PCOS

Polycystic Ovary Syndrome (PCOS)

Introduction

Polycystic ovary syndrome (PCOS) is a hormonal disorder that women can get during their childbearing years (ages 15 to 44).  Women with PCOS  produce an excess amount of male hormone (androgen), that are usually present in women in small amounts.

Extra male hormones disrupt the menstrual cycle of a women, hence, women with PCOS get fewer periods than usual. This hormone imbalance can affect your ability to have a child.

Further, PCOS also cause hair growth on the face and body and it can contribute to long-term health problems like diabetes and heart disease.

What is PCOS?

PCOS affects a woman’s ovaries and ovulation. Ovulation occurs when a mature egg is released from an ovary. This happens so it can be fertilized by a male sperm.

But in PCOS, many small cysts (fluid-filled sacs) can develop inside the ovaries. These sacs are actually follicles, each one containing an immature egg. The eggs never mature enough to trigger ovulation. Due to lack of ovulation, the androgen (male hormone) levels in women with PCOS are higher than usual.

As a result, the excess male hormone levels can cause more problems with a woman’s menstrual cycle and makes it harder for them to get pregnant.

The 3 main features of PCOS are:

  • Irregular Periods: which means your ovaries do not regularly release eggs (ovulation).
  • Excess male hormone (Androgen): excess levels of male hormones may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne.
  • Polycystic ovaries: your ovaries contain many fluid-filled sacs (follicles) that surround the eggs. As a result, your ovaries might fail to function regularly.

Please note, if you have at least 2 of these features, you may be diagnosed with PCOS.

Who gets 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.

You may be more likely to have PCOS if you have obesity or if you have a mother or sister with PCOS.

What Causes PCOS?

The exact cause of Polycystic ovary syndrome (PCOS) is not clear. Most experts think that several factors play a role include:

  1. Insulin resistance: Insulin is the hormone produced in the pancreas that allows cells to use sugar from foods for energy. But many women with PCOS have insulin resistance, meaning that their body’s cells can’t use insulin properly.

    When cells can’t use insulin properly, the body demand for insulin increases. As a result, your insulin levels become higher than normal. Further, excess insulin might increase androgen (male hormone) production, causing difficulty with ovulation.

    Kindly note, Overweight or Obesity are major causes of insulin resistance in a women. Over time, both obesity and insulin resistance can increase your risk to type 2 diabetes.

  2. Excess androgens: Women with PCOS have high level of androgens (male hormone) than normal. Higher androgen levels in women can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle, and can cause extra hair growth and acne.

  3. Inflammation: Research has shown that women with PCOS often have a increased levels inflammation in their body, that stimulates polycystic ovaries to produce androgens (male hormone).

  4. Family History: PCOS may also run in families. You might be more likely to have PCOS if your sister or mother also has it.

Symptoms of PCOS

Symptoms of PCOS often develop around the time of the first period. But some women discover they have PCOS, when they have gained a lot of weight or when they have trouble in getting pregnant.

The symptoms of PCOS may include:

  • Irregular periods: The most common PCOS symptoms are missed, irregular, infrequent or very light periods. Some women with PCOS get fewer than eight periods a year.

  • Infertility: Difficulty getting pregnant as a result of irregular ovulation or failure to ovulate.

  • Too much hair: More than 70 percent of women with PCOS grow hair on their face and parts of their body. Excess hair growth is called hirsutism.

  • Acne or oily skin.

  • Weight gain, especially around the belly.

  • Darkening of the skin: Dark or thick patches of skin can form on the back of the neck, in the groin and under the breasts.

  • Male pattern baldness: Thinning hair or hair loss on the scalp.

Effects of PCOS

Women with PCOS are more likely to develop certain serious health problems. These include:

  • Infertility: To get pregnant, you have to ovulate. Women who don’t ovulate regularly don’t release as many eggs to be fertilized. Therefore, PCOS is one of the leading causes of infertility in women.
  • Pregnancy complications: PCOS can also cause problems during pregnancy for you and for your baby. Women with PCOS have higher chance of miscarriage and premature birth.
  • Metabolic syndrome: It is a group of health issues including high blood pressure, high blood sugar and abnormal cholesterol level. Together, these factors are called metabolic syndrome and they increase your risk of heart disease, diabetes, and stroke.
  • Sleep apnea: Women with PCOS, particularly when they are overweight, can be at an increased risk of developing sleep apnea. In this condition your upper airway is obstructed during sleep. This leads to repeated pauses in breathing during the night, which interrupt sleep.
  • Endometrial cancer: Regular periods help to prevent excess thickening of the lining of the uterus. Not having regular periods can lead to abnormal cells building up inside the womb.

    Women who have had absent or very irregular periods (fewer than 4 periods a year) have a higher risk of developing cancer of the womb lining (endometrial cancer).
  • Gestational diabetes: It is a type of diabetes that happens only during pregnancy. Women with PCOS are at greater risk for developing gestational diabetes. This risk increases if you are overweight.

    Usually gestational diabetes goes away after your baby is born. However, you still remain at a higher risk of developing type 2 diabetes after pregnancy, so monitoring and prevention are very important.
  • Depression and Anxiety: The symptoms of PCOS like unwanted hair growth can negatively affect your emotions and confidence. Many women with PCOS end up experiencing depression and anxiety.
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