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Polycystic ovary syndrome (PCOS) is a hormonal condition that affects many women of reproductive age. Women with PCOS may have irregular or prolonged menstrual cycles, as well as high amounts of male hormone (androgen). The ovaries may generate a large number of tiny collections of fluid (follicles) and fail to release eggs on a regular basis.
PCOS's actual cause is uncertain. Early detection and treatment, as well as weight loss, may lower the risk of long-term consequences like type 2 diabetes and heart disease.
WHAT ARE THE SYMPTOMS OF PCOS?
PCOS symptoms frequently appear around the time of the first menstrual period during puberty. PCOS can develop later in life, for example, as a result of significant weight gain.
PCOS symptoms and signs vary. When you have at least two of the following symptoms, you have PCOS.
- Irregular periods: The most prevalent symptom of PCOS is infrequent, irregular, or extended menstrual periods. For instance, you could have less than nine periods per year, more than 35 days between periods, or extremely heavy periods.
- Excess androgen: Elevated amounts of male hormones can cause physical symptoms such as abundant face and body hair (hirsutism), severe acne, and male-pattern baldness.
- Polycystic ovaries: Your ovaries may be enlarged, with follicles around the eggs. As a result, the ovaries may cease to function on a regular basis.
Obesity usually worsens the signs and symptoms of PCOS.
WHAT ARE THE CAUSES OF PCOS?
The precise cause of PCOS is unknown. Factors that may be relevant include:
- Excess insulin: Insulin is a pancreatic hormone that permits cells to use sugar, your body's principal energy source. If your cells develop resistant to insulin's activity, your blood sugar levels may rise, and your body may create more insulin. Excess insulin may boost testosterone production, making ovulation problematic.
- Heredity: According to research, certain genes may be connected to PCOS.
- Excess androgen: Hormone levels in the ovaries are excessively high, resulting in hirsutism and acne.
- Low-grade inflammation: This word refers to the production of anti-infective chemicals by white blood cells. Women with PCOS have a sort of low-grade inflammation that drives polycystic ovaries to generate androgens, which can lead to heart and blood vessel problems, according to research.
WHAT ARE THE COMPLICATIONS OF PCOS?
PCOS complications can include:
- Infertility
- Pregnancy-induced hypertension or gestational diabetes
- Premature birth or miscarriage
- Type 2 diabetes or prediabetes
- Sleep apnea
- Anxiety, depression, and eating problems
- Abnormal uterine bleeding
- Nonalcoholic steatohepatitis is a severe liver inflammation induced by fatty liver buildup.
- Metabolic syndrome is a group of diseases that includes high blood pressure, excessive blood sugar, and abnormal cholesterol or triglyceride levels and increases your risk of cardiovascular disease greatly.
- Uterine lining cancer (endometrial cancer)
Obesity is linked to PCOS and can exacerbate the disorder's problems.
HOW IS PCOS DIAGNOSED?
There is no definitive test for PCOS. Your doctor will most likely begin by going through your medical history, including menstrual cycles and weight fluctuations. A physical examination will look for evidence of excessive hair growth, insulin resistance, and acne.
Your doctor may then suggest:
- A pelvic exam: The doctor examines your reproductive organs visually and manually for lumps, growths, or other abnormalities.
- Blood tests: Hormone levels in your blood may be measured. This testing can rule out potential causes of menstrual irregularities or androgen excess that mimics PCOS. Additional blood tests may be performed to assess glucose tolerance as well as fasting cholesterol and triglyceride levels.
- An ultrasound: Your doctor examines the appearance of your ovaries as well as the thickness of the uterine lining. A transducer (wand-like instrument) is inserted into your vagina (transvaginal ultrasound). The transducer generates sound waves, which are then converted into visuals on a computer screen.
If you have PCOS, your doctor may recommend extra tests to rule out issues. Among these tests are:
- Blood pressure, glucose tolerance, and cholesterol and triglyceride levels should be checked on a regular basis.
- Depression and anxiety screening
- Obstructive sleep apnea screening
WHAT ARE THE TREATMENTS FOR PCOS?
PCOS treatment focuses on addressing your specific issues, such as infertility, hirsutism, acne, or obesity. Specific treatment may include dietary changes or medication.
Changes in lifestyle
Your doctor may advise you to lose weight by following a low-calorie diet and engaging in moderate exercise. Even a small weight loss — for example, losing 5% of your body weight — may improve your condition. Losing weight may also improve the effectiveness of PCOS drugs prescribed by your doctor and may help with infertility.
Medications
Your doctor may advise you to do the following to manage your menstrual cycle:
- Combination birth control pills: Estrogen and progestin-containing pills reduce androgen production and control estrogen. Hormone regulation can reduce your chance of endometrial cancer as well as address abnormal bleeding, unwanted hair growth, and acne. Instead of tablets, you could try a skin patch or vaginal ring containing estrogen and progestin.
- Progestin therapy: Progestin taken for 10 to 14 days every one to two months can help control your periods and prevent you from endometrial cancer. Progestin medication has no effect on testosterone levels and will not prevent conception. If you also want to avoid pregnancy, a progestin-only minipill or a progestin-containing intrauterine device is a preferable option.
Your doctor may advise you to do the following to assist you ovulate:
- Clomiphene: This anti-estrogen drug is administered orally and is given throughout the early portion of your menstrual cycle.
- Letrozole (Femara): The ovaries may be stimulated by this breast cancer medication.
- Metformin: This type 2 diabetes oral medicine decreases insulin resistance and lowers insulin levels. If you are unable to become pregnant while taking clomiphene, your doctor may advise you to take metformin. If you have prediabetes, metformin can help you lose weight and slow the progression to type 2 diabetes.
- Gonadotropins: These hormone medicines are administered via injection.
Your doctor may advise you to perform the following to minimize excessive hair growth:
- Birth control pills: These pills reduce testosterone production, which can lead to excessive hair growth.
- Spironolactone (Aldactone): This drug inhibits androgen's effects on the skin. Because spirolactone might cause birth abnormalities, it is necessary to utilize effective contraception while using this medicine. It is not advised if you are pregnant or intend to get pregnant.
- Eflornithine (Vaniqa): In women, this cream can help to slow the growth of facial hair.
- Electrolysis: Each hair follicle is pierced with a fine needle. The needle delivers an electric current pulse that damages and finally destroys the follicle. You may require repeated treatments.
HOME REMEDIES FOR PCOS
To help reduce the affects of PCOS, try the following:
- Keep a healthy weight: Weight loss can lower insulin and testosterone levels, perhaps restoring ovulation. Consult your doctor about a weight-control program, and visit with a dietician on a regular basis to help you attain your weight-loss objectives.
- Limit your carbohydrate intake: Diets high in carbohydrates and low in fat may raise insulin levels. If you have PCOS, consult your doctor about a low-carbohydrate diet. Choose complex foods to steadily raise your blood sugar levels.
- Be active: Exercise aids in the reduction of blood sugar levels. If you have PCOS, increasing your daily activity and participating in a regular exercise program may help you treat or even prevent insulin resistance, regulate your weight, and avoid diabetes.