Women in their reproductive age carry two special hormones that keep them fertile. Those hormones are progesterone and estrogen. In Polycystic Ovary Syndrome (PCOS) these two hormones get out of balance. The disturbance in these hormones leads to the development of cysts in the ovary. Most of these ovarian cysts are non-cancerous and do not cause any harm, but they can create complications in some cases. The prolonged disturbance in hormone levels can lead to many changes in fertility, physical appearance, menstrual cycle, and cardiac function.
Frequency of PCOS
This disease is very common. The research of the US Department of Health and Human Services shows that 1 in every 20 women in their fertile age is suffering from PCOS. In some regions, this rate is almost 1 in every 10 women. According to one estimate, in the United States almost 5 million women are suffering from this disease. In the UK, studies have shown a rate of 1 in 5 women suffering from this disease but more than 50% of these women don’t show any kind of symptoms. These stats are alarming because they show a high percentage of women being affected but who aren’t being treated for the condition. This is dangerous because PCOS can lead to additional very serious issues.
Symptoms of PCOS
The internal symptoms of PCOS generally appear when a girl starts to menstruate, and observable symptoms appear in late teens or early twenties. There are many symptoms of PCOS, and the occurrence of symptoms varies with each person. PCOS decreases the production of female reproductive hormones in the body, and some of the main symptoms include
• Change of voice
• Thinning of hair on the head
• Noticeable decrease in the size of breast
• Development of excessive hair on various parts of the body including face, toes, stomach, thumbs, and chest
Other symptoms include
• Oily skin
• Hair loss
• Anxiety and depression
• Weight gain
• Difficulty in losing weight
• Irregular or non-existent menstruation
• Acne on face and body
Your Doctor will also look for
• Increase in the size of your ovaries and the presence of cysts
• Decrease in the production of estrogen and progesterone
• Increase in the production of androgen
Diagnosis of PCOS
According to the Mayo Clinic, there is no specific test for Polycystic Ovary Syndrome, rather your doctor will come to the diagnosis after multiple tests and exams rule out other conditions.
“During this process, you and your doctor will discuss your medical history, including your menstrual periods, weight changes and other symptoms. Your doctor may also perform certain tests and exams:
- Physical exam. During your physical exam, your doctor will note several key pieces of information, including your height, weight and blood pressure.
- Pelvic exam. During a pelvic exam, your doctor visually and manually inspects your reproductive organs for signs of masses, growths or other abnormalities.
- Blood tests. Your blood may be drawn to measure the levels of several hormones to exclude possible causes of menstrual abnormalities or androgen excess that mimic PCOS. Additional blood testing may include fasting cholesterol and triglyceride levels and a glucose tolerance test, in which glucose levels are measured while fasting and after drinking a glucose-containing beverage.
- Ultrasound. An ultrasound exam can show the appearance of your ovaries and the thickness of the lining of your uterus. During the test, you lie on a bed or examining table while a wand-like device (transducer) is placed in your vagina (transvaginal ultrasound). The transducer emits inaudible sound waves that are translated into images on a computer screen.” (Quotation taken directly from http://www.mayoclinic.org/diseases-conditions/pcos/basics/tests-diagnosis/con-20028841)
Causes of PCOS
Doctors still have not found a direct cause for this condition, but there are a few factors they believe have an effect.
- Excess insulin. Insulin produced in the pancreas helps your body process sugar, which is your body’s primary energy supply. Excess insulin might affect the ovaries by increasing androgen levels, which may interfere with ovulation.
- Low-grade inflammation. White blood cells produce substances to fight infection in a response called inflammation. Research shows that women with PCOS often have low-grade inflammation that stimulates polycystic ovaries to produce androgens.
- Heredity. If your direct blood relative has or had PCOS, your chances are high as well. Researchers also are looking into the possibility that specific genes are linked to PCOS.
Treatment of PCOS
Polycystic ovary syndrome treatment usually will focus on management of your individual symptoms, such as infertility, acne or obesity. According to the Mayo Clinic:
“Your doctor may prescribe a medication to:
- Regulate your menstrual cycle. To regulate your menstrual cycle, your doctor may recommend combination birth control pills — pills that contain both estrogen and progestin. These birth control pills decrease androgen production and give your body a break from the effects of continuous estrogen, lowering your risk of endometrial cancer and correcting abnormal bleeding. As an alternative to birth control pills, you might use a skin patch or vaginal ring that contains a combination of estrogen and progestin. During the time that you take this medication to relieve your symptoms, you won’t be able to conceive.If you’re not a good candidate for combination birth control pills, an alternative approach is to take progesterone for 10 to 14 days every one to two months. This type of progesterone therapy regulates your periods and offers protection against endometrial cancer, but it doesn’t improve androgen levels and it won’t prevent pregnancy. The progestin-only minipill or progestin-containing intrauterine device are better choices if you also wish to avoid pregnancy.
Your doctor also may prescribe metformin (Glucophage, Fortamet, others), an oral medication for type 2 diabetes that improves insulin resistance and lowers insulin levels. This drug may help with ovulation and lead to regular menstrual cycles. Metformin also slows the progression to type 2 diabetes if you already have prediabetes and aids in weight loss if you also follow a diet and an exercise program.
- Help you ovulate. If you’re trying to become pregnant, you may need a medication to help you ovulate. Clomiphene (Clomid, Serophene) is an oral anti-estrogen medication that you take in the first part of your menstrual cycle. If clomiphene alone isn’t effective, your doctor may add metformin to help induce ovulation.If you don’t become pregnant using clomiphene and metformin, your doctor may recommend using gonadotropins — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications that are administered by injection. Another medication that your doctor may have you try is letrozole (Femara). Doctors don’t know exactly how letrozole works to stimulate the ovaries, but it may help with ovulation when other medications fail.
When taking any type of medication to help you ovulate, it’s important that you work with a reproductive specialist and have regular ultrasounds to monitor your progress and avoid problems.
- Reduce excessive hair growth. Your doctor may recommend birth control pills to decrease androgen production, or another medication called spironolactone (Aldactone) that blocks the effects of androgens on the skin. Because spironolactone can cause birth defects, effective contraception is required when using the drug, and it’s not recommended if you’re pregnant or planning to become pregnant. Eflornithine (Vaniqa) is another medication possibility; the cream slows facial hair growth in women.” (Quotation from http://www.mayoclinic.org/diseases-conditions/pcos/basics/treatment/con-20028841)
Lifestyle changes or home remedies recommended tend to center around losing weight and dietary adjustments in order to help manage insulin production.
If you think you may have PCOS or if you’re having any of the symptoms listed in this article, please consult your doctor for diagnosis and treatment.