Polycystic Ovarian Syndrome (PCOS)
Polycystic Ovarian Syndrome is a common hormonal disorder among women of reproductive age. It can affect you from adolescence to older age. The symptoms are irregular or prolonged periods, excessive hair growth all over, acne, increased weight, male-pattern baldness and infertility.
What are the symptoms of Polycystic Ovarian Syndrome?
In adolescence, absence or infrequent menstruation may be a single sign associated with increase in weight and excessive hair growth. Women who are beyond adolescence can experience irregular periods, leading to pregnancy delays, unexplained weight gain or loss.
Causes
- Large ovaries containing numerous small cysts – This can be detected by ultrasound.
- Excessive insulin causes insulin resistance, so the pancreas has to produce more insulin, increasing the production of androgen, therefore leading to acne, excessive hair growth and weight gain.
- Excessive androgen can cause male pattern hair growth and acne; it also causes irregular periods that can lead to infertility.
What are the health risks for women with PCOS?
PCOS affects all areas of the body, not just the reproductive system. It increases a woman’s risk of serious conditions that may have lifelong consequences. For example, insulin resistance increases the risk of type 2 diabetes mellitus and cardiovascular disease.
Women with PCOS may have endometrial hyperplasia – when the lining of the uterus becomes too thick. This condition increases the risk of endometrial cancer.
Other complications are:
- A higher risk of obesity
- A higher blood pressure
- High cholesterol and lipids
- Obstructive sleep apnoea
- Heart attack and stroke
- Abnormal uterine bleeding
- Gestational diabetes and diabetes mellitus
- Sub-fertility
Tests and diagnosis
To test for PCOS, a thorough medical history check is the first step. A physical examination including pelvic examination, blood tests for androgen/insulin levels, blood sugar levels, lipid profile and a pelvic ultrasound looking for pearl necklace appearance of the ovaries, are primarily used in diagnosis for PCOS.
Polycystic ovarian syndrome treatments
- Life style changes – a 5% reduction in body mass may help a woman to ovulate. Consider dietary changes and increase exercise, which can lower your blood sugar levels.
- Medication – Oral contraceptive pills are used to regulate the periods and to prevent increase in the thickness of endometrial lining.
- Letrozole can induce ovulation if the problem is infertility.
- Spironolactone or oral contraceptive pills can decrease androgen production, therefore reduces excessive hair growth and acne.
- Surgery – Laparoscopic ovarian drilling can reduce androgen formation.