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Understanding PCOS: Causes, symptoms, and diagnosis

12 Jun 2024

Whether you’re personally affected or supporting someone who is, this information aims to empower and inform, making the journey a little easier.

Living a life with PCOS can be overwhelming but there’s always room for clarity if you really want it. Today we’ve brought a friendly guide to help you understand the basics of PCOS, the symptoms, the causes, the treatments and more. Be it yourself, or someone you love, remember to make the most of this info so we can have yet another successful PCOS management journey.

What is PCOS?

Polycystic ovary syndrome (PCOS) is a hormonal condition occurring during the reproductive years of a person. Someone with PCOS may either have irregular periods or have periods lasting for too many days. Additionally, the presence of androgen also increases in the body.

Being diagnosed with PCOS means that there are sacs of fluid that develop in the outer edge of your ovary called cysts. The cysts carry immature eggs called follicles. The follicles fail to release eggs regularly, causing PCOS.

What are the causes of PCOS?

Although the exact cause of Polycystic Ovary Syndrome is not known, there are a couple of factors that may lead to it:

  • Insulin Resistance: Your pancreas produces a hormone called insulin. This hormone helps cells to take up sugar from the bloodstream and use it as energy. However, if cells do not respond or become resistant to insulin, then the sugar levels can rise. In turn, this makes your body produce more insulin so the glucose levels can be brought down this extra insulin leads to more production of male hormones.
    Some signs of insulin resistance are discoloured patches of skin (on the neck, breasts, armpits and groin), weight gain and big appetite.
  • Inflammation: Our white blood cells produce substances in response to infections and injuries. This process is known as low-grade inflammation. In people with PCOS, there is long-term low-grade inflammation leading to androgen production. It also leads to heart problems. Being overweight can also contribute to inflammation.
  • Genes: As per studies, PCOS also runs in families. A family history of PCOS may increase your chances of developing it. It is also possible that the contribution comes from more than one gene.
  • High androgen hormone:High levels of androgen create a problem for your ovaries in releasing eggs. This leads to irregular periods. When the ovulation is also irregular, it can cause fluid sacs to develop in the ovaries. High levels of androgen are also responsible for acne and severe hair growth.

What are the symptoms of PCOS?

Symptoms of Polycystic Ovary Syndrome often start around the time of the first menstrual period. Sometimes PCOS symptoms develop later after you have had periods for a while.

  • Irregular periods: Experiencing less-than-usual menstrual cycles throughout the year is one of the most common signs of PCOS. It’s also periods that last for lots of days or an unusual amount of days. Some women are also known to have less than eight menstrual cycles in a year.
  • High levels of androgen: Too much androgen results in excess hair production called hirsutism. Hair growth occurs on the face and the body like the back and chest. At times acne and male-pattern baldness can occur as well.
  • Polycystic ovaries: PCOS ovaries tend to be bigger. Hence, a lot of follicles with immature eggs can show up on the edge of the ovaries resulting in faulty working of the ovary.
  • Headaches:Hormonal changes can also cause headaches in some women.
  • Weight gain:About 3/4th of women with PCOS are most likely to be overweight or obese.
  • Heavy bleeding:When the uterine line keeps developing for a long time, the menstrual periods can be heavier than normal.
  • Skin darkening:Dark skin patches form on the skin of body parts like the groin, breasts and neck.

How can PCOS be diagnosed?

Although there’s no specific test to diagnose a condition like Polycystic Ovary Syndrome, your doctor may begin by looking at your PCOS symptoms and other conditions. You may also be asked about the regulations of your menstrual period and your weight. When going through a physical exam, there may be checking of your hair growth, acne and insulin resistance.

You may be recommended to take the following tests:

  • Blood tests: Blood tests help measure your hormonal levels. This excludes potential causes of menstrual problems or excess androgen. Other blood tests could be tasting cholesterol and triglyceride levels. A glucose test is also recommended to check your sugar levels.
  • Pelvic exam: A pelvic exam is conducted to check your reproductive organs for growth, masses, and any other changes and look for the causes of abnormal bleeding.
  • Ultrasound:Ultrasounds help inspect your ovaries and the thickening of the uterus lining. Usually, a transducer is placed in the vagina which produces sound waves that create images on the screen.

How can PCOS be treated?

Treatment of Polycystic Ovary Syndrome includes closely keeping a loon on issues like acne, obesity, infertility and hirsutism. A specific PCOS treatment would mean making some lifestyle changes and taking medication.

  • Lifestyle changes: Practising weight loss with the help of a refined diet and an exercise routine. Even the slightest loss in your weight, say 5%, can help better your condition. Weight loss can also contribute to how effectively your medications are working. A good healthcare provider and a dietician can help develop a personalised weight-loss plan for you.
  • Medications: For menstrual period regulation, your doctor may recommend the following medication:

    1. Combination of birth control pills:These are the pills that contain both estrogen and progestin which helps bring down androgen production and regulate estrogen. Hormone regulation can also lower risk of endometrial cancer and help fix irregular bleeding, excessive hair growth as well as acne.

    2. Progestin therapy:Taking progestin for 10-14 days every 1-2 months regulates your periods and helps fight endometrial cancer. The therapy does not prevent pregnancy or improve androgen levels.

A major step towards managing Polycystic Ovary Syndrome (PCOS) is understanding it. Although one size can’t fit all, PCOS symptoms and treatments does come in handy. Some modifications in how you live can go a long way and right now might just be the best time to start it!

About the Author

Medically reviewed by

Dr. Devina Aswal
MBBS, DDM, FCR, CIC

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