Polycystic ovary syndrome or “PCOS,” is a common problem affecting women of child-bearing age caused due to hormonal imbalance and metabolic issues. The condition of PCOS occurs in approximately 5 to 10 per cent of women. This condition can cause irregular periods, acne (oily skin and pimples), extra facial hair, or hair loss from the head. Let’s read about how PCOS can be managed, especially for women planning children, Dr Zeel Shah, MS, DNB (OB-GYN), Associate Gynecologist, Gynaecworld, Mumbai and Dr Duru Shah, Founder President, PCOS Society of India and Founder of Gynaecworld.
What Happens In PCOS?
Those who have PCOS often suffer from the problem of irregular menstrual periods, and menstrual periods are irregular because monthly ovulation is not occurring as the level of androgens (male hormones) in these women are elevated. The elevated androgen levels can sometimes cause facial hair, acne, hair thinning, etc. Most women become overweight, but not all of them. Some are even at the risk of developing sleep apnea and diabetes.
Also Read: 8 Facts That No One Tells You About PCOS
Symptoms of PCOS
Some of the most common symptoms of PCOS are listed below, as told by Dr Zeel Shah, MS, DNB (OB-GYN), Associate Gynecologist, Gynaecworld, Mumbai:
- Menstrual irregularity: One of the most typical issues, women will have less than 8 cycles per year. In the absence of ovulation, the lining of the uterus (called the endometrium) does not uniformly shed and regrow as in a normal menstrual cycle. In PCOS, some women during puberty may experience their normal cycles, but due to a sudden increase in weight, the periods might get affected and irregular.
- Hair growth and acne: Male-pattern thick hair may be seen on the upper lip, chin, neck, sideburn area, around the nipple and areola, upper or lower abdomen.
- Infertility: Many women with PCOS do not ovulate regularly. Hence those women who have PCOS might find it difficult to conceive, and some may even face issues of infertility.
- Heart disease: There is a close relation of PCOS with insulin resistance (insulin is a hormone released from the pancreas whose function is disturbed in women with PCOS) which is related to an increased risk of coronary artery disease, which increases the risk of having a heart attack.
- Sleep apnea: Sleep apnea is a condition that causes brief spells where breathing stops (apnea) during sleep. Hence, women with PCOS might face this issue. Those with PCOS induced sleep apnea may experience fatigue and sleepiness.
Apart from these symptoms, women with PCOS are at increased risk of other problems that can impact the quality of life, explains Dr Zeel Shah. These include
- Depression and anxiety
- Sexual dysfunction
- Eating disorders may include bulimia or binge eating
If you think you might be experiencing any of these problems, talk with your health care provider. There are often treatments that can help. Some women with PCOS, especially ones with irregular period, may find it difficult to get pregnant. Although PCOS is not entirely reversible, various treatments can help in getting relief from the horrid symptoms that it can have.
How To Diagnose PCOS in Women?
There is no single test for PCOS diagnosis, but more than one test to know what it actually is, explains Dr Duru Shah, Founder President, PCOS Society of India and Founder of Gynaecworld, “The correct diagnosis will be made by a health care professional by based upon your symptoms, clinical examination and blood tests. As suggested by professional organizations, diagnosis of PCOS is made when a woman has two or more out of three of the following.
- Irregular menstrual periods (Cycle length less than 21 or more than 35 days)
- Evidence of excess male hormones. This can be based upon signs (excess hair growth, acne, or male-pattern balding) or blood tests which show higher than normal values of male hormones.
- Polycystic ovaries on pelvic ultrasound
Blood tests are done to know the cause of the symptoms. Blood tests for pregnancy, certain hormones such as Thyroid, Prolactin and Androgens may be recommended. If PCOS is confirmed, an oral glucose tolerance test is usually recommended to rule out prediabetes. There are some home remedies to manage PCOS that one can try to manage the symptoms.
Also Read: Gynaecologist Reveals Why Ignoring PCOS Condition Is Dangerous For Women
PCOS And Pregnancy
Talking about pregnancy and PCOS, Dr Duru Shah explains that most women with PCOS can get pregnant, but it is usually easier for those who are not overweight. Ideally, all women should have one preconceptionally counselling by a specialist. “Women with PCOS are more likely to face a miscarriage in the early months of pregnancy. Some risk factors that women with PCOS have in their pregnancy:
- Gestational Diabetes: This is the diabetes of pregnancy, and women with PCOS are more likely to have them compared to women without PCOS. Increased sugars can lead to increased baby weight (macrosomia) which is not considered healthy. Patients with PCOS need to be screened for diabetes in pregnancy and need to be treated to prevent further complications. However, it is best to be aware of the myths ans facts of diabetes.
- Preeclampsia: This is increased blood pressure after 20 weeks of pregnancy with an increased quantity of protein in the urine. This also has an association with PCOS.
- Cesarean delivery: Women with PCOS may have a slightly higher rate of cesarean delivery due to increased incidence of gestational diabetes, macrosomia, preeclampsia.
How To Prepare For Pregnancy with PCOS?
“All women planning a pregnancy should take folic acid one month before trying for pregnancy to prevent any neural tube defect in the baby. If you are overweight, losing even 5- 10 per cent weight can help make your periods more regular. If your periods remains erratic despite losing weight, one must see a doctor as you may need some medication to induce ovulation and help you to get pregnant,” says Dr Duru Shah.
Why Are Women More Prone To PCOS?
Unfortunately, we still don’t know the exact cause of PCOS and why certain women have this endocrine issue. There are various theories that have been supported by evidence to explain the possible causes for the syndrome, explain Dr Zeel Shah, which includes:
- PCOS tends to run in families. We are not able to find a single gene abnormality for the problem, and more than one gene has been implicated for the same.
- Another possible cause is the exposure of a baby to extra male hormones or insulin whilst it’s in the mother’s womb.
- Patients with Diabetes in the family, with history of PCOS in mother or sibling, women who are overweight and obese (BMI OF 25 and more) and women with Insulin resistance are more prone for developing the syndrome.
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Also Read: PCOS Diet: Nutritionist Kavita Rastogi Explains 5 Foods To Consume And 5 Food Items To Avoid
Since the exact cause is not known, there is no treatment or cure for PCOS. Various treatment options are available for regularizing the cycle, managing the acne and hair growth/ scalp hair fall, treatment for fertility to help patients with PCOS. A change in lifestyle and exercise forms a key point in the management of PCOS in all woman, including the ones that have normal weight or are lean.
Women with PCOS should be monitored by a health care professional. Symptoms of PCOS may not be extreme in all, and some may not warrant treatment according to some patients, but care must be taken in documenting all symptoms of PCOS. This is because untreated PCOS can lead to more health issues in women over some time, concludes Dr Duru Shah.
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