PCOS
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Dr. Smita Jadhav: Best PCOS doctor in Kolkata
What is Polycystic Ovary Syndrome (PCOS)?
Common signs of PCOS
- Missed, irregular, or very light periods
- Enlarged ovaries or ovaries with multiple cysts
- Excess body hair, particularly on the chest, stomach, and back (hirsutism)
- Weight gain, especially around the abdomen
- Acne or oily skin
- Thinning hair or male-pattern baldness
- Infertility
- Skin tags, small extra growths on the armpits or neck
- Dark or thickened patches of skin on the back of the neck, under the breasts, or in the armpits
What is Abnormal Menstruation?
Abnormal menstruation, or menstrual irregularity, refers to any deviation from a regular menstrual cycle. While variations in menstrual patterns are common, abnormal menstruation involves significant deviations in frequency, duration, or intensity. This condition can manifest in various ways, disrupting the usual rhythm of a woman’s menstrual cycle and, in some cases, leading to other, more severe health concerns.
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Causes of PCOS
Insulin, produced by the pancreas, helps cells use sugar for energy. When cells become insulin resistant to insulin, blood sugar levels rise, prompting the body to produce more insulin. High levels of insulin can increase androgen production, which may disrupt ovulation. Signs of insulin resistance include dark, velvety skin patches on the neck, armpits, groin, or under the breasts, as well as increased appetite and weight gain.
White blood cells release substances in response to infection or injury, leading to low-grade inflammation. Research shows that people with PCOS may experience long-term, low-grade inflammation, which stimulates the ovaries to produce more androgens, potentially leading to heart and blood vessel issues.
Genetic factors may also play a role, as PCOS is often seen in families. Certain genes might be linked to the condition.
In PCOS, the ovaries may produce elevated levels of androgens, which can interfere with ovulation, preventing eggs from developing and being released. Excess androgen also contributes to symptoms like hirsutism (excess body hair) and acne.
Types of PCOS
This is the most common type, where insulin resistance plays a significant role. Women with this type often have elevated insulin levels, which can lead to increased androgen production. Common symptoms include weight gain, irregular periods, and acne. Women may also experience symptoms of diabetes or prediabetes.
This type is associated with chronic inflammation in the body, often linked to obesity or other inflammatory conditions. Symptoms may include weight gain, fatigue, and skin issues like acne or hirsutism. Women may also experience more severe symptoms related to inflammation.
This type occurs after discontinuing hormonal birth control pills. The body may take time to regulate hormone levels, leading to a return of PCOS symptoms. Women may experience irregular periods, acne, and hair loss. Symptoms may worsen initially before stabilising.
In this type, the primary issue is an overproduction of androgens by the adrenal glands rather than the ovaries. Symptoms can include irregular periods, excessive hair growth, and sometimes fatigue or mood changes.
What is Abnormal Menstruation?
Abnormal menstruation, or menstrual irregularity, refers to any deviation from a regular menstrual cycle. While variations in menstrual patterns are common, abnormal menstruation involves significant deviations in frequency, duration, or intensity. This condition can manifest in various ways, disrupting the usual rhythm of a woman’s menstrual cycle and, in some cases, leading to other, more severe health concerns.
How is PCOS clinically diagnosed?
Ultrasound
This imaging test uses sound waves and a computer to create pictures of your blood vessels, tissues, and organs. It helps assess the size of the ovaries and check for cysts, as well as measure the thickness of the uterine lining (endometrium).
Blood tests
These tests check for elevated levels of androgens and other hormones. Your provider may also test your blood glucose levels, along with cholesterol and triglyceride levels.
What are the treatments for PCOS?
Diet and lifestyle changes
Adopting a healthy diet and increasing physical activity can help with weight loss, reduce symptoms, improve insulin sensitivity, lower blood sugar levels, and potentially help with ovulation.
Ovulation-inducing medications
These medications can help stimulate the ovaries to release eggs. However, they carry some risks, such as an increased chance of multiple births (twins or more) and ovarian hyperstimulation, which can cause bloating and pelvic pain.
Birth control pills
These regulate menstrual cycles, lower androgen levels, and help reduce acne.
Medications for other symptoms
Certain medications can be used to treat specific symptoms like excessive hair growth or acne.
Diet and lifestyle changes
Similar to the approach for those seeking pregnancy, a healthy diet and increased physical activity can help manage symptoms, improve insulin function, and lower blood glucose levels.
Diabetes medications
These are often prescribed to reduce insulin resistance in PCOS. They may also lower androgen levels, slow excessive hair growth, and promote regular ovulation.
PCOS Complications
- Infertility
- Gestational diabetes or high blood pressure during pregnancy
- Miscarriage or premature birth
- Metabolic syndrome — a group of conditions, such as high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels, that increase the risk of cardiovascular disease
- Type 2 diabetes or prediabetes
- Sleep apnea
- Endometrial cancer (cancer of the uterine lining)
Frequently Asked Questions
Irregular menstrual cycles, unwanted hair growth, acne and weight gain are considered to be some of the earliest signs and symptoms of PCOS.
Yes, PCOS can run in families, suggesting that genetics may play a role in its development. Having a family history of PCOS may increase your risk of developing the condition.
PCOS can increase the risk of developing other health conditions, such as type 2 diabetes, heart disease, and endometrial cancer. Managing PCOS effectively can help reduce these risks.
While PCOS cannot be prevented, its symptoms can be managed with lifestyle changes and medical treatment. Early diagnosis and management can help mitigate the impact of the condition.
PCOS can make weight management more challenging due to factors like insulin resistance, which can lead to increased appetite and difficulty losing weight. Many people with PCOS find that they gain weight more easily, especially around the abdomen. Adopting a healthy diet, regular physical activity, and possibly medications can help manage weight and improve symptoms.
