As women, our lives revolve around our monthly cycles and their associated issues. When we were younger, we could not wait for our hormones to kick in so we would get boobs, hair, and periods. As young adults, we quickly realized the right of womanhood was not all we hoped it would be. Suddenly clothing, activity, and social life were taken into consideration when 'Aunt Flo' was visiting. As parents, we go through a time of worry and grieving when dear old 'Aunt Flo's' visits become less frequent before finally stopping.
Considering that so much of our overall health is affected by our monthly cycles, it is no wonder our reproductive system is a frequent topic of discussion. Unfortunately, the symptoms of many female reproductive issues are so vague or common that they are often dismissed. Polycystic ovarian syndrome (PCOS) is one such disorder.
Polycystic Ovarian Syndrome: Risks
Polycystic ovarian syndrome (PCOS) affects 5-7 % of women, and is now recognized as the most common endocrine disorder in reproductive-aged women, with key features of menstrual irregularity, elevated levels of male hormones (androgens), and presence of a number of small cysts (fluid-filled sacs) in the ovaries. It has significant clinical implications to a woman’s reproductive health (leading to infertility and higher rate of early pregnancy loss) and increases the risks of type 2 diabetes mellitus, cardiovascular disease, hypertension, metabolic syndrome, and endometrial cancer among patients.
Polycystic Ovarian Syndrome: Symptoms
The symptoms of PCOS vary with age, race, weight, and medications, adding to the challenges of accurate diagnosis by your doctor. Other than the key symptoms mentioned, additional common early signs include:
- Extra hair on your face or other parts of your body
- Male-pattern baldness
- Oily skin
- Weight gain and/or trouble losing weight
- Presence of a number of small cysts in the ovaries.
- Pelvic pain
- Skin discolorations
- Excess skin tags in the armpits or neck area
- Elevated insulin levels
- High cholesterol levels
- High Blood Pressure
In women with Polycystic Ovarian Syndrome (PCOS), the ovary does not make all of the hormones it needs for an egg to fully mature. The follicles may start to grow and build up fluid, but ovulation does not occur because progesterone is not made. Without progesterone and because of the excess androgen, a woman's menstrual cycle is irregular or absent and some follicles may remain as cysts.
Polycystic Ovarian Syndrome: Contributing Factors
No one is quite sure what factors cause PCOS, but these likely play a role:
- Excess insulin in the body, which may boost androgen production by your ovaries.
- Low-grade inflammation (white blood cells produce substances that can lead to insulin resistance and cholesterol accumulation in your blood vessels).
- Genetics–If a family member has PCOS, it may increase your risk of having it. Researchers are looking into the possibility that mutated genes may be linked to PCOS.
- Abnormal fetal development that may be caused by exposure to male hormones (androgens) in fetal life.
- Environmental factors.
What To Do If You Suspect PCOS
If you have irregular or absent menstrual periods, you may have PCOS, and you should talk to your doctor. Unfortunately there is no magic test to diagnose PCOS, so your doctor will have to go through a series of questions and tests to make a diagnosis. Some of these tests are:
Family history: To see if another family member has PCOS and if you have any symptoms.
Physical exam: To see if your blood pressure, weight, hair growth, acne are normal.
Pelvic exam: To check if your ovaries are enlarged or swollen by the increased number of small cysts (polycystic ovaries alone do not confirm the diagnosis).
Blood tests: To measure the androgen and glucose levels in your blood.
Vaginal ultrasound: For a closer look for ovarian cysts and to check your endometrium.
While there is no cure for PCOS, managing it can help reduce the risk of long-term complications such as type 2 diabetes, high blood pressure and heart disease.
Treatment for PCOS
The following lifestyle adjustments can help manage the condition. Your doctor will monitor for complications and can also assist if pregnancy is a consideration.
- Weight management (weight loss, maintenance or prevention of excess weight gain): Maintaining an ideal body weight can increase your chance of fertility and help lower your insulin and androgen levels.
- Healthy diet: A low Glycemic Index (GI) diet may decrease some long-term health risks associated with PCOS. Dietary fats should be restricted to ≤30% of total calories with a low proportion of saturated fat.
- Regular exercise: Many studies have demonstrated that women with PCOS can improve their insulin resistance and weight loss with a moderate amount of exercise.
- Healthy Lifestyle: Try and avoid all forms of stress as much as possible – attempt to keep your mind as well your body relaxed.
- Many studies have shown that the administration of an isoform of inositol (myo-inositol), belonging to the vitamin B complex, would improve insulin-receptor activity, restoring normal ovulatory function, but additional research is needed.
- Birth Control Pills: To reduce your androgen levels and acne, and control your menstrual cycles.
- Fertility medications: To stimulate ovulation and help women with PCOS become pregnant.
- Surgery: "Ovarian drilling" is a surgery that may increase your chance of ovulation.
Polycystic ovarian syndrome symptoms can affect your quality of life and can cause you stress or depression, as can the diagnosis of this chronic disease. However, early diagnosis and treatment of polycystic ovarian syndrome can help you alleviate and control long term complications.