Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is a group of symptoms characterized by severe hormonal imbalances in women of reproductive age. It is not a disease itself, but it is responsible for several other health disorders in women.

Statistical data indicate that PCOS affects 4% to 20% of women at their reproductive stage worldwide. Every year in USA PCOS affects  6% to 2% of the women population, while 20% to 25% of western women in the U.K.
A closer and comparative look at PCOS stats shows that 52% of the Pakistani women population suffers From polycystic Ovarian syndrome, which is higher than in other Asian and western countries.

As the PCOS stats and figures are growing, the need to create awareness is in demand.PCOS awareness can help to :

• Handle existing PCOS cases
• Early diagnosis with proper treatment
• It can also reduce the PCOS ratio by preventing the causes leading to the syndrome.

What happens in polycystic Ovarian Syndrome (PCOS)?

Women who suffer from PCOS have higher levels of testosterone than normal. Testosterone is a male hormone that stimulates the production of estrogen. High levels of estrogen cause the follicles in the ovaries to become enlarged and produce cysts. These cysts block the flow of blood to the ovaries causing them to stop producing eggs.

Signs and Symptoms of Polycystic ovarian syndrome

Signs and symptoms of PCOS vary depending upon the time of diagnosis and severity of the syndrome. Here are some of the most common signs and symptoms of Polycystic ovarian syndrome.

• Irregular menstruation or absence of periods
• Cyst formation in the ovaries
• Sudden and excessive facial and body hair
• Male pattern baldness in women
• The appearance of dark patches on the skin
• Infertility (in 10% of women)
• Inflammation
• Excessive weight gain leading to Increased BMI
• PCOS-related acne and pimples
• Experiencing menstruation after long durations of months
• Excessively low or high blood flow during periods

Causes of PCOS

The exact cause or factor responsible for PCOS is still not known. However, evidence suggests that genetic and environmental factors can be the reason for the excessive release of androgens in women of reproductive age. Here are some of the causes of PCOS.

1. Hormonal Imbalance

One of the primary underlying causes of PCOS is hormonal imbalance, specifically involving increased levels of androgens (male hormones) such as testosterone. This hormonal dysregulation disrupts the normal functioning of the ovaries, leading to irregular menstrual cycles, ovarian cysts, and other symptoms associated with PCOS.

2. Insulin Resistance

Insulin resistance, a condition where cells become less responsive to the hormone insulin, is commonly observed in women with PCOS. This resistance causes the body to produce higher levels of insulin to maintain normal blood sugar levels. Elevated insulin levels can stimulate the ovaries to produce more androgens, exacerbating hormonal imbalances and contributing to PCOS symptoms.

3. Lifestyle Factors

Obesity and a sedentary lifestyle are significant risk factors for PCOS. Excess body weight, particularly abdominal obesity, can exacerbate insulin resistance and hormonal disturbances, increasing the likelihood of developing PCOS or worsening existing symptoms. Additionally, poor dietary habits and inadequate physical activity may contribute to insulin resistance and metabolic dysfunction.

4. Chronic Inflammation

Chronic low-grade inflammation is increasingly recognized as a contributing factor in the development of PCOS. Elevated levels of inflammatory markers in women with PCOS may disrupt ovarian function and exacerbate insulin resistance. The exact mechanisms linking inflammation to PCOS are still under investigation.

5. Genetic Factors

Parents possessing genes for polycystic ovarian syndrome can pass the infected genes to their offspring. It leads to PCOS in their children at the reproductive age when the phenotype becomes visible. The infected or muted gene can pass between male and female parents, but the genes express themselves only in the female child.
The other genetic factor, besides heredity, can be the mutation of genes during any stage of life.

6. Environmental Factors

Many environmental factors can lead to the syndrome. Stress is the most common and significant cause of different types of hormonal imbalances. Other environmental factors which can contribute to PCOS include:

• Sedentary lifestyle
• Poor diet and nutrition
• Drugs
• Toxins
• Other health conditions(such as obesity)
• Unhealthy and unhygienic habits
• Geography and other socioeconomic problems.

7. Other Contributing Factors

Several other factors may also play a role in the development of PCOS, including:

• Prenatal exposure to certain hormones or environmental factors.
• Disrupted hypothalamic-pituitary-ovarian (HPO) axis function.
• Excess production of luteinizing hormone (LH) from the pituitary gland.
• Imbalances in other hormones such as anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH).

Effects of Polycystic ovarian syndrome

1. Infertility

70% to 80% of women suffer from infertility in PCOS. 20-25% of infertility is due to a lack of ovulation. Ovulation is prevented in women with PCOS because of higher levels of androgens. Therefore, infertility is common in women suffering from PCOS.

Infertility in polycystic ovarian syndrome occurs due to low estrogen levels. Estrogen is responsible for regulating the menstrual cycle and maintaining fertility. Women who suffer from polycystic ovarian syndrome may experience symptoms such as acne, weight gain, and excessive facial hair. These symptoms are caused by higher than normal levels of testosterone.

Testosterone is a hormone produced by the testicles that stimulate sex drive and helps maintain muscle mass. In women, testosterone is converted into estrogen by the enzyme aromatase. Aromatase converts testosterone into estradiol, which is the primary female hormone. High levels of testosterone cause the conversion of testosterone into estrogen to occur at a faster rate. As a result, estrogen levels rise and become out of balance. 

Related: PCOS Fertility Diet Plan

2. Obesity

40-80%  of women suffering from PCOS are overweight and obese. Therefore, the bodies of women with PCOS appear apple-shaped rather than pear-shaped. The cause of weight gain in PCOS is not fully understood. However, some studies suggest that insulin resistance is a major factor in the development of obesity in PCOS patients.

Insulin resistance occurs when cells become resistant to insulin, causing them to produce higher amounts of insulin than normal. High levels of insulin lead to increased fat storage in the body. Another theory suggests that excess testosterone causes weight gain in PCOS patients. Testosterone is a hormone produced by the testes that stimulate muscle growth and increases appetite.

3. Insulin resistance

Insulin is a hormone responsible for glucose intake from the blood cells. Insulin resistance is a condition in which muscle, liver, and fat cells don’t respond to insulin. In short, the cells become resistant to insulin. Hence, insulin can not use glucose for energy production even if it is available. It leads to increased blood glucose levels causing type-2 diabetes. Insulin resistance in PCOS is of common occurrence. It occurs in 70 to 80% of overweight women suffering from PCOS.

4. Mental Health Issues associated with PCOS

Research studies indicate that the ratio of mental disorders is high in women suffering from polycystic ovarian syndrome. Mental health problems such as mood and anxiety disorders have a high prevalence in PCOS women. Depression scores and risk of depression also increase, irrespective of their BMI. Therefore, screening for PCOS women is necessary for their good mental health along with physical health.

5. Hirsutism

Hirsutism is the condition in which there is excessive male-pattern body hair growth in women. Facial hair is common in women suffering from PCOS. The hormones responsible for causing hair growth are testosterone and estrogen. Testosterone is produced primarily in the testicles, while estrogen is produced in both the ovaries and adrenal glands. When a woman’s body produces too much estrogen, her hair follicles become enlarged and produce excessive amounts of hair. This causes hair loss in some parts of the body, including the scalp.

Other effects and symptoms of PCOS include:

• Body inflammation
• Male pattern baldness
• Sleep apnea
• Heart attacks
• Stroke etc

 PCOS Treatment

PCOS treatment is a term used to describe the use of prescription drugs to treat polycystic ovary syndrome (PCOS). PCOS is a condition where women have irregular menstrual cycles, high levels of male hormones, and enlarged ovaries. Women who suffer from PCOS often experience acne, hair loss, weight gain, and infertility. There are many different types of treatments for PCOS including birth control pills, fertility drugs, diet changes, exercise, and surgery.

1. Birth Control Pills

Birth control pills are prescribed to help regulate menstrual cycles and reduce the risk of pregnancy. These pills work by blocking the release of certain hormones, which in turn stops ovulation. Birth control pills are generally taken daily and last between three months and five years depending on the type of pill.

 2. Fertility Drugs

Fertility drugs are medications that stimulate ovulation and cause the release of eggs from the ovaries. They are commonly prescribed to women who are unable to conceive naturally due to low sperm count, poor-quality semen, or blocked fallopian tubes. Fertility drugs may be taken orally or injected directly into the uterus.

Read More: How to get pregnant with PCOS quickly?

 3. Diet Changes

A proper diet plan is recommended for women suffering from PCOS. A low-calorie diet is often suggested to reduce the number of calories consumed each day. Eating smaller meals throughout the day is also encouraged. Many women find that eating less sugar helps them feel fuller and faster and reduces cravings.

 4. Exercise

Exercise is a great way to burn calories and lose weight. Weight training is especially helpful for those with PCOS because it increases muscle mass and tone. Yoga is another good option for those looking to get fit while reducing stress.

Read More: Best Exercises For PCOS

5. Surgery

Surgery is only considered if other methods do not work. In some cases, doctors recommend removing cysts from the ovaries using laparoscopic surgery. Laparoscopy is a minimally invasive surgical procedure that uses small incisions instead of traditional open surgeries.

The Bottom Line

In short, PCOS treatment includes lifestyle changes and medications. Lifestyle changes include eating a balanced diet, exercising regularly, and avoiding alcohol. Medications include birth control pills, spironolactone, and clomiphene citrate. Birth control pills reduce the amount of testosterone in the body. Spironolactone reduces the amount of estrogen in the body. Clomiphene citrate increases the amount of estrogen in a woman’s body.

Frequently Asked Questions