By Apollo 24|7, Published on- 17 October 2022 & Updated on - 04 November 2022
Symptoms: Infrequent menstruation, heavy bleeding during periods, abnormal hair growth, acne, weight gain, darkened skin, persistent headaches, hair thinning and baldness, fatigue, trouble sleeping, abnormal lipid levels in the blood, problem with conception (pregnancy)
Causes: High percentage of male hormones or androgen, genetics or family history, insulin resistance, higher inflammation in the body
Risk Factors: Diabetes (type 1 and 2), gestational diabetes, unhealthy lifestyle, genetics
Severity: Mild to severe
Which doctor to consult: OB-Gynaecologist
Polycystic ovarian syndrome is a health condition that affects women during their reproductive years. It usually occurs due to excess androgen formation, insulin secretion resistance, and genetic factors.
The polycystic ovary contains many harmless follicles in which eggs develop. When the sacs fail to release eggs, the hormonal imbalance leads to PCOS.
This condition can lead to enlarged ovaries and the formation of multiple fluid-filled sacs called cysts on the outer edges of the organ. These cysts contain follicles carrying immature eggs up to 8 mm in size.
Depending on the extent of PCOS development or the cyst numbers, the severity of the condition varies. Usually, the patients exhibit mild to severe symptoms, including irregular periods, weight gain, excessive hair growth or thinning, oily skin, failed pregnancy, etc.
PCOS doesn't have a cure, but its symptoms can be treated with medication and lifestyle changes. In addition, laparoscopic ovarian drilling is also recommended for patients with fertility complications.
If not diagnosed and treated timely, PCOS can lead to an increased risk of type 2 diabetes and heart conditions. The prolonged presence of PCOS and hormonal imbalance can also cause ovarian cancer in the patients and extreme fertility complications.
On Symptoms: Upon observations of signs such as infrequent menstruation, heavier bleeding, oily skin, acne, extreme hair loss, and hair growth in unwanted areas, consultation with a gynaecologist is essential. The frequency and length of the periods must be taken into consideration for seeking consultation. That's to say, the appropriate time to consult an expert is as soon as the patient exhibits the related symptoms.
Failure to Get Pregnant: PCOS can increase the risk of pregnancy failure in the first trimester of gestation. Moreover, if you're trying to conceive but have been failing for a year, your chances of carrying cysts in your ovaries are high. That's why immediate consultation is crucial if you're pregnant or aiming to in the near future.
On Annual Screening: Most ovarian disorders slowly build up inside the body without causing severe discomfort. For any person of childbearing age, it's essential to check the overall health and functioning of the reproductive system. That's why an annual gynae visit is a must to prevent complications.
Preliminary Discussion: The primary diagnosis for PCOS involves understanding the signs and symptoms through the patient's description. In this step, the gynaecologist will enquire about the first occurrence and observation of the signs. In addition, the doctor will require details about the family history associated with PCOS. Upon comprehensive evaluation, your gynaecologist will suggest a combination of diagnostic tests.
Physical Exam: Your doctor may also check the changes in blood pressure, the alteration in skin and hair and BMI. In addition, the analysis for PCOS will also include pelvic examination by evaluating the look and feel of body parts, including swelling around ovaries, and routine pelvic tests.
Lifestyle Changes: The specific PCOS treatment involves tackling the symptom of the condition with healthy habits. Lifestyle changes aimed at weight loss can help the medications work effectively and ensure good metabolism. Depending upon your goals, your gynaecologist might recommend handling bodily changes to determine the best management course.
Medication: Based on the severity of symptoms, your gynaecologists can suggest a combination of medications. It includes birth control pills, progestin therapy, Clomiphene, Letrozole, Metformin, Gonadotropins and Aldactone.
Surgery and Alternative Treatment: In addition to the medications, your gynaecologists can also recommend a series of hormonal therapies, removal treatment and surgery. These methods are more helpful when medications fail to prove useful.
Hormonal therapies involve a combination of estrogen-progestin contraceptives with metformin and spironolactone. This helps address reproductive, metabolic and dermatologic disruptions in the patient's body.
To deal with excessive hair growth, your expert doctor also recommends electrolysis and laser hair removal. It involves multiple rounds of the procedure on the affected area to control the follicular hair growth.
For patients dealing with complicated fertility problems, the laparoscopic ovary drilling procedure is used. This method enables the restoration of normal ovarian functioning through surgical treatment of cyst formations.
In this PCOS condition, your body will gain more weight around the abdomen and waist. It also causes sugar cravings along with brain fog. Such a heightened level of insulin leads to enhanced androgen levels causing hair growth, male pattern loss and acne.
To improve the condition, your gynaecologist will recommend a range of lifestyle activities to enhance insulin sensitivity. The treatment will involve physical exercises, low-sugar food intake and supplementation with magnesium, inositol, chromium, NAC and berberine.
It is one of the rare forms of PCOS which occurs after stopping contraception intake. In this condition, the usual PCOS symptoms start appearing only after you restrict pill usage.
This condition occurs due to the impact of synthetic progestins in oral contraceptives. After stopping the medication, your body undergoes a regular balancing drive leading to an increase in androgen.
In this type, the patient will not face any insulin resistance, and it improves within 3-6 months. However, adequate medication and nutritional support can quickly alleviate the symptoms and resolve the complication.
Adrenal PCOS is one of the rarest forms of PCOS, which impacts 10% of the affected population. It occurs due to the rise in DHEA-S, which is a form of androgen in adrenal glands.
Such elevation in the specific androgen isn't usually detected with normal diagnosis as other hormones remain in the normal range.
Since this happens due to an increase in stress levels, upon confirmation, your gynaecologist will suggest relevant treatment. It will also involve avoidance of food which can spike up bodily stress responses like caffeine.
Due to the prolonged exposure of ovaries to hormonal imbalance, chronic inflammation persists. This leads to the overproduction of testosterone in the ovaries. Such hyperactivity of testosterone causes headaches, fatigue, skin issues, joint pain etc.
In order to provide effective treatment, your gynaecologists recommend a range of blood tests. These assessments consist of observing inflammatory markers like high CRP, fasting glucose levels, and insulin.
PCOS diagnosis requires clinical analysis of the symptoms. That's to say, there's no single test that affirms the presence of PCOS.
That being said, your gynaecologists can recommend a number of analyses to assess the dysfunction in your hormones. These tests include:
To confirm the presence of PCOS, your gynaecologists need to consider only two factors out of three, i.e.:
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What are the main complications of PCOS?
The most common complication of PCOS includes weight gain and obesity. Due to the combined effect of hormonal imbalance and extra lipids in the blood, cardiovascular problems follow. In addition, it also leads to infertility and uterine conditions, including endometrial cancer.
Does PCOS make you severely sick?
PCOS is a prolonged condition that severely impacts your body. It adversely affects the physiological and psychological well-being of the patient. It can begin right after puberty and remain undetected, only to cause sickness later in life. So, it doesn't impact the patient from the very start but can turn serious if left undiagnosed for a long time.
Can PCOS worsen with age?
Absolutely. PCOS impacts the overall hormonal balance of the body and slowly weakens the body causing long-term consequences. In addition to causing irregular periods, the condition can lead to trouble even after menopause in the form of type 2 diabetes and cardiovascular disease.