PCOS: Causes, symptoms and prevention

PCOS means Polycystic Ovary Syndrome, which is a common hormonal disorder affecting people with ovaries. It disrupts the normal menstrual cycle and can lead to irregular periods, cysts on the ovaries, and hormonal imbalances. PCOS often causes elevated levels of androgens (male hormones) and insulin resistance. Symptoms include irregular periods, acne, weight gain, and excess facial or body hair. 

PCOS can impact fertility, increase the risk of diabetes and cardiovascular issues. While the exact cause is unclear, genetic and lifestyle factors contribute. Management involves lifestyle changes, medications to regulate hormones, and sometimes fertility treatments for those trying to conceive. 

What causes PCOS?

The exact cause of Polycystic Ovary Syndrome (PCOS) is unclear, but a combination of genetic and environmental factors plays a role. Individuals with a family history of PCOS are more prone to developing it. Insulin resistance, where cells fail to respond effectively to insulin leading to increased insulin levels, is common in PCOS. 

This triggers the ovaries to produce more androgens, disrupting the normal balance of hormones and resulting in PCOS symptoms like irregular periods, cysts on the ovaries, and hormonal imbalances. Lifestyle factors such as poor diet and sedentary habits may contribute. PCOS is a complex interplay of genetic and environmental influences. 

What are the risks for PCOS?

Polycystic Ovary Syndrome (PCOS) is associated with various risks and complications, including:

1. Infertility: PCOS can affect ovulation, reducing the chances of conception.
2. Metabolic issues: Insulin resistance often accompanies PCOS, increasing the risk of type 2 diabetes and metabolic syndrome.
3. Cardiovascular problems: PCOS is linked to higher risks of hypertension, high cholesterol, and cardiovascular disease.
4. Endometrial cancer: Irregular or absent menstrual cycles in PCOS may lead to the overgrowth of the uterine lining, increasing the risk of endometrial cancer.
5. Obesity: There's a higher likelihood of weight gain and obesity in individuals with PCOS, exacerbating related health risks.
6. Gestational diabetes: Pregnant individuals with PCOS are more prone to developing gestational diabetes.
7. Sleep Apnea: PCOS increases the risk of sleep apnea, a condition associated with breathing difficulties during sleep.

What are the symptoms of PCOS

Learning that PCOS symptoms can manifest with a variety which may vary in severity is important. Common symptoms include:

1. Irregular menstrual cycles: Menstrual periods may be irregular, infrequent, or absent.
2. Ovulatory dysfunction: Difficulty in ovulating regularly, leading to fertility issues.
3. Hyperandrogenism: Elevated levels of androgens (male hormones) can cause acne, excess facial and body hair (hirsutism), and male-pattern baldness.
4. Polycystic ovaries: Enlarged ovaries with small cysts on the outer edges.
5. Weight gain: Increased insulin levels, contributing to weight gain and difficulty in maintaining a healthy weight. Difficulty in losing weight and a tendency to gain weight, often concentrated around the abdomen.
6. Skin issues: Acne, oily skin, and skin tags may occur.
7. Mood changes: Increased likelihood of mood swings, anxiety, and depression.
8. Sleep problems: Conditions like sleep apnea may be more prevalent.
9. Pelvic pain: Discomfort or pain in the pelvic region.

Not everyone with PCOS experiences all these symptoms, and their severity can vary. Early diagnosis and management help in addressing symptoms and reducing associated risks. If you suspect you have PCOS, consult a healthcare professional for evaluation and guidance.

How PCOS affects your body

PCOS symptoms significantly impact the body due to hormonal imbalances and metabolic disturbances. 

1. The condition disrupts the normal menstrual cycle, leading to irregular or absent periods, and often results in anovulation, contributing to fertility challenges. 
2. Elevated levels of androgens, or male hormones, can cause hirsutism, acne, and male-pattern baldness. 
3. Insulin resistance, a common feature of PCOS, leads to increased insulin levels, weight gain, and a heightened risk of type 2 diabetes. 
4. The syndrome is associated with difficulties in losing weight and an increased likelihood of obesity, particularly around the abdomen. 
5. Metabolically, individuals with PCOS face a higher risk of developing cardiovascular issues, hypertension, and metabolic syndrome.
6. Beyond physical impacts, PCOS may affect mental health, with an elevated risk of mood disorders like anxiety and depression. 

How can PCOS be treated?

PCOS treatment aims to manage symptoms and reduce associated health risks. The approach often involves a combination of lifestyle changes and medications:

Lifestyle Modifications

1. Healthy diet: Adopting a balanced, nutrient-rich diet can help regulate insulin levels. Focus on whole foods, including fruits, vegetables, lean proteins, and whole grains. Limit processed foods, sugars, and refined carbohydrates.
2. Regular exercise: Physical activity improves insulin sensitivity and helps with weight management. Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise per week, along with strength training exercises.
3. Weight management: Maintaining a healthy weight can reduce insulin resistance and regulate hormonal balance. Even a modest weight loss of 5-10% can have significant health benefits for individuals with PCOS.

Medications

Upon consultation, your doctor may recommend you one of these:

1. Oral contraceptives: Birth control pills regulate menstrual cycles and reduce androgen levels, addressing symptoms like acne and hirsutism.
2. Anti-androgen medications: Drugs like spironolactone can help reduce excess hair growth and acne.
3. Metformin: It improves insulin sensitivity, addressing insulin resistance and lowering the risk of type 2 diabetes.

Fertility treatments

For individuals trying to conceive, medications such as clomiphene or letrozole may be prescribed to induce ovulation. In more complex cases, assisted reproductive technologies like in vitro fertilisation (IVF) may be considered.

Management of other symptoms

Additional treatments may be prescribed for specific symptoms, such as topical treatments for acne or hair removal methods for excess hair.

Regular monitoring

Routine check-ups are essential to monitor hormone levels, manage symptoms, and address any emerging health concerns.

Individualised PCOS treatment plans are crucial, considering the varied manifestations of PCOS. Consulting with a healthcare professional, typically a gynaecologist or endocrinologist, is essential for proper diagnosis and personalised management.

When should I seek medical care?

Seek medical care if you experience irregular menstrual cycles, signs of hyperandrogenism (excess facial or body hair, acne), fertility concerns, unexplained weight changes, symptoms of insulin resistance, mood swings, or concerns about PCOS-related health risks. Timely consultation with a healthcare professional, such as a gynaecologist or endocrinologist, is crucial for accurate diagnosis and personalised management. 

If you're a teenager experiencing irregular periods or signs of PCOS, early intervention is essential. Prompt medical attention ensures appropriate testing, diagnosis, and the development of an effective treatment plan tailored to your specific needs and circumstances.

Role of awareness and education in PCOS

Awareness and education about PCOS symptoms and PCOS treatment are pivotal for several reasons. 

1. Increased awareness fosters early recognition of symptoms, prompting timely medical intervention. 
2. Education empowers individuals to understand the condition's complexities, manage symptoms through lifestyle choices, and seek appropriate medical care. 
3. It reduces stigma and promotes a supportive environment for those affected. 
4. Heightened awareness encourages research, leading to improved treatments. Healthcare professionals and communities must be well-informed to facilitate accurate diagnosis, personalised management, and the mitigation of associated health risks. 
5. Ultimately, comprehensive awareness and education initiatives contribute to enhanced well-being, early intervention, and improved quality of life for individuals with PCOS.

Frequently Asked Questions

What is Polycystic Ovary Syndrome (PCOS)?

PCOS is a common hormonal disorder affecting people with ovaries, disrupting menstrual cycles, causing cysts on ovaries, and leading to hormonal imbalances. Symptoms include irregular periods, acne, and excess hair growth. It can impact fertility and increase the risk of diabetes and cardiovascular issues.

What causes PCOS?

The exact cause of PCOS is unclear, but genetic and lifestyle factors contribute. Insulin resistance plays a role, triggering increased androgen production, disrupting hormone balance, and leading to symptoms associated with PCOS.

How can PCOS be treated?

PCOS is managed through lifestyle changes, medications to regulate hormones, and, if necessary, fertility treatments. Lifestyle modifications include a balanced diet, regular exercise, and maintaining a healthy weight. Medications address specific symptoms like irregular periods and androgen excess.

Are there any natural remedies for PCOS?

Natural remedies for PCOS include adopting a healthy diet, rich in fruits, vegetables, and whole grains, regular exercise, and stress management. Certain supplements like inositol may help regulate insulin and hormone levels. However, consulting a healthcare professional is crucial for personalised advice and treatment.