Overview
In this article, we explain how to diagnose PCOS and the steps a doctor can take to treat it.
Polycystic Ovarian Syndrome (PCOS) is a very common endocrine disorder in females. It affects over 1 in 10 women in the U.S. According to the National Institute of Health (NIH), PCOS can cause a variety of symptoms that range from irregular periods to acne. PCOS also can cause infertility. According to Dr. Wen-Long Lohr, a urologist at the City University of New York’s Department of Urology and Endocrinology, and the Medical College of Wisconsin, PCOS is associated with hormones called androgens. The two hormones in question, androgens and estrogens, are thought to be the driving force behind the symptoms of PCOS.
A buildup of androgen hormone may also cause the skin, breasts, and hips to develop as more pronounced, enlarged areas of thickened tissue. These symptoms of polycystic ovary syndrome (PCOS) can make it difficult for women to get pregnant. PCOS may also lead to fertility problems, such as low fertility, infertility, or the inability to achieve a pregnancy. The symptoms of PCOS differ depending on the type of PCOS.
PCOS Meaning
PCOS affects the ovaries, which produce estrogen. With PCOS, your body doesn’t respond normally to this hormone, so there’s an overproduction of male hormones called androgens. The excess androgens can affect the blood flow in your heart, making it difficult to stay healthy. High androgen levels may cause your body to develop unusually large ovaries. For a PCOS diagnosis, your doctor may check for insulin resistance (a form of diabetes), inflammation of the ovaries, abnormal estrogen levels blood clotting, abnormal liver function, and problems with bone density (2, 3).
Symptoms of PCOS
The symptoms of PCOS are grouped into two categories:
- Symptoms that may be associated with PCOS and
- Symptoms that are unrelated to PCOS.
Here are the Symptoms that may be associated with PCOS:
Some PCOS symptoms Polycystic ovary syndrome can cause you to have symptoms of the following: a feeling of being bloated (abdominal distention) an enlarged liver and/or blood vessels a higher risk of thyroid problems an increased risk of heart disease, cancer, and diabetes proteinuria, or too much protein in your urine increased facial and body hair, especially on your face, chest, and back These symptoms may come and go, and they usually have no impact on your ability to carry a pregnancy to term.
However, PCOS may lead to problems such as: fertility problems, including irregular menstrual cycles, difficulty achieving an ovulatory period, and menstrual abnormalities over excessive body hair, especially on your face, chest, back, and vulva (your vulva is the skin around the vagina) long and heavy periods, or difficult or painful periods inadequate hair growth on the face and body (acne) irregular ovulation or early menopause, which may happen when your ovaries stop working properly There may be other symptoms. Ask your doctor if you have any changes in your health and lifestyle and if you are pregnant.
Steroid therapy can help treat symptoms, but it’s not a long-term solution for many women. Women with severe PCOS also have a harder time conceiving naturally, but research shows that diet, exercise, and weight loss may improve a woman’s chances of pregnancy. The Conversation , CC BY-ND Men and women with poly cystic ovary syndrome (PCOS) have significantly high rates of infertility, but the causes of the condition are poorly understood. The common symptoms of PCOS include excessive hair loss.
Here are the Symptoms that are unrelated to PCOS.
This includes brown skin and hair, especially in your face and neck, irregular periods, rapid weight gain, high blood pressure, intense mood swings, chronic cough, wheezing, and swelling in the throat, blood in the urine, kidney disease, Gallbladder disease, kidney stones, benign bladder tumor, kidney cancer, kidney failure, diabetes, jaundice, breathing problems, hoarseness, and coughing
What is the cause?
There is no known cause for PCOS, and the symptoms may be a sign of a combination of conditions.
Polycystic ovary syndrome (PCOS) is more common among women with polycystic ovaries. Polycystic ovaries produce an excess of androgens that the body cannot regulate, resulting in the formation of cysts or lesions in the ovaries. PCOS is a complex disorder that has many possible causes.
What causes PCOS?
Certain conditions can cause PCOS.
The following are some of the most common:
Genetics
Genetics can cause PCOS. Research suggests that PCOS is caused by a combination of genetic and environmental factors. Research has found that people who have a higher number of PCOS related gene mutations have a greater risk of developing PCOS. It is not yet known exactly which gene mutations lead to PCOS, but the identified genes may affect a woman’s fertility. If a genetic defect results in irregular ovulation, an individual with PCOS may have a greater risk of infertility and recurrent miscarriages.
Hereditary
The researchers took DNA samples from the DNA of 70 individuals who didn’t have PCOS, and compared it to DNA samples from PCOS patients. They found that three genes were linked to the disorder. The genes exact role in PCOS hasn’t been discovered yet, but one of them might be involved in the way that cells in the ovaries interact. The researchers suspect that this gene may affect how estrogen and progesterone work in women’s bodies.
The two other genes have been associated with other types of cancers and with Type 2 diabetes, so they are unlikely to play a role in PCOS alone. However, other researchers might find them useful in treating the disorder, the researchers say. In fact, for a PCOS drug to be effective, researchers may need to find molecules that target these genes, which would mean they need to first identify them in cells.
Gene therapy to treat PCOS is a newer approach. Researchers recently reported that they had used gene therapy to correct an inherited form of PCOS in mice. This method is likely to be more effective than treating PCOS with medications, the researchers say. The researchers report their findings in the American Journal of Human Genetics.
Obesity
Obesity is a contributing factor in a person’s likelihood of developing PCOS. When the body lacks enough of the hormone testosterone, the ovaries may not work properly, and the ovaries may not release enough of the female hormone, estrogen.
Females with PCOS have higher testosterone levels and lower estrogen levels than the general population. Low levels of estrogen can cause the ovaries to produce too much of another hormone called androgen.
Because androgen is an essential androgen for many male reproductive organs, such as testicles, a woman with PCOS who has androgen levels high enough to affect her uterus may have a higher risk of infertility.
Genetics
PCOS is most commonly known as polycystic ovary syndrome (PCOS). The term polycystic ovary syndrome comes from the idea that the ovaries are enlarged, cystic, and covered in small, fluid-filled sacs, or follicles. A person may develop PCOS by inheriting one of these polycystic ovary gene mutations from a parent. If a woman has one of these mutations, the ovaries may produce higher levels of androgen hormones, which leads to the characteristic symptoms of PCOS.
PCOS is also a genetically inherited disease. According to the Centers for Disease Control and Prevention, it has no known cause. While there is still much that is not known about the causes of PCOS, genetics play a significant role. One of the most common inherited genetic causes of PCOS is a variant of the insulin-like growth factor receptor (IGF-1R). The IGF-1R is a protein that is responsible for regulating androgen levels, which are also affected by PCOS.
The cause of PCOS is unknown, but several factors may increase a woman’s risk of developing the condition.
They include:
- opiates
- stress
- infertility
- kidney disease
- severe acne diseases that affect the ovaries, such as endometriosis anatomy of the ovaries that is not in line with the rest of the body chronic kidney disease.
PCOS During Pregnancy
This condition can also increase the risk for pregnancy complications. For instance, if you have ovulatory dysfunction, an ectopic pregnancy, or preterm birth, it may be caused by PCOS.
A review of all available studies found that PCOS is associated with pregnancy complications in up to half of all women with this condition. However, women with PCOS are also at a higher risk of miscarriage, stillbirth, preterm birth, gestational diabetes, and other pregnancy complications.
A woman with PCOS has about a 50 percent chance of miscarrying a pregnancy. She has a 25 percent chance of having a gestational diabetes disorder, and a 15 percent chance of having preterm birth. Nearly 5,000 women who had been diagnosed with PCOS and were included in a study had a miscarriage or stillbirth in the last three months of pregnancy.
PCOS may be the leading cause of infertility in women. In fact, 40 percent of women with PCOS are infertile. It is no wonder that PCOS is often mistaken for other diseases.
Life Style Tips For PCOS During Pregnancy
It is important to eat a healthy diet that is low in simple carbohydrates and high in fiber. Avoid trans fat and follow a healthy eating plan. A high fiber diet is also recommended to reduce blood sugar levels. Losing weight is an effective way to manage PCOS, and weight loss is supported by research. Lowering the ratio of body fat to lean muscle mass will increase lean muscle mass, leading to the weight loss in the long run .
Sleep more can also help improve hormone levels and control inflammation. You should aim for 7 to 8 hours of sleep per night, and begin going to bed at the same time every night. Antidepressant medication can be used to treat PCOS, although it is often only a short-term fix.
Medications
Medications to manage PCOS include:
- Cyproterone acetate (CPA)
- Lipitor (Coumadin®)
- Medroxyprogesterone acetate (Depo-Provera®)
- Lutetium bromide (Binagliptin®)
- Nolvadex (norgestrel intrauterine system)
Prevention
The symptoms of PCOS often go away in time. So a person can do the following to prevent the developing condition:
a) Keep your period regular
b) Eat a healthy diet
c) Keep your weight stable
d) Avoid smoking and excessive alcohol
Couples who are looking to have a baby should speak to a doctor if they are experiencing symptoms like infertility, as this can be a risk factor for PCOS. Here are some alternative ways to manage your PCOS symptoms.
These include:
Eating
Eating well, getting plenty of sleep, exercising regularly, managing stress, avoiding smoking, staying hydrated, changing the body’s diet to provide the right balance of nutrients and managing medications including regular physical activity.
Pilates, yoga, mindfulness, mindfulness meditation, acupuncture, massage therapy and prenatal yoga are proven therapies for PCOS. They can also help a woman make healthy eating and exercise choices. For women who aren’t able to get pregnant, adoption, surrogacy and other ways to give a child a family is another option.
Remission
The symptoms of PCOS often disappear over time. A person who has had PCOS for an extended period of time may find that symptoms disappear or their symptoms will become less severe over time. They may even notice that their menstrual cycle has improved and that they no longer experience irregular ovulation or hypoglycemia.
Doctor will usually keep a person in touch to offer reassurance that the symptoms may return if their body is still not responding to any treatment or other treatment changes. Doctors will also offer treatments that may prolong the effects of PCOS, or provide alternatives to pregnancy and infertility treatment. Doctors may prescribe medication, hormonal therapy, or other approaches to manage their PCOS symptoms.
Bottom Line
Managing the symptoms of PCOS can be confusing and hard to pin down. Perhaps even more confusing is determining whether or not it is actually PCOS. It all comes down to the way in which your body reacts to insulin, which in turn affects your weight, cholesterol levels, and blood sugar levels.
As PCOS is a known cause of several chronic health conditions, treatment may include lifestyle changes, medications, or surgery to alleviate the symptoms. The most important part of the treatment is ensuring that a person takes their medication as prescribed. Staying on the treatment for many months to years will help the body gain control over the PCOS and may reduce the risk of it developing more serious conditions.
Sirisha B