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Polycystic ovary syndrome (PCOS) is a common condition that affects how a woman’s ovaries work. The three main features of PCOS are:
- Irregular periods – which means your ovaries don’t regularly release eggs (ovulation)
- Excess androgen – high levels of “male hormones” in your body, which may cause physical signs such as excess facial or body hair (see signs and symptoms below)
- Polycystic ovaries – your ovaries become enlarged and contain many fluid-filled sacs (follicles) which surround the eggs (it’s important to note that, despite the name, if you have PCOS you don’t actually have cysts).
It’s difficult to know exactly how many women have PCOS, but it’s thought to be very common affecting about one in every five women in the UK. More than half of these women don’t have any symptoms. Between 5% and 10% of women between 15 and 44, or during the years you can have children, have PCOS. Most women find out they have PCOS in their 20s and 30s, when they have problems getting pregnant and see their doctor. But PCOS can happen at any age after puberty. Women of all races and ethnicities are at risk of PCOS. Your risk of PCOS may be higher if you have obesity or if you have a mother, sister, or aunt with PCOS.
Self diagnosis : You may have PCOS, if you get symptoms like menstrual irregularity, excess hair growth, acne and obesity.
How does PCOS affect your body?
Polycystic ovaries contain a large number of harmless follicles that are up to 8mm (approximately 0.3in) in size. The follicles are under-developed sacs in which eggs develop. In PCOS, these sacs are often unable to release an egg, which means that ovulation doesn’t take place.
Also, many women with PCOS are resistant to the action of insulin in their body and produce higher levels of insulin to overcome this. This contributes to the increased production and activity of hormones such as testosterone. Being overweight or obese also increases the amount of insulin your body produces.
What are the Causes of PCOS?
The exact cause of polycystic ovary syndrome (PCOS) is unknown, but it’s thought to be related to abnormal hormone levels. These include :
- Resistance to insulin – Insulin resistance means the body’s tissues are resistant to the effects of insulin. The body therefore has to produce extra insulin to compensate. High levels of insulin cause the ovaries to produce too much testosterone, which interferes with the development of the follicles (the sacs in the ovaries where eggs develop) and prevents normal ovulation. Insulin resistance can also lead to weight gain, which can make PCOS symptoms worse, because having excess fat causes the body to produce even more insulin.
- Raised levels of testosterone – a hormone often thought of as a male hormone, although all women usually produce small amounts of it
- Raised levels of luteinising hormone (LH) – this stimulates ovulation, but may have an abnormal effect on the ovaries if levels are too high
- Low levels of sex hormone-binding globulin (SHBG) – a protein in the blood, which binds to testosterone and reduces the effect of testosterone
- Raised levels of prolactin (only in some women with PCOS) – hormone that stimulates the breast glands to produce milk in pregnancy
The exact reason why these hormonal changes occur isn’t known. It’s been suggested that the problem may start in the ovary itself, in other glands that produce these hormones, or in the part of the brain that controls their production. The changes may also be caused by the resistance to insulin.
Genetics – PCOS sometimes runs in families. If any relatives, such as your mother, sister or aunt, have PCOS, then the risk of you developing it is often increased.
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What are the Risk Factors of PCOS?
Common risk factors include :
- Depression and anxiety
- Endometrial cancer
- Problems with ovulation
- Insulin resistance
What are the symptoms of PCOS?
Common symptoms include :
- Irregular periods or no periods at all
- Difficulty getting pregnant as a result of irregular ovulation or failure to ovulate
- Excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks
- Weighteight gain
- Thinning hair and hair loss from the head
- Oily skin or acne
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How is PCOS diagnosed?
- Physical examination – Your doctor will look for signs of high levels of androgens such as excess hair growth and acne on your body. You may also receive a pelvic exam to check your ovaries.
- Blood and Imaging tests – Your doctor may recommend blood tests to measure hormone levels and a pelvic ultrasound to get a closer look at your ovaries. This information will help your doctor will look for these three defining signs of PCOS.
- Irregular menstrual periods caused by a lack of ovulation or by irregular ovulation. Periods more than 35 days apart are a strong sign of ovulation problems. But if your periods are slightly irregular – more like 32 to 35 days apart – your doctor may order blood tests at mid-cycle to check progesterone levels, a sign of ovulation.
- Higher than normal androgen levels. Your doctor may look for physical signs of high levels of testosterone and other male hormones – such as excess hair, male-pattern hair loss, and stubborn, severe acne – or use the results of blood tests.
- Polycystic ovaries on pelvic ultrasound – Doctors should look for 25 or more cysts on a woman’s ovary to diagnose polycystic ovaries. In teenagers, the number of cysts may be higher. Your doctor may also look for enlarged ovaries
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How to prevent & control PCOS?
It is possible to prevent PCOS (or keep it from getting worse) by avoiding these things:
- High-carbohydrate foods
- Excess calorie consumption
- Chronic stress
- Inappropriate level of physical activity, whether too high or too low
- Exposure to endocrine-disrupting chemicals (e.g., Bisphenol A, 4-methylbenzylidene, Methylparaben, Nicotine, Sodium Fluoride, PBDEs/PCBs, and Perchlorate )
- Having a high percentage of body fat (being overweight or obese)
- Having a low percentage of body fat due to unhealthy calorie restriction
Treatment of PCOS Allopathic Treatment –
There is no cure for PCOS, treatment is given only to alleviate symptoms. These include :
- Hormonal therapies to stimulate ovulation, including:
- Follicle stimulating hormone (FSH), which stimulates the growth the egg
- Luteinizing hormone (LH), which triggers the release of the egg from the ovary
- Human chorionic gonadotropin (HCG), which ensures the maturation of the egg
- Estrace (estrogen), which prepares the uterus to receive the egg
- Provera (progesterone), which prepares the uterus of implantation
- Menopur (menotropins), which deliver FSH and LH by injection
- Bravelle (urofollitropin), which delivers FSH by injection
For PCOS-related insulin resistance, medication options include:
- Glucophage (metformin), which can control diabetes and assist with weight loss
- Victoza (liraglutide), an injectable drug used to control insulin and glucose levels
- Actos (pioglitazone), a class of injectable drug used to reduce high blood sugar
- Avandia (rosiglitazone), an injectable drug of the same class as pioglitazone
- Avandamet, a combination of rosiglitazone and metformin.
To assist weight loss, current options include:
- Xenical (orlistat), a drug that can prevent the absorption of fat
- Qsymia (phentermine/topiramate), an appetite suppressant
- Belviq (lorcaserin), another appetite suppressant
- Contrave (naltrexone/bupropion), which can curb food cravings
- Saxenda (liraglutide), used to treat insulin resistance and obesity
- Inositol, a natural supplement associated with weight loss in women with PCOS
Women with PCOS often have elevated levels of male hormones (androgens), including testosterone. Anti-androgen medications work by blocking the synthesis of these hormones and minimizing secondary male characteristics, including hirsutism (excessive facial and body hair) or hair loss. Treatment options include:
- Aldactone (spironolactone), a diuretic which has anti-androgenic effects
- Vaniqa (eflornithine hydrochloride), a topical cream used to block hair growth
- Propecia (finasteride), used off-label to treat hair loss in women with PCOS
Treatment of PCOS Homeopathic Treatment –
- Sepia – Best medicine for curing PCOS
- Pulsatilla – For suppressed menses for long duration
- Calcarea Carb – For prolonged and profuse periods
- Natrum Mur – For PCOS with irregular and suppressed menstrual cycles
- Thuja Occidentalis – For retarded menstrual flow
- Pulsatilla, Kali Carb and Senecio – For suppressed or absent menses
PCOS – Lifestyle Tips
- Maintain a healthy weight – Weight loss can reduce insulin and androgen levels and may restore ovulation. Ask your doctor about a weight-control program, and meet regularly with a dietitian for help in reaching weight-loss goals.
- Limit carbohydrates – Low-fat, high-carbohydrate diets might increase insulin levels. Ask your doctor about a low-carbohydrate diet if you have PCOS. Choose complex carbohydrates, which raise your blood sugar levels more slowly.
- Be active – Exercise helps lower blood sugar levels. If you have PCOS, increasing your daily activity and participating in a regular exercise program may treat or even prevent insulin resistance and help you keep your weight under control and avoid developing diabetes.
What are Recommended Exercises for Person with PCOS?
- Cardio exercises – Good for reducing insulin resistance, boosting fertility, stabilising mood
- Strength training -Good for reducing insulin resistance, increasing metabolic rate, improving body composition (more muscle and less fat tissue)
- High intensity internal training – Good for increasing cardiovascular fitness, decreasing waist circumference, and achieving a healthy BMI
- Core strength – Good for general well-being and injury prevention, preparing your body for pregnancy
PCOS & Pregnancy – Things to know
PCOS can cause problems during pregnancy for you and for your baby. Women with PCOS have higher rates of –
- Gestational diabetes
- Cesarean section (C-section)
- Your baby also has a higher risk of being heavy (macrosomia) and of spending more time in a neonatal intensive care unit (NICU).
Common Complications Related to PCOS
- Weight gain or obesity
- Type 2 diabetes
- Cardiovascular disease
- Metabolic syndrome (generally having at least two of high blood pressure, high cholesterol, obesity, high fasting blood glucose)
- Endometrial cancer
- Sleep apnoea
Other FAQs about PCOS
Q. Can I still get pregnant if I have PCOS?
A. Yes. Having PCOS does not mean you can’t get pregnant. PCOS is one of the most common, but treatable, causes of infertility in women. In women with PCOS, the hormonal imbalance interferes with the growth and release of eggs from the ovaries (ovulation). If you don’t ovulate, you can’t get pregnant.
Q. Does PCOS mean I have cysts on my ovaries?
A. The term “polycystic ovaries” means that there are lots of tiny cysts, or bumps, inside of the ovaries. Some young women with PCOS have these cysts; others only have a few. Even if you do have lots of them, they’re not harmful and they don’t need to be removed.
Q. Why do I have patches of dark skin?
A. Many adolescents with PCOS have higher levels of insulin in their blood. Higher levels of insulin can sometimes cause patches of darkened skin on the back of your neck, under your arms, and in your groin area.