higher than normal. Many woman with PCOS have insulin resistance, specially those with overweight or obesity, have unhealthy eating habits, lack of physical activity and family history of diabetes. This with time leads to Type II Diabetes.

Inflammation – Woman with PCOS often have increased levels of inflammation within their body. Being overweight can also contribute to inflammation. Studies have linked excess inflammation to higher androgen levels. 

SIGNS AND SYMPTOMS-Signs and symptoms vary ranging from menstrual irregularities, excess hair growth, darkening of the skin (in the neck, groin and under breasts,) headaches to obesity. Menstrual irregularities include infrequent, irregular or prolonged cycles (fewer than 9 periods per year). Excess androgens may result in excess facial body hair (hirsuitism) acne and male –pattern baldness.

A diagnosis of PCOS can be made when at least two of these signs are present –

. Irregular periods

. Excess androgen

. Polycystic ovaries (enlarged ovaries which contain follicles that fail to ovulate and release eggs on time)

COMPLICATION-Complications of PCOS can include Infertility, pregnancy complications like pregnancy-included hypertension, mis carriage or premature births, gestational diabetes), Non – alcoholic steatohepatitis, Metabolic syndrome ( hypertension, diabetes mellitus  abnormal cholesterol or trigly cerides , obesity, cardio vascular disease), Type II diabetes mellitus  or prediabetes   , sleep apnea ( the condition causes repeated pauses in breathing during night which interrupts sleep and is more common is woman who are overweight ), Depression, Anxiety, Eating disorders, Abnormal uterine bleeding and cancer of uterine lining (endometrial cancer).

TREATMENT-Treatment can help but this condition can’t be cured. Life style change is the key to keep it under contro .

SELF CARE-Self care includes physical exercise ( at least 30 min 5 days a week of aerobic activity), weight lose ( improves cardio vascular health and reduces the risk of complications related to obesity), diet Losing first 5-10% of body weight can help regulate the menstrual cycle and improve cholesterol levels, lower insulin and reduce heart disease and diabetes risk. Any diet that helps to lose weight can help the condition. Low carbohydrate diets are effective for both weight loss and lowering insulin levels. A low glycemic index  (GI) diet that gets most carbohydrates from fruits, vegetables and whole grain help better

Some evidence shows that acupuncture can help improve PCOS, but more research is needed.

Medications:  May included birth control pills to regularise periods, antidiabetic medications like metformin to prevent diabetes, statins to control high cholesterol, hormones to increase fertility and procedures to remove excess hair growth.

Surgery – Surgery can be an option to improve fertility if other treatments don’t work. Ovarian drilling is a procedure that makes tiny holes is the ovary with laser or thin heated needles to restore normal ovulation.

See your doctor if-

. You have missed periods and you are not pregnant.

. You have symptoms of PCOS like hair growth on the face and body. 

. You have been trying to get pregnant for more than 12 months, but have not been successful.

. You have symptoms of diabetes mellitus like excess thirst or hunger, high BP and other possible complications.