Women with PCOS suffer a great deal, and in India, one in five women are living with this condition. Here are some insights on what PCOS is, its causes, treatment and more.
What is PCOS?
Polycystic ovarian syndrome (PCOS) is a prevalent hormonal imbalance commonly in women. ‘Polycystic’ refers to the appearance of small cysts, and ‘syndrome’ refers to the hormonal symptoms.
In this condition, several small fluid-filled sacs called cysts develop in the ovary and contain immature eggs or ‘follicles’. The maturity and release of the eggs, are dysregulated.
What causes PCOS?
- High levels of androgens: Male hormones called androgens are present excessively, which prevents the ovaries from releasing the egg and causes the formation of cysts. Androgens are also responsible for symptoms of PCOS, such as increased growth of facial hair
- Insulin resistance: It is a condition when the cells in your body are not responding to insulin properly. Insulin is released in response to the presence of glucose in the blood and is essential for glucose uptake by different cells in the body. If cells are resistant to insulin, it leads to insulin overproduction by the pancreas, which then acts on the ovaries and stimulates androgen production
- Low-grade inflammation: Inflammation is the body’s response to infections and injury. When there is an injury, the white blood cells release certain chemicals called inflammatory mediators. Research has shown that people with PCOS have long-standing low-grade inflammation in the body
- Heredity: Several genes that contribute to the development and progression of PCOS have been identified. These genes are involved in the regulation of the synthesis of androgens and steroids
What are the types of PCOS?
Based on the causes, PCOS is classified into 4 types:
- Inflammatory PCOS: it occurs due to long-standing inflammation driving the production of androgens. The symptoms can be minimised by treating the cause of inflammation
- Insulin-resistant PCOS occurs due to insulin resistance of the cells. This is the most frequently occurring subtype of PCOS
- Adrenal PCOS occurs due to excess production of DHEA (dehydroepiandrosterone) by the adrenal glands. The excess DHEA synthesis is in response to stress
- Post-pill PCOS occurs after discontinuation of birth control pills due to increased androgen production
What are the symptoms of PCOS?
- Increased androgens (male hormones) that show excess hair growth, acne, or raised testosterone levels
- Irregular menstrual periods
- The appearance of cysts in your ovaries by ultrasound
- Weight gain around your abdomen region
- Diabetes
- Abnormal lipid levels
Are PCOS and PCOD the same?
Although the signs and symptoms of PCOS and PCOD overlap, they are not the same.
| Polycystic Ovarian Disorder (PCOD) | Polycystic Ovarian Syndrome (PCOS) |
|---|---|
| Ovaries contain and release multiple immature eggs that cause hormone imbalance and swelling of the ovaries | Hormone imbalance leads to increased production of androgen by the ovaries leading to cyst formation and other symptoms. This is a more serious condition |
| More common | Relatively less common |
| Easier to treat: Lifestyle changes often lead to a reversal of the condition | Difficult to treat: Lifestyle changes minimise the symptoms but do not reverse the condition |
| Does not lead to infertility in all women.It is relatively easier to get pregnant with little or no assistance | Pregnancy can be challenging due to hormonal irregularities |
How is PCOS diagnosed?
The first step to diagnosis is a discussion of your signs and symptoms with your doctor, who may advise you to undergo the following tests:
- Blood tests
- Complete blood count
- Blood sugar tests
- Lipid profile
- Hormone profiles (thyroid hormone, androgens, insulin)
- Ultrasound: to detect the presence of cysts, bilateral polycystic ovaries and to check the appearance of the ovaries and the lining of the uterus
What is the treatment for PCOS?
- Lifestyle changes
- Weight loss through regular exercise and following a healthy diet
- Avoid junk food
- Reduce sugar intake
- Minimise stress
- Medicines
- Contraceptive pills to regulate the menstrual cycle, reduce acne and abnormal hair growth, and minimise the risk of endometrial cancer
- Metformin found to be effective in managing insulin resistance
- Medicines that block androgens
- Surgery (Laparoscopic ovarian drilling)
The doctor makes a small cut through your lower abdomen, passes a small instrument called a laparoscope, and destroys the cells producing androgens using heat or laser
Can PCOS be cured?
PCOS can not be cured however, the symptoms can be managed by lifestyle changes, medicines, and surgery.
I have PCOS. What diet plan should I adopt?
Being overweight or obese can worsen your PCOS. Therefore, you must maintain a healthy diet regularly and avoid foods that are rich in sugar and starch. Also, it is important to minimise the quantity of fat in your diet. Consuming more healthy vegetables, legumes, and pulses helps to minimise your symptoms.
How will PCOS affect my chances of getting pregnant?
High levels of androgens in the body prevent normal ovulation and hence pose challenges to pregnancy. To overcome these challenges and increase your chances of conception:
- Maintain a healthy body weight
- Exercise
- Treat the hormonal imbalance properly
- Monitor ovulation and time the sexual intercourse around ovulation.
- Miscarriage
- High blood pressure
- High blood sugar levels
- Premature birth of the baby
What are the complications of PCOS?
- Diabetes
- High blood pressure
- High cholesterol levels
- Heart diseases
- Complications in pregnancy
- Endometrial cancer
