Polycystic Ovary Syndrome (PCOS): Causes, Symptoms, and Treatments
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder in women that occurs when the ovaries produce higher-than-normal levels of male hormones (androgens). This condition typically affects women of reproductive age (15–45 years) and primarily impacts the ovaries, which are responsible for producing female hormones such as estrogen and progesterone, as well as small amounts of androgens. The hormonal imbalance in PCOS can cause irregular menstrual cycles, making it difficult for women to conceive. Additionally, it can lead to excessive hair growth on the body and hair loss, potentially resulting in baldness.
PCOS affects approximately 27% of women and is associated with long-term health risks such as diabetes and heart disease.
Treatment for PCOS
While there is no definitive cure for PCOS, several treatments can help manage its symptoms:
- Lifestyle Adjustments:
- Adopting a low-calorie diet that limits certain dairy products and carbohydrates to reduce androgen levels.
- Weight loss and increased physical activity can also help improve symptoms and hormone balance.
- Medications:
- Birth control pills to regulate menstrual cycles and lower androgen levels.
- Anti-androgens to control excessive hair growth and other androgen-related symptoms.
- IVF as a Solution:
- For women with PCOS struggling to conceive, IVF (In Vitro Fertilization) is often considered the most effective treatment to bypass fertility challenges caused by this condition.
Symptoms of PCOS
The most common symptoms of PCOS include:
- The presence of ovarian cysts or immature, non-viable eggs, making pregnancy difficult.
- Irregular or absent menstrual cycles.
- Elevated androgen levels beyond the normal range.
- Sleep apnea.
- Stress and anxiety.
- High blood pressure.
- Infertility.
- Skin issues such as acne or dandruff.
- High cholesterol and triglyceride levels.
- Darkened skin patches, a condition known as Acanthosis Nigricans.
- Type 2 diabetes.
- Pelvic pain.
- Depression and mood disorders.
- Difficulty managing weight, including weight gain or trouble losing weight.
- Hirsutism: Excessive hair growth on the face and body.
- Decreased libido.
Diagnosing PCOS
Diagnosis involves a combination of medical history, physical exams, and laboratory tests.
- Medical History:
- The doctor will ask about the patient’s symptoms, family medical history (e.g., any history of PCOS in the mother or sisters), and any issues related to weight or fertility.
- Physical Examination:
- The doctor will check blood pressure, BMI, and waist circumference.
- The skin will be examined for signs of excessive hair growth, acne, and dark patches.
- Pelvic Examination:
- A physical inspection of the reproductive organs, including the vulva, vagina, uterus, ovaries, fallopian tubes, bladder, and rectum.
- This exam involves both an external and internal evaluation, using a speculum to inspect the vaginal walls and cervix, as well as manual palpation to assess the size and shape of the pelvic organs.
- Pelvic Ultrasound:
- This test provides images of the ovaries and uterine lining. The doctor inserts an ultrasound probe into the vagina to check for ovarian cysts and measure the thickness of the uterine lining. In PCOS cases, the uterine lining is often abnormally thick due to missed periods, and the ovaries may be enlarged.
- Approximately 90% of women with PCOS are diagnosed through ultrasound imaging.
Hormonal Tests
The doctor may order blood tests to check for hormonal imbalances, including:
- Follicle-Stimulating Hormone (FSH): To assess egg production.
- Luteinizing Hormone (LH): To evaluate ovulation.
- Testosterone: To measure androgen levels.
- Estrogen: To check for estrogen imbalances.
- Sex Hormone Binding Globulin (SHBG): To evaluate free testosterone levels.
Additional Tests
- Pregnancy hormone (HCG).
- Blood glucose and insulin levels: To check for insulin resistance or diabetes.
- Cholesterol and triglyceride tests.
