Polycystic Ovarian Syndrome (PCOS)

By:-Dr. Pooja Mittal 30 Oct, 2017

WHAT IS PCOS?

Polycystic ovarian syndrome or Polycystic Ovarian Disease is a common health problem among women caused by an imbalance of reproductive hormones. Because of this hormonal imbalance, the functioning of ovaries becomes disordered, they may not produce an egg each month or the egg is not released as it should happen normally. This results in problems with conceiving, irregular periods and a host of other symptoms.

WHO GETS PCOS?

PCOS can affect a woman any time after puberty, but most commonly women come to know that they have PCOS in their 20s and 30s when they visit the doctor due to infertility, irregular periods or other symptoms. PCOS happens in reproductive age group (between ages 15 and 44 years). The incidence is 2 to 26%. One has a greater risk of having PCOS if one is obese, has a sedentary lifestyle, or if one’s mother, sister or aunt has it.

SYMPTOMS OF PCOS

• Irregular Periods – Women with PCOS may have infrequent or scanty periods. Sometimes, the periods may be heavy and prolonged. Some women stop having periods altogether.
• Infertility (Difficulty in conception)
• Acne
• Weight gain- Women with PCOS often find it difficult to lose weight.
• Unwanted hair- Growth of hair over face, chest, breasts, abdomen and upper back.
• Hair fall and thinning of hair.
• Darkening of skin and pigmentation- particularly over back of the neck, groin and axillae and below the breasts.

WHEN SHOULD ONE SHOULD VISIT THE DOCTOR

One should visit the gynaecologist if one has concerns about periods, if there is difficulty in conceiving, or has problems like excessive hair, weight gain, hair fall or acne.

WHY DOES PCOS HAPPEN?

The exact cause of PCOS is not known. Factors like genetics and unhealthy lifestyle and diet play a role.

Insulin resistance and high insulin levels – Insulin is a hormone that controls how the food we eat is converted into energy and how this energy is used up. Many women with PCOS particularly those with obesity have tissue resistance to insulin leading to high insulin levels. This can predispose to Type 2 Diabetes.

High levels of androgens – Androgens are male hormones but women also have small amount of androgens in their bodies. Women with PCOS have higher than normal levels of androgens in their bodies which causes unwanted hair, hair fall and acne. Abnormal androgens also prevent release of egg from the ovary every month and this leads to difficulty in conception.

WHY SHOULD WE TREAT PCOS – POSSIBLE RISKS

PCOS leads to changes in a woman’s appearance, overall health and life; hence it is important to treat it.

Studies have found a link between PCOS and a host of other health problems including:

• Diabetes – Many women with PCOS will develop diabetes. PCOS also predisposes to diabetes during pregnancy.
• High Blood Pressure – Women with PCOS have a higher risk of developing high blood pressure compared to women of same age without PCOS. High blood pressure is the leading cause of heart disease.
• High cholesterol levels – PCOS predisposes to high blood cholesterol levels which in turn predisposes to coronary artery disease.
• Sleep apnea and snoring – This happens when breathing stops momentarily during sleep due to obstruction.
• Endometrial (uterine) cancer – Studies have found increased risk of endometrial cancer in women with PCOS

COMPLICATIONS DURING PREGNANCY

PCOS can pose problems for the woman and the baby during pregnancy. Women with PCOS have higher rates of:

• Miscarriage
• Diabetes during pregnancy
• Big sized baby
• High blood pressure in pregnancy (pre eclampsia)
• Higher rates of Cesarean section

MEASURES TO CURB PCOS

Lifestyle measures:

• Regular exercise
• Healthy balanced diet, avoiding processed and junk food
• Maintaining a healthy weight

Medicines:

Women with PCOS can be prescribed medication to regularize their periods, normalize hormone levels, decrease high androgen levels, and reduce insulin resistance and to help conception. A thorough evaluation, history and investigations will generally be done for the woman before prescribing medicines.