PCOS or polycystic ovarian syndrome is a rapidly growing reproductive endocrine disorder in females characterized by enlarged ovaries and cyst (a solid or fluid-filled sac within or on the surface of the ovary) formation. The disease is characterized by prolonged or irregular periods with a gap of about 2 months of more. The female body also starts secreting excess of androgens which causes hirsutism. The ovaries collect excess fluids and thus fails to release the egg every month resulting in delayed menstrual cycle. It may also lead to infertility. Despite the serious manifestations, the etiology of PCOS remains unknown. However, doctors and scientists predict that the disease occurs due to complex interactions between environmental, genetic, and lifestyle complications.
What happens in PCOS?
The anatomically female reproductive system consists of five main parts: the vagina, uterus, fallopian tubes, cervix, and ovary. In PCOS due to an imbalance in female hormones, ovulation does not occur monthly and the ovaries develop small cysts which produces androgen (male sex hormones). This imbalance occurs due to abnormal hormones secretions by the hypothalamus and pituitary gland. The pituitary gland secretes LH (Luteinizing Hormone) and FSH( Follicle Stimulating Hormone) that regulates androgen synthesis (from cholesterol) in ovaries and in turn, estrogen synthesis (from androgens).
When the level of LH increases relative to FSH, the overall androgen level increases in blood. LH-FSH level is monitored by gonadotrophin hormones secreted by the hypothalamus. Researchers predict that the LH to FSH levels fluctuate due to gonadotropin secretion from the hypothalamus as a result. A comprehensive treatment of PCOS is still not available but medicines can reduce the symptoms and prevent health problems.
Symptoms of PCOS
The symptoms of PCOS may develop around puberty but in some cases, it develops at a later age. These symptoms include –
- Irregular or absence of menstrual cycle or very light flow– due to cyst formation, androgen level are dysregulated which affects ovulation leading to missed or delayed periods.
- Enlarge ovaries– the volume of ovaries of PCOS women compared to that of a normal women increases by 10 cm3 due to cysts formation.
- Excess body hair, including the chest, stomach, and back (hirsutism)- due to excess androgen production.
- Weight gain, especially around the belly (abdomen)– due to excess androgen secretion and insulin resistance.
- Acne and oily skin– elevated androgen levels causes oil and sebum production in the skin which leads to pimples and acne. Acne may also occur face, back, neck, and chest.
- Male pattern baldness and hair thinning– the androgens produced causes hair thinning which could eventually result in hair fall.
- Infertility- due to an hormone imbalance and impaired ovulation, infertility could occur
Problems associated with PCOS
PCOS patients are at risk of developing serious complications such as type-II diabetes, hypertension, cardiovascular disorders, and in extreme cases, cervical cancer.
- Type-2 diabetes– the exact reason that how PCOS causes type-2 diabetes is not known, scientists speculate that it could be due to high androgen levels.
- High blood pressure– PCOS women are at a higher risk of hypertension compared to normal women.
- High cholesterol– PCOS patients suffer from insulin resistance which can increase fat accumulation, especially around the abdomen. This abdominal or visceral fat which is directly linked with high cholesterol levels.
- Cancer– Obese PCOS patients are at a higher risk of developing cancer which can be attributed to delayed or absent periods. The endometrial lining of the uterus thickens which may cause the uterine cells to become malignant. PCOS patients are advised to undergo the hormonal method in order to have regular periods.
PCOS treatments and precautions–
A precise treatment for PCOS is not available till date and the only management strategy is to reduce symptoms. The main reason for the increased incidence of PCOS in the current day is lifestyle. Consuming food that are high in preservatives and additives and other habits like smoking and drinking exacerbates PCOS development.
Adapting healthy food habits, exercising 4-5 times a week (to reduce blood sugar), consuming fruits and veggies, tracking periods, and meditating (reducing stress) can help to keep PCOS development at bay. Regular screening and consulting with a nutritionist also helps to monitor PCOS progression.
Ritika Gupta is an MPharm. graduate who is keen on spreading awareness about various unexplored medical fields through her writings.