PCOS – Symptoms, Causes and Diagnosis
Polycystic Ovary Syndrome commonly called PCOS refers to a problem of the ovaries. This is a medical condition in which the ovaries develop cysts and are not able to function normally. The ovaries play an essential role in conception.
The ovaries are the female reproductive organs which store the female eggs. These eggs are needed for pregnancy. Whena female egg fuses with a male sperm it forms a new life known as the embryo. This embryo grows into a foetus in the womb with proper nourishment, and a baby is born.
A woman has two ovaries which are filled with follicles. These follicles have immature eggs in them. For the female reproductive cycle to take place the pituitary glands release the Follicle stimulating hormone known as the FSH and LH. In the ovaries approximately 5 of the follicles will begin to mature the eggs that they contain. One of the dominant eggs will mature fully while the others just disintegrate. When the egg reaches its final stage of maturation it is released into the fallopian tubes. This stage is known as ovulation, when the egg is in the fallopian tube and waiting to be fertilised. The ovulation window varies between 12 to 24 hours. If fertilisation does not take place the egg disintegrates and is absorbed by the body.
This cycle takes place like clockwork every 28 days. However there are instances when this process does not take place as scheduled. There is a disruption in the process. The pituitary gland did not release the hormones as it is supposed to, in turn the ovary did not mature the egg and ovulation did not take place. Even though it may seem like the trail starts from the pituitary gland but there is more to this than meets the eye.
What is PCOS?
Polycystic ovary syndrome is a condition caused due to a hormonal imbalance in the body. The ovaries produce oestrogen and progestogen, when the production of these two hormones is out of balance it leads to an ovulation disorder. PCOS is characterised by a decrease of the female sex hormone. The imbalance of these hormones is said to be triggered by the presence of cysts in the ovaries which affects the proper working of the ovaries.
A woman who has polycystic ovaries fails to ovulate or does not ovulate regularly as scheduled. Ovulation is a fertility cycle which results in a menstrual cycle when pregnancy does not take place.
A woman who has cysts in her ovaries may also have an excess production of androgen which is the male hormone. In general the female body produces small amounts of androgen but when the hormone balance is out of control, the level of androgen produced becomes in excess. Hormones signal the release of other hormones. A woman with a PCOS condition has the hormones production in her body out of control and the normal balance is upset. This causes a disruption in ovulation and her fertility cycle making it difficult for her to conceive.
What are ovarian cysts?
In simple terms cysts can be described as sacs that are filled with fluid. When the follicles mature and the egg is released, sometimes the follicle gets filled with fluid. Other follicles that do not mature also may turn to cysts. These cysts are called functional cysts and will disappear over a period of time usually 3 months or so. They do not cause any harm or damage to fertility or ovulation.
Symptoms of PCOS
Usually the symptoms of PCOS begin to show as soon as a woman enters puberty and begins her menstrual cycle. Some women may not realise that something is amiss at the onset of PCOS. However a skipped period is a cause for alarm and should not be taken lightly. The most common symptom that any woman with PCOS will face is irregularities with her periods.
The common symptoms of PCOS are:
- Excessive hair growth: on the face and other areas of the body which are not normal for a woman but are actually more manly characteristics. This is caused due to the excessive amounts of androgen (male hormone) in the body. The male hormone induces the growth of facial hair and excessive hair on the chest and limbs.
- Weight gain: Due to the hormonal imbalance women with PCOS tend to gain weight very easily. Most women suffering from PCOS find it difficult to lose weight. If a woman is able to control her weight and lose the excess weight she will be able to contain the hormonal imbalance. Women suffering from PCOS also find that they have a thyroid problem. This also affects the ability to maintain regular weight.
- Irregular periods: Most women who suffer from PCOS have very irregular periods or no periods at all. Some of women have what is known as surprise periods, they never know when they will have their period, it comes as a surprise after irregular gaps of over a month.
- Heavy periods: Some women with PCOS tend to have more regular but very heavy menstrual bleeding which is not normal. Heavy bleeding can cause weakness and deficiencies in the body.
- Scanty periods: Very light or scanty periods are a symptom of PCOS. The period may last for a few days or just a day or two. While it may seem like a very manageable period but it is not normal and should be reported to a doctor.
- Acne: Some women who have PCOS may suffer from excessive acne on the face or the body. This is cause due to the hormonal imbalance in the body.
- Hair loss: Thinning scalp hair is a symptom of PCOS that affects some women. They have a bad hair fall problem.
- Skin patches: Dark skin patches may appear around the body or hands and face. It is not a common symptom and only some women may have it.
- Emotional health: Women with PCOS are prone to mood swings. They can become very depressed and suffer from excessive anxiety. Sudden mood swings are a common symptom of PCOS patients.
These are some of the fairly common symptoms of PCOS. The symptoms may present themselves in a variety of ways and it is not always easy to figure out if a woman is suffering from PCOS just by the symptoms. A blood test is the best way to confirm the diagnosis.
Some women with PCOS have regular periods but do not ovulate due to the excessive amounts of androgen and the increased levels of insulin in the blood. If a woman has less than 8 menstrual cycles in a year or has a gap of longer than 35 days between her periods, it is a cause for concern. She should have a medical check-up and a blood test to check the hormone levels.
Impact on Fertility
Polycystic ovary syndrome has a negative effect of fertility. With the hormones all out of sorts and the menstrual cycle irregular, women with PCOS are usually not able to get pregnant and in most cases are declared infertile.
Women who have PCOS usually do not ovulate regularly and will find it increasingly difficult to get pregnant. To conceive a woman has to ovulate. Without the release of a mature egg for the sperm to fertilise, conception is not possible.
In women with a PCOS condition the immature eggs in the ovaries do not mature due to the lack of the required hormone to stimulate the egg maturation. This prevents women with PCOS from being able to get pregnant without medical intervention. IVF treatment is the most successful fertility treatment for PCOS patients. Numerous women with PCOS have been able to successfully conceive and have babies through IVF treatment.
Cause of PCOS
The exact cause of PCOS is not clear. Researchers have attributed a number of diverse reasons as possible factors that contribute to the initiation of PCOS in women from much before they even enter puberty. Some causes of PCOS as compiled from research statistics are:
Researchers believe that family history can play a major role in young women getting PCOS. They believe that PCOS is a hereditary condition that can get passed down through the genes from one generation to the next.
Woman who have an insulin resistance are prone to suffering from PCOS. Insulin resistance could be genetic or due to being overweight. Women who are conscious about their diet and eat foods that are not insulin dependent (like carbohydrates) can keep the insulin levels under control.
The most common cause of PCOSnowadays is the unhealthy lifestyle factors. This ranges from unhealthy habits such as smoking, alcohol, improper sleep schedule to poor diet comprising of junk foods and processed foods. Stress is also a major cause poor health among the present generation.
Leading a disciplined life which entails maintaining a healthy and nutritious diet, getting proper rest and exercise can help to prevent PCOS from manifesting.
Diagnosing polycystic ovaries
There is no specific test to diagnosis of PCOS. The first thing a doctor does is conducts a physical examination. This entails checking for excessive hair on different parts of the body and lookingfor acne on the body and face. The doctor may also checkthe hair growthon your head to see is there is a thinning of the hair. The doctor should be apprised of hair fall and hair loss if you are suffering from it. To check if a woman has PCOS the doctor may prescribe a number of different blood tests to check various factors. Some of the tests are:
- Thyroid function test
- Fasting glucose test
- Lipid level test
Other tests could include a vaginal ultrasound. Though this test real time images are taken of the reproductive organs to check if they appear to be normal or if there are any visible signs of abnormalities.
Pelvic laparoscopy is a minor surgery in which a camera is inserted into the abdomen area by making a small incision in the stomach area. Through this camera they check the ovaries, uterus and fallopian tubes to see if there are any growths or cysts. If any kind of abnormality or growth is found that doctor will take a tissue sample called biopsy to test it and check if it is cancerous. Cancer of the uterus and ovaries is not uncommon among women after the age of 40.
Through these different tests the doctors can come to some sort of conclusion regarding the patients fertility problem and if the patient is suffering from polycystic ovaries. The symptoms for PCOS vary from person to person.
Treatment for PCOS
PCOS is medically not curable. There are certain treatment options to control the PCOS through medication and hormone supplements. Some lifestyle changes can also have positive impact on PCOS. Some of the recommendations for PCOS including treatments are:
Healthy diet: A good diet can contain weight gain and regulate blood sugar levels. Researchers have found that eating a good healthy breakfast with around 600 to 800 calories is good for PCOS patients. This should be followed by a healthy lunch with half the number of calories and ¼ the calories for dinner. The diet should include plenty of fresh fruit and vegetables.
Exercise: Exercising helps in a number of different ways. It boosts the metabolism and helps the person to lose weight as well as prevents them from gaining excess weight from the food they eat by helping to burn the calories before they can turn into fat and settle. Exercise also helps to improve blood circulation which promotes health and has a positive effect on the reproductive organs such as uterus and ovaries.
Birth control pills: these have been known to be helpful for treating acne and regulating the menstrual cycle. It also helps to contain the excess amount of androgens in the body. Birth control pills are recommended in cases when the woman does not want to become pregnant but needs the PCOS symptoms to be contained.
Medication: There are some anti-androgen medicines that can help to reduce the level of androgen in the body. This will help to reduce some of the symptoms like excessive hair growth, and acne problem. Medicines for diabetes can help to regulate the high sugar levels in the blood.
Surgery: This is used in some cases as a temporary solution to boost ovulation. Small amounts of electric current are sent into the ovary through small holes that have been drilled in it. This electric current destroys that area of the ovary. This is done in an attempt to curtail the production of the male hormone. Surgery to remove cysts is also performed sometimes in cases where the woman is suffering for pain and discomfort due to the ovarian cysts.
Sarita was diagnosed with polycystic ovary syndrome and suffered from irregular periods. She was ill treated by her in-laws and labelled as barren. She was not able to hold her head up at family gatherings and always looked for a corner to stay out of sight. She could feel the other family members looking at her with disdain and discussing how she was cursed from God.
Sarita visited Medicover for help to get pregnant. She was able to convince her husband that IVF would work for them. Few months later Sarita was pregnant and watched as relative looked upon her with guilt and shame for treating her badly.
“I went through great emotional trauma with being labelled as barren. The panditsaid that I must have committed great sins in my previous life to suffer this fate. Every day I prayed for patience and tolerance to be able to bear this life I had. One day my dad said he was taking me to Medicover Fertility Clinic. I met the doctor who did some tests and then said that I could have a baby. My husband agreed and gave his support for the treatment. I got pregnant in the first IVF cycle. It was such a relief for me.”
Infertility is still looked down upon in India and this is the reason that there is a huge demand for good quality infertility treatment here.
Fertility treatment for PCOS at Medicover
Medicover Fertility clinic specialises in providing fertility treatment to women suffering from various conditions of infertility. Many young women diagnosed with PCOS go to fertility clinics looking for a way to conceive. Infertility is not acceptable in Indian society and brides who are suffering with any condition that can make them infertile are looked down upon.
Fertility treatment has progressed to new highs with many advanced techniques to treat all kinds of fertility problems. Women with PCOS have successfully had babies at Medicover Fertility Clinic through IVF treatment. The latest technology methods and highly experienced and skilled doctors are able to help patients even with complex infertility issues.
Medicover offers patients international standards medical treatment and patient care. The clinic is well equipped with the latest tools and equipment for providing advanced medical treatments. Medicover has a state of the art laboratory which is used for fertilisation and embryo culturing.
Q: I was diagnosed with polycystic ovaries last year. Can I get pregnant and have children naturally?
A: Most women with PCOS find it difficult to get pregnant naturally and are advised IVF treatment as the best option to have children.
Q: My daughter has PCOS for several years. Now we are looking for a boy for her marriage. Will her medical condition prevent her from having children?
A: She may not be able to conceive naturally but with the help of medical treatment she can have children.
Q: I have ovarian cysts, should I have them removed?
A: If the cysts are not bothering you and causing any pain or discomfort it is better to just leave it. If you are suffering from abdominal pain due to the cysts then you can have it removed.
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