What is PCOS?

One of the most common conditions affecting women all around the world is PCOS or polycystic ovary syndrome. It is a hormonal disorder that women can get in their reproductive age that can affect their ability to bear a child. Our body needs both male and female hormones to work but if you are suffering from PCOS your ovaries produce an abnormal amount of androgens or male sex hormones that were present in your body but in a small amount.

This abnormal production may lead to form small cysts in the ovaries. You may experience prolonged or infrequent menstrual periods or excess male hormone levels. The numerous small collections of fluid or follicles developed by ovaries fail to release eggs regularly.

The release of an egg each month is known as ovulation that can be fertilized by a man’s sperm. FSH or follicle-stimulating hormone and LH or luteinizing hormone produced by the pituitary gland control ovulation. PCOS affects both the ovaries and ovulation.

Features pcos

Due to the stimulation by the FSH, the ovary produces a follicle, a sac containing an egg that triggers by LH to release a mature egg. PCOS is a group of symptoms or a syndrome that affects your ovulation and ovaries. The three main features of this syndrome are:

1. High level of male hormone or androgen
2. Cysts (fluid-filled sacs) in the ovaries
3. Irregular menstrual periods

The term ‘polycystic’ means ‘many cysts that are follicles containing immature eggs not enough mature to ovulate. This lack of ovulation changes the progesterone, oestrogen, LH, and FSH levels. In PCOS, androgen levels are higher than usual and progesterone levels are lower than usual. Therefore, women suffering from PCOS get fewer periods than normal because of the extra male hormone.

Polycystic Ovaries and the Role of Hormone

Polycystic ovaries are actually underdeveloped sacs that contain a large number of follicles harmless in nature and up to 8mm in size. The sacs in PCOS are unable to release an egg hence, ovulation does not take place. PCOS today is affecting 1 in every 10 women around the globe mostly without any symptoms.

PCOS occurs due to the imbalance of the reproductive hormones that leads to irregular periods or even no periods. Different hormones produced by your body affect the menstrual cycle that also gives you the ability to bear a child. The role hormones play in PCOS are androgens, progesterone, and insulin.

Progesterone: When you have PCOS you may not produce enough progesterone that leads to trouble predicting exact period timing or missing periods.

Androgens: These are male hormones but found in women as well, however, in a lesser amount. Women suffering from PCOS tend to have a higher level of this hormone.

Insulin: It is the hormone responsible for managing blood sugar. Your body may not react to insulin as it normally should if you have PCOS.

Common symptoms  of PCOS

Around the time of the first menstrual period when puberty starts, PCOS symptoms began to develop in some women while others find them when they had trouble getting pregnant or when they gained weight. Your diagnosis begins when you experience two of these symptoms that vary from person to person. Some of the common symptoms of PCOS are:

• Irregular Periods: The first symptom is missing periods that prevent the uterine lining from shedding every month. While some women experience no menstrual periods at all, some experience fewer than eight periods in a year, or their periods even come after every 21 days or more often.
• Androgen Excess: A high percentage of women with this condition suffer from hirsutism or high hair growth on the face, back, chest, and buttocks. The elevated levels of androgen or male hormones result in hair growth and severe acne and even male-pattern baldness.
• Heavy Bleeding: Periods might be heavier than usual because your uterine lining builds up for a longer time.
• Darkened Skin: Thick or dark skin patches in the creases of your body such as in the armpits, back, groin, under the breasts, or neck.
• Acne: If you have PCOS you may find your skin a bit oilier than normal because of the male hormonethat causes breakouts on the face, upper back, chest, and other such areas.
• Polycystic Ovaries: Your ovaries in PCOS become enlarged and have many cysts that surround the eggs are filled with fluid

Some other symptoms of PCOS include:

• Weight gain
• Headaches
• Male pattern baldness
• Mood swings
• Pelvic pain
• Infertility

Types of PCOS

Insulin Resistance PCOS

It is one of the most common types of PCOS affecting 70 percent of women around the globe. Mostly caused by Trans fat, sugar, pollution, and smoking. In this type of PCOS, the cells become numb to the effect of insulin thus the increased level of insulin prevents ovulation and activates ovaries to produce testosterone.

Some of the symptoms of PCOS are sugar cravings, abdominal weight gain, and fatigue. If your diabetes is on the borderline then quitting sugar might help. Apart from that to treat this type of PCOS regular exercise, taking a balanced diet, reducing stress, and sleeping well might manage the insulin levels.

Adrenal PCOS

Similar to the other type of PCOS, adrenal PCOS symptoms are the same, however, without any inflammation or insulin resistance issues. Unlike other types, it is not related to hormonal birth control. It occurs due to a massive amount of stress as the adrenal organs are controlling the stress response.

The high level of cortisol and DHEA makes the stress response imbalance; this hormonal imbalance leads to PCOS. Managing stress levels, good sleep, and meditation can minimize the causes of this type of PCOS. Avoiding high-intensity exercise can also help.

Post-Pill PCOS

It is the second most common type of PCOS caused by the intake of birth control pills. These pills suppress ovulation while some women get regular menstrual periods after the effects of the pills have gone, others do not resume ovulating even after a year or so. An increase in androgen production causes hair loss, acne, or hair growth on the body and PCOS.

If you are experiencing normal menstrual periods before taking the pills then this might indicate that you have post-pill PCOS. However, this kind of PCOS is temporary and reversible. To mitigate this type of PCOS low stress and good sleep might help. Certain nutrients like zinc, vitamin E and B6, and magnesium can also help.

Inflammatory PCOS

Poor diet, stress, unhealthy lifestyle, and environmental toxins can cause hormonal imbalance and the production of androgens. This type of PCOS suppresses ovulation and decreases the production of progesterone. Moreover, the inflammation causes higher insulin and blood sugar that result in higher production of androgens and lower production of progesterone.

Some of the symptoms of inflammatory PCOS are headache, skin issues, high C reactive protein, and fatigue. Improving digestive enzymes and avoiding stress and foods such as sugar, dairy products, etc might improve the condition. Intake of supplements such as magnesium or natural anti-inflammatories like antioxidants, turmeric, and omega-3 fatty acid can also help.

When should you see a doctor?

You should visit a doctor when you have symptoms such as missing or irregular menstrual periods, weight gain, or if you are experiencing infertility. Signs of hirsutism such as male-pattern baldness, and acne are also some symptoms. Bear in mind that it is still possible to get pregnant even you are suffering from these conditions, however, proper tests and diagnosis and regular visit to your doctor is needed.

Causes and Triggers

The exact cause of PCOS is still unknown, however, few factors play an important role such as genes, high levels of male hormones, insulin resistance, inflammation, etc. Some of them are listed below.

GENES OR HEREDITY

Some researches suggest that PCOS often runs in families as there are certain genes related to the disease. If your mother or sister suffered from PCOS then you are more likely to get it too.

INSULIN RESISTANCE

Your ovaries can get affected if your body produces too much insulin and thus inhibits ovulation. Insulin is the hormone that helps your body’s cells to use sugar as the primary energy supplier. Many women with PCOS suffer from insulin resistance which means your body is not using insulin well and is resisting the action of insulin. The rise in blood sugar in your body produces more insulin that causes a higher level of androgen production.

HIGH LEVEL OF MALE HORMONES OR ANDROGEN

Due to various reasons mentioned such as insulin resistance, heredity, inflammation, etc, your ovaries start producing a high level of androgen that results in acne and hirsutism.

LOW-GRADE INFLAMMATION

Women who are suffering from PCOS might develop a type of low-grade inflammation that causes androgen production. Research shows that polycystic ovaries get stimulates by inflammation and produces androgen that might lead to blood vessel and heart issues.

OBESE OR OVERWEIGHT

It is complicated to say whether PCOS makes you overweight or being overweight causes PCOS. However, obesity increases the amount of insulin production that leads to a higher level of androgen. But many women of normal weight also have PCOS.

RISK FACTORS

If you have a family history of PCOS then you are more likely to have it. Furthermore, some other risks related to PCOS might be insulin resistance or obesity.

PCOS COMPLICATIONS

Women who are suffering from PCOS are prone to develop certain serious health issues due to the high level of androgen. However, these complications differ from person to person, some of them are listed below.

INFERTILITY

It is necessary to ovulate to get pregnant, cysts in the ovaries hinder ovulation. If you are suffering from PCOS then it will be impossible for your eggs to be fertilized by a sperm thus causing trouble in getting pregnant. One of the leading causes of infertility in women today is PCOS. However, you may still get pregnant even if you have PCOS, but regular treatment from a fertility specialist is necessary.

DIABETES AND INSULIN RESISTANCE

As mentioned above insulin resistance causes your body to produce a higher level of androgens. Your body’s muscles, cells, and organs don’t absorb sugar well as they should thus cause insulin resistance. Therefore, your blood sugar level rises due to too much sugar moving through your bloodstream which is also known as diabetes that affects the nervous and cardiovascular systems.

SLEEP APNOEA

PCOS also causes sleep interruption which means repeated pauses in breathing during the night. Women who are obese or overweight and suffering from PCOS can be found with sleep apnoea. However, if a woman is only overweight and does not have PCOS is on the safer side compared to those who have PCOS, who are more prone to the risk of having sleep issues.

METABOLIC SYNDROME

It is a group of symptoms that affects women who are obese or overweight that increases the risk of high blood pressure, high blood sugar, low HDL or good cholesterol, and high LDL or bad cholesterol. Together these factors are known as a metabolic syndrome which in turn increases the risk of getting diabetes, heart disease, and stroke.

ENDOMETRIAL CANCER

This type of cancer begins in the inner lining of the uterus known as the endometrium. When you ovulate the uterine lining sheds, but if you don’t ovulate every month, it causes the uterine lining to build up which increases the risk of endometrial cancer due to the thickened uterine lining.

DEPRESSION

All the symptoms and hormonal changes in a woman affect their mental health. Excess hair growth, risk of infertility, and much more can negatively affect the emotions that lead to anxiety and depression.

Diagnosing PCOS

If you have at least two of the major symptoms such as irregular menstrual cycle and high androgen level your doctor might start diagnosing by asking about your medical history, etc. There is no definite test to diagnose PCOS. However, your doctor might check your medical history and physical examination. Some of the tests that your doctor might recommend are:

Blood Tests

To check your hormone level, androgen excess, and what might be the cause of your menstrual irregularities these testing are necessary. Moreover, a blood test can be done to measure your blood sugar level, and your triglyceride and cholesterol levels.

Pelvic Examination

This examination is done to check manually and visually the problems with your reproductive system especially ovaries.

Transvaginal Ultrasound

To check your reproductive systems such as your ovaries and the thickness of your uterine lining a transducer or a wand-like device will be placed in your vagina that emits sound waves. These sound waves will be translated into images on the screen of the computer.

Some additional diagnosis includes screening for sleep apnoea, anxiety, and depression.

Treatment

Depending on the symptoms, the treatment of PCOS focuses on managing individual concerns such as hirsutism, obesity, infertility, acne-pimples etc. Some of the treatments might involve.

• Lifestyle changes
• Birth control
• Metformin
• Progestin therapy
• Medications to ovulate
• Medications to reduce excess hair growth

To treat PCOS you can also opt for natural or Ayurvedic treatment. Naturoveda Health World specialises in treating PCOS naturally. To With the help of medications, therapies, and even follow-up treatments, you will get a cure for your disease.