Polycystic Ovary Syndrome or PCOS: What is It, Causes, Symptoms, Treatment

Hormones are the means of propulsion of a female reproductive functioning and development. The imbalance or change of these key reproductive hormones can lead to hormonal conditions such as PCOS or Polycystic Ovarian/Ovary Syndrome. PCOS has become the most common and concerning hormonal disorder in women. As per the recent data, almost 3 out of 10 women are commonly diagnosed with PCOS, and nearly 6 out the 10 PCOS diagnosed women are teenagers. 

Centers for disease control and prevention have records stating that PCOS can begin as soon as puberty commences (age of 11 and above) or even start in the late 20’s or 30’s. Women of every race and ethnicity across the globe are affected by PCOS. 

Also Read: PCOS is the Prime Cause of Infertility in Women in India, New Study Says

PCOS women generally have higher levels of androgens and become resistant to insulin. The ovaries, as a result, stop ovulating, and the follicles transform themselves into cysts. Hence the name polycystic ovaries. The bundle of symptoms observed in women with PCOS requires proper medical management along with appropriate lifestyle and dietary changes. 

Also Read: PCOD vs PCOS: What is the Difference?

PCOS: What is it?

PCOS, Polycystic Ovarian/Ovary Syndrome, is a disorder of the endocrine system having multiple manifestations and a single characteristic – Poly cysts over the ovarian surface. Women with PCOS have unusually higher amounts of androgens or male hormones, which otherwise are present in meager quantities.

The increased androgens do not allow the ovaries to release the eggs during ovulation in a menstrual cycle. The follicles nurturing eggs in the ovaries transform into sacs filled with a liquid called cysts. These cysts are the least harmful. 

While in some cases, the woman’s endocrine system does not make enough hormones required for ovulation, so no ovulation occurs during the menstrual cycle. These immature follicles form cysts that release more androgens into the body.

The sequences of accumulation of such cysts after each menstrual cycle are the development of polycystic ovaries that look like a bunch of pearls when observed through an ultrasound scan.

PCOS: Causes

The PCOS problem is one of the leading causes of infertility in women, and the main cause of PCOS is an increase in androgen levels. These PCOS causing factors can be explained through a series of theories mentioned below. 

• Excess LH production: A defect of the endocrine system can affect the pituitary glands to produce more than normal amounts of gonadotropin-releasing hormones (GnRH) or luteinizing hormones. This can lead to ovulation problems, increased androgen forming a chain reaction, and disrupting the menstrual cycle. 
• The no ovulation cycle: When a woman is not ovulating, the production of progesterone decreases, and testosterone (androgen) levels steep up. This in turn becomes a self-perpetuating vicious cycle of no ovulations causing PCOS. 
• Lack of Iodine: Some scientists suggest that PCOS cysts may form due to low iodine intake. The theory suggests that formations of nodules, scar tissues, other protrusions, including cysts, result from the low amounts of iodine present in the body. 
• Toxic substances: Several studies have stated the innumerable effects of xenobiotics, environmental pollutants, chemicals, and certain medications. These toxins disrupt the hormonal balance and damage the ovarian follicles within the developing embryo (in a pregnant woman). The after-effects of such damage when the child attains puberty and such toxicity can cause PCOS. 
• Insulin resistance: The pancreas produces insulin that helps convert blood glucose into energy. But when there is insulin resistance, the body’s cells do not recognize the insulin to convert glucose into energy. The pancreas produces more insulin forcefully, coupled with insulin resistance cells, causing an increase in blood glucose. The increased sugar levels stimulate androgen production, causing PCOS and other metabolic disorders, including Type 2 diabetes. 
• Inherited genes: Women who have inherited genes linked to PCOS are more likely to have PCOS.
• Low-grade inflammation: Another suggestion is that low-grade inflammation in women stimulates the production of androgens and polycystic ovaries. 

PCOS: Identifiable symptoms

PCOS cysts can create a lot of varied symptoms because of the distinct hormonal variations that occur in PCOS-affected women. A woman may get a PCOS diagnosis after examination, taking a detailed study of medical history when the woman may have one or more of the below-mentioned symptoms.

• Irregular menstrual cycles
• Absence of periods for more than three months
• Very light menstruation period
• Menstruation with heavy bleeding and pain
• Enlarged ovaries with multiple cyst formations 
• Excessive facial and body hair (hirsutism)
• Increased acne with oily-prone skin
• Too much thinning of hair and Male-pattern baldness
• Unable to get pregnant (infertility)
• Skin tags or excess skin tags near the neck or armpits
• Dark skin patches near the skin foldings of the neck, armpits, and below the breasts.

After a thorough study of the symptoms, PCOS diagnostic tests of pelvic examination, a check of androgen and glucose levels along an ultrasound scan can confirm PCOS.

PCOS: Management and Treatment

Prolonged PCOS or untreated PCOS can lead to serious health complications or side-effects of PCOS like type 2 diabetes, high blood pressure, sleep apnea, heart ailments, and endometrial cancer. Pregnant women with PCOS are at risk of developing gestational diabetes during the pregnancy term or can have a preterm delivery. 

• PCOS treatment mainly focuses on the 3 requisites of lifestyle management-i.e. diet for healthy weight management, moderate exercising, and medications to regularise ovulation and other PCOS symptoms. 
• The proven benefits of yoga and acupuncture can help women with PCOS symptoms. 
• Birth control pills and Fertility-improving medications like clomiphene, metformin, letrozole, and gonadotropins help modulate ovulation and menstrual cycles by male hormone reduction.
• In certain cases, surgical procedures like cyst aspiration (drain the fluid from the cyst), ovarian drilling (puncturing the ovaries to restore ovarian functions), hysterectomy (removal of uterus, ovaries and tubules), or oophorectomy (removal of both the PCOS affected ovaries) are  prescribed as a permanent treatment solution for PCOS. 

Also Read:

1. Metformin for PCOS and PCOD: Uses, Health Benefits, and Side Effects 
2. Ashokarishta for PCOS: What Does the Research Say, Benefits and Side Effects
3. OZiva HerBalance for PCOS: What Does the Research Say, Is It Good or Bad, Side Effects and More

Conclusion/Take Away

Most women with PCOS – Polycystic Ovarian/Ovary Syndrome struggle with the various manifestations it poses. If you are having irregular periods, missed the periods, or are unable to get pregnant, consult a specialist who can guide you with proper PCOS management and tailor the best possible treatment for PCOS and its varied symptoms.