Polycystic Ovarian Syndrome (PCOS)
PCOS is a health issue that can affect a womanbs health and well-being in a multitude of ways. PCOS impacts such things as, menstrual cycle, fertility, hormones, insulin production, heart, blood vessels, weight, and physical appearance. The results of these physical impacts can also result in poor self image and depression.
What symptoms are typically associated with Polycystic Ovarian Syndrome (PCOS)?
Often women with PCOS have characteristics that first appear in their reproductive systems. Women with PCOS can display a degree of symptoms including:
- Weight gain or obesity, typically consisting of extra weight around the waist
- Abnormal growth of hair on the face, chest, stomach, back, thumbs, and toes
- Irregular menstrual periods, no menstrual periods, and/or irregular bleeding
- Infertility or difficulty in becoming pregnant due to lack of ovulation
- Male-pattern baldness or thinning hair
- Elevated levels of male hormones (androgens)
- Ovarian cysts (fluid-filled sacs in the Ovaries)
- Pelvic pain or discomfort
- The development of acne, oily skin, or dandruff
- Type 2 diabetes
- High cholesterol
- High blood pressure
- Patches of denser and darker skin on the neck, arms, breasts, or thighs
- Skin tags, or small excess flaps of skin near the armpits or neck area
- Sleep apnea and/or snoring
How common is Polycystic Ovarian Syndrome (PCOS)?
PCOS is the most frequent hormonal and reproductive concern in women of childbearing age. It is estimated that 5 to 10 percent of women of childbearing age have PCOS.
What are the causes of Polycystic Ovarian Syndrome (PCOS)
While the exact origin of PCOS remains unknown, women with PCOS often have other family members such as a mother or sister with PCOS. The appearance of in other family members is often a sign of a genetic link, yet there remains a lack of evidence to connect PCOS to a genetic link. Several theories regarding the cause of PCOS focus on the bodybs weight. In many cases women with PCOS have difficulty in maintaining their weight despite a healthy lifestyle. Research has been conducted to further understand the relationship between PCOS and the body's ability to make insulin. Further research may help to reveal how Insulin's ability to regulate and transform sugar into energy differs in women with PCOS.
How does Polycystic Ovarian Syndrome (PCOS) impact a woman's menstrual cycle?
The ovaries are two small organs, situated on each side of a woman's uterus. A woman's ovaries have follicles, which are tiny liquid-filled sacs that hold the eggs. These sacs are also called cysts. Each month approximately 20 eggs develop and reach maturity, with the final result of only one being dominant. As this dominant egg continues to develop, the follicle accumulates fluid. When the egg reaches maturity, the follicle releases the egg so it can voyage through the fallopian tube for fertilization. When the single egg departs from the follicle, ovulation is said to have occurred.
In women with PCOS, the process is often profoundly different. Women with PCOS may face a set of circumstances where the ovary fails to completely generate the essential hormones necessary for competing eggs to fully mature. In sharp contrast they may start to develop and accumulate fluid, only to be faced with the condition of no single egg growing large enough to become dominant. The end result of no single egg becoming dominant is that competing eggs remain as cysts. This interruption in the cycle means that no mature egg is released, ovulation does not occur, resulting in the bodybs failure to create the hormone progesterone. Without the creation of progesterone, a womanbs menstrual cycle becomes irregular and oftentimes completely absent. It could be said that a new cycle emerges in that the now present cysts produce male hormones, which in turn further disrupt the cycle by preventing ovulation.
How is Polycystic Ovarian Syndrome (PCOS) diagnosed?
There is no single test to diagnose PCOS. Your doctor will utilize several methods to determine your individual situation. Typically a the methods will included a survey of your medical history, a physical exam which may include an ultrasound, hormone level measurement, glucose tolerance test, and other blood work. As other factors can lead to the production of male hormones a thorough diagnosis is needed to rule out other factors or conditions. With the use of a pelvic ultrasound in addition to a pelvic exam, your doctor will be able observe possible enlarged or swollen ovaries which are caused by a growing number of small cysts. In addition the ultrasound helps to identify if the endometrium (lining of the uterus) has thickened. This is often an important factor in PCOS diagnosis, as the uterine lining often times will become thicker if there has not been a habitual period.
PCOS Treatment - What treatment options exist for Polycystic Ovarian Syndrome?
Since we lack a miracle cure for PCOS, it needs to be managed to avert problems. PCOS treatment approaches are based on the individual symptoms that each patient is experiencing and their overall goals. Symptoms that cause the most discomfort or pose significant health risk will take a higher precedent in PCOS treatment. If pregnancy is desired, the treatment approach will focus on safely enabling the Individuals desire to conceive.
The current PCOS treatments are as follows:
Birth control pills for PCOS treatment.
Individuals with PCOS who have not listed pregnancy as a goal are often given birth control pills to normalize menstrual cycles, decrease male hormone levels, and help to clear acne. The birth control pill does not cure PCOS. If use of the birth control pill is discontinued, an individual will again encounter irregular menstrual cycles. Individuals may also consider taking a pill that only has progesterone, in order to normalize the menstrual cycle and avert endometrial issues.
Metformin PCOS treatment.
Individuals may also obtain treatment for PCOS via diabetes medications. Metformin a medicine which is used to treat type-2 diabetes also aids in combating PCOS symptoms. Metformin works by affecting the way insulin regulates glucose and decreases the testosterone production. Excessive hair growth will slow down and ovulation may come back after several months of use. The use of these medications does not indicate that a person is or will become diabetic.
Fertility Medications for PCOS treatment.
The lack of ovulation is the chief fertility issue for women with PCOS. The fertility medications, Clomiphene and Gonadotropins can be utilized to encourage start of ovulation. Individuals with PCOS are at greater risk for multiple births when utilizing these types of medications. Oftentimes Metformin is utilized in conjunction with fertility medications to help women ovulate on lower doses of fertility medications.
Surgical treatments for PCOS.
The surgical procedures for treating PCOS are generally not recommended as a first line of treatment. The surgical procedure involves drilling into the ovary to induce ovulation. An extremely small incision is made in the navel region and a small telescope-like instrument is inserted into the abdomen. The ovary is then penetrated with a small needle and an electrical pulse is utilized to destroy a minute section of the ovary. The risks involved with this procedure are the development of scar tissue in the ovary. There is drop in male hormone levels and greater chance of ovulation, but in many cases the results are only temporary in their duration.
The importance of a healthy weight and diet on PCOS
Sustaining a healthy weight is one more way women can help to control PCOS and related symptoms. Given that obesity is widespread with PCOS, a healthy diet and physical exercise will help the individual maintain a healthy weight. The resulting benefits are lower glucose levels, a more efficient use of insulin, and the possible restoration of a normal period. The loss of 10% of body weight can help to normalize a menstrual cycle.
PCOS pregnancy and related issues
Women with PCOS tend to have a higher rate of miscarriage, gestational diabetes, pregnancy-related high blood pressure, and premature delivery. The medication Metformin is being studied for its potential in preventing or reducing the chances of encountering these issues while pregnant. Fetal safety issues are being examined in that Metformin crosses the placental barrier and its effects on a developing baby are yet unknown
What other conditions are women with PCOS at risk of developing?
Women with PCOS are at elevated risk for diabetes, high cholesterol, high blood pressure, heart disease, and endometrial hyperplasia or cancer. Taking steps to get PCOS symptoms under control may help to reduce these risks.
How does menopause affect Polycystic Ovarian Syndrome (PCOS)?
Research is being conducted on how male hormone levels vary as women with PCOS age. It believed that as a woman arrives at menopause, ovarian function change and the menstrual cycle may develop into a more regulated function. Given this, even with the resulting decline of male hormone levels the disproportionate hair growth continues, and male pattern baldness or thinning hair may actually increase after menopause.
In closing if you feel that you can identify with many of the PCOS symptoms and conditions it is recommended that you talk to a specialist about your individual condition.
In many cases PCOS symptoms have been dismissed as an individualbs dietary and physical failure by general physicians. Ultimately it is the individualbs responsibility to take an honest inventory of their personal efforts, to see if past statements can be reconciled with reality. Many women have made valiant efforts to follow their physicianbs decrees to lose weight, only to encounter despair when no amount of exercise would work. By following their instincts and pursuing a truthful diagnosis many have found success in the relief of PCOS symptoms.
