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Summary
PCOS is a common but often misunderstood hormonal disorder that affects women's reproductive health. However, it can be managed through lifestyle changes, medical treatments, and early diagnosis despite the stigma and misinformation surrounding it.
Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects millions of women during their reproductive years (ages 15 to 44). Characterised by hormone imbalances, cysts in the ovaries, and irregular menstrual cycles, PCOS can impact both a woman’s health and quality of life.
Despite its prevalence, many women remain undiagnosed and unaware of the condition’s broader health implications. There is also a significant amount of misinformation surrounding PCOS, and many women with the condition face stigma and misunderstanding due to misconceptions about the disorder. These misconceptions can often lead to unnecessary shame and isolation for those living with PCOS.
What is PCOS?
PCOS occurs when a woman’s ovaries produce an abnormal amount of androgens (male hormones) that are usually present in small amounts. This hormonal imbalance disrupts the normal development and release of eggs during ovulation. As a result, women may experience irregular menstrual periods, infertility, and the development of fluid-filled sacs in the ovaries. Studies suggest that between 2.2% and 26.7% of women in their childbearing years may have PCOS, with up to 70% remaining undiagnosed.
Causes and Risk Factors
While the exact cause of PCOS is unknown, several factors are believed to contribute to its development. Genetics play a significant role, as studies show that PCOS often runs in families, suggesting a hereditary link. Insulin resistance is another key factor, as up to 70% of women with PCOS struggle with inefficient insulin use, leading to higher insulin levels in the body.
This, in turn, triggers the ovaries to produce more male hormones. Inflammation is also common in women with PCOS, which may further contribute to excess androgen production.
Symptoms of PCOS
The symptoms of PCOS can vary, but common signs include irregular periods, which occur due to the lack of ovulation. Many women with PCOS experience fewer than eight periods per year, or none at all. In addition, the uterine lining may build up longer than usual, causing heavier periods.
Another common symptom is excess hair growth on the face and body, including areas like the back, chest, and abdomen, a condition known as hirsutism. PCOS also leads to oily skin, which may cause severe acne, particularly on the face, chest, and upper back.
Up to 80% of women with PCOS are overweight or obese, and weight gain is a common symptom. Thinning hair or male-pattern baldness can occur as a result of elevated androgen levels. Women with PCOS may also develop dark patches of skin in areas such as the neck, groin, and under the breasts.
Health Impacts Beyond Fertility
PCOS has significant long-term health effects beyond fertility. Women with PCOS have a higher risk of developing metabolic syndrome, which includes high blood sugar, high blood pressure, and high cholesterol levels. This increases the risk for heart disease and type 2 diabetes. Sleep apnea is more common in women with PCOS, particularly those who are overweight.
Women with PCOS may also have an increased risk of developing endometrial cancer due to the buildup of the uterine lining caused by irregular ovulation. Furthermore, hormonal changes and the visible symptoms of PCOS, like excess hair growth, can negatively affect a woman’s emotional health, leading to depression and anxiety.
Diagnosis
Doctors diagnose PCOS when a woman has at least two of the three main symptoms: elevated androgen levels, irregular menstrual cycles, and cysts in the ovaries.
A pelvic exam can check for growth in the ovaries or other reproductive organs. Blood tests can measure hormone levels, while an ultrasound can identify abnormal follicles in the ovaries. Doctors may also conduct additional tests to check for related health issues, such as diabetes or high cholesterol.
Managing PCOS
- Lifestyle Changes
The first approach to managing PCOS usually involves lifestyle modifications. Losing just 5–10% of body weight can help regulate menstrual cycles and alleviate symptoms like excess hair growth and acne. Weight loss also improves insulin sensitivity, reduces the risk of heart disease, and lowers blood sugar levels.
A low-carbohydrate or low-glycemic-index diet, which includes fruits, vegetables, and whole grains, has been shown to be particularly effective in managing PCOS symptoms. Regular exercise, especially at moderate intensity for at least 30 minutes, three times a week, can also help with weight loss, improve insulin levels, and enhance ovulation. Combining a healthy diet with exercise has proven to be more effective than either intervention alone.
- Medical Treatments
When lifestyle changes alone do not suffice, doctors may prescribe medications. Birth control pills, for example, can help regulate the menstrual cycle and lower androgen levels, which, in turn, alleviate symptoms like hair growth and acne. Metformin, a medication used to treat type 2 diabetes, can also help improve insulin sensitivity and restore normal ovulation in women with PCOS.
Fertility drugs such as Clomiphene (Clomid) can assist women with PCOS in getting pregnant by stimulating ovulation. In more severe cases, surgical options like ovarian drilling can help restore normal ovulation.
Pregnancy and PCOS
PCOS can make it harder for women to get pregnant due to irregular ovulation. Between 70% and 80% of women with PCOS experience fertility issues.
However, with fertility treatments and lifestyle changes, many women with PCOS can achieve a healthy pregnancy. Women with PCOS are at an increased risk for pregnancy complications, such as miscarriage, premature birth, and gestational diabetes.
Conclusion
Polycystic Ovary Syndrome is a complex condition that can affect a woman’s fertility, physical appearance, and overall health. By understanding its causes, symptoms, and treatment options, women can take steps to manage the condition and improve their quality of life.
Through lifestyle changes and appropriate medical treatments, many women with PCOS can successfully regulate their menstrual cycles, manage symptoms, and achieve their fertility goals.
