POLYCYSTIC OVARIES

Polycystic ovary syndrome, PCOS is a hormonal condition in which a woman’s fertility is adversely affected.

It’s characterised by:

    • 1. Irregular periods – poor ovulation which causes your period to stop or become harder to predict.
    • 2. Physical signs of acne and unwanted facial or body hair due to excess androgen (male hormone) in your body
  • 3. Polycystic ovaries – large and fluid-filled sacs (follicles) surrounding the eggs.

You may have PCOS with or without cysts on your ovaries. Someone with two or three of these features may be infected with PCOS.

POLYCYSTIC OVARIES

The ovaries are described as polycystic when there’s a presence of a large number of underdeveloped harmless follicles (sacs) about 8mm (approximately 0.3in) in size. This is what cuts off ovulation and the timely release of eggs.

PCOS is not easily detected, though it’s common. More than half of the women infected with PCOS have zero symptoms.

SIGNS AND SYMPTOMS

PCOS may not be easily diagnosed at first but may be discovered in your early 20s or late teens. Some symptoms are:

    • 1. Weight gain or loss becomes problematic
    • 2. Excess hair growth (hirsutism) in unwanted areas like your chin, breasts, stomach, face, chin, thumbs and toes.
    • 3. Loss of hair on the women’s head that could worsen in middle age
    • 4. Hormone-triggered headaches
    • 5. Difficulty in getting pregnant
    • 6. Acne or oily skin
  • 7. Irregular periods

There’s also the increased risk of having type 2 diabetes and high cholesterol levels later in the future.

CAUSES OF PCOS

The underlying cause is unknown. PCOS could run in families. It can also be connected to abnormal hormonal levels, including increased levels of insulin in an attempt by the body to resist it. Obesity contributes to increased insulin production in the body.

TREATING PCOS

PCOS has no cure. Its symptoms can be treated. For obese women, losing weight and healthy eating habits can ameliorate symptoms. There are fertility medications that can treat symptoms like hirsutism, period problems, and infertility.

Surgical treatment like Laparoscopic ovarian drilling (LOD) could help in destroying tissues in the ovaries generating androgens like testosterone. Most women become pregnant with this treatment.

Learn more about treating PCOS.

SYMPTOMS

These become obvious in your late teens or early 20s.

Common symptoms are:

    • 1. Weight gain
    • 2. Period problems
    • 3. Excessive hair growth (hirsutism) on the buttocks, face, chest, or back
    • 4. Oily skin or acne
    • 5. Hair loss or thinning hair from the head
  • 6. Skin tags

FERTILITY ISSUES

This is one major effect of PCOS. It affects ovulation—hindering natural menstrual cycle thus, presenting irregular or absent periods which in turn provides no egg for fertilisation and consequent conception.

FUTURE RISKS

Women infected with PCOS stands the risk of:

    • 1. Type 2 diabetes – a condition of increased blood sugar level
    • 2. High blood pressure and cholesterol levels
    • 3. Depression and anxiety
    • 4. Endometrial cancer
  • 5. Sleep apnea (interrupted breathing during sleep)

CAUSES

The cause of PCOS is not known although, it’s related to abnormal hormone levels

Resistance to Insulin

PCOS makes the body unable to respond to the effect of insulin—a hormone controlling blood sugar level. This causes more insulin to be produced; an increase that triggers too much testosterone production in the ovaries. The body’s resistance to insulin enables obesity which aids in worsening symptoms of PCOS.

Hormone imbalance

The cause of this is not obvious. PCOS-infected women have an imbalance in hormones like testosterone; Luteinising hormone (LH); Sex hormone-binding globulin (SHBG); and Prolactin. These changes start in the ovaries and may be caused by resistance to insulin.

Genetics

It’s possible that PCOS can run in families but, no genetic link has yet been discovered.

Diagnosis

Since there’s no diagnostic test for PCOS, your GP will talk to you about your medical history and do examinations and tests like:

    • 1. Physical exam
    • 2. Pelvic exam
    • 3. Pelvic ultrasound (sonogram)
  • 4. Blood tests

Diagnosis demands you meet at least 2 of the following 3 criteria:

    • 1. You experience period problems
    • 2. You have a high level of male hormones
    • 3. The scan shows you have polycystic ovaries

If positively diagnosed, you may be treated by your doctor or referred to a specialist gynaecologist with recommended follow-ups.

Treatment

PCOS cannot be cured, but symptoms can be managed with:

    • 1. Lifestyle changes: Regular exercise and healthy eating for weight loss are implemented in obese women.
    • 2. Medications: Several medicines like a contraceptive pill (for period problems); IVF, Clomifene, Metformin (for infertility); Contraceptive tablets, eflornithine (for hirsutism); and Statins (for other symptoms) are given.
  • 3. Surgery – done via Laparoscopic ovarian drilling (LOD)

Pregnancy risks will be high especially if you’re obese. PCOS can trigger complications like hypertension, miscarriage, gestational diabetes, and pre-eclampsia. You can reduce this risk by losing weight before conceiving.