Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment

Polycystic ovary syndrome (PCOS) is a condition in females, in which their hormone level is affected. PCOD (Polycystic Ovarian Disease) or PCOS (Polycystic Ovarian Syndrome) are names given to the same ailment. PCOD affects nearly 1 million women per year in India only, mostly striking at an early age. As the name already suggests, in the disease, the development of multiple cysts (blisters inside the body) in the ovary takes place. Due to this ovary enlarges and excessive production of androgen and estrogen (female hormones) happens to lead to multiple disorders in the body. Symptoms of the ailment are already listed above.

PCOS causes more than normal amounts of male hormone secretion in women. This causes a hormonal imbalance in their body, leading to skipping menstrual periods and difficulty in getting pregnant. PCOS can cause some long-term health issues like diabetes and heart disease and can also cause hair growth on the face and body, and baldness. Hormonal imbalance can be fixed and the symptoms can be improved up to certain levels by the use of birth control pills and diabetes drugs.

More about PCOS

PCOS is a problem with hormones that affects women during their childbearing years (ages 15 to 44). Between 2.2 and 26.7 percent of women in this age group have PCOS. The condition PCOS causes hormone-related issues in women during their childbearing age (15 to 44 years). According to a study, between 2.2 to 26.7 % of women in this age group have PCOS.

One in every 10 women suffers from PCOD/PCOS on average. Some experiences obesity, weight gain, and acne while some experiences abnormal menstruation, irregular or heavy menstruation, depression, and loss of scalp hair are also some significant symptoms of PCOS. All these side-effects-cum-symptoms are threatening and alarming too. In a world where stress and anxiety are common, there is a high risk for women to suffer from PCOS/PCOD. But every problem has a solution and this deadly-looking worst situation also has some specific solutions.

Many women have PCOS but they don’t know it. According to another study, up to 70 % of women are unaware that they have PCOS.

Ovaries, the female reproductive organs- which produce estrogen and progesterone are affected by PCOS. These hormones are responsible for the regulation of the menstrual cycle. In addition to secreting estrogen and progesterone, ovaries also produce a scanty amount of male hormones called androgens.

There is a release of an egg each month called ovulation. The ovaries release eggs to be fertilized by a man’s sperm. Ovulation is controlled by follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH is involved in stimulating the ovary to produce a follicle — a sac that contains an egg, after that LH stimulates the ovary to release a mature egg. PCOS can cause a group of symptoms affecting the ovaries and also ovulation. The three most common symptoms are:

1. Irregular or skipped periods

2. Cysts in the ovaries

3. High levels of male hormone

Many small, fluid-filled sacs grow inside the ovary of women having PCOS. This is what is called polycystic, which means “many cysts”. These sacs are follicles, each containing 1 immature egg. The main issue is that these eggs never mature enough to trigger ovulation. Lack of ovulation causes alteration in levels of hormones that are involved in the whole procedure of ovulation, like estrogen, progesterone, FSH, and LH. Androgen levels increase higher than usual, while the level of estrogen and progesterone falls. High levels of androgens disturb the menstrual cycle, so women with PCOS get fewer periods than usual. PCOS isn’t a new condition. Italian physician Antonio Vallisneri first described its symptoms in 1721.

In short:

Up to 27% of women during their childbearing age are affected by PCOS. The main issues associated are irregular periods, cysts in the ovaries, and high levels of male hormones.

Causes of PCOS

The exact causes of PCOS are still unknown but excess production of male hormones (androgen) inside the body may lead to it. High levels of the male hormone inside the body prevent ovaries from producing eggs normally, leading to many problems.  PCOS runs in families so, it is related to genes, meaning that if your ancestor had it there are high chances of you catching it. Insulin resistance and inflammation of tissues also lead to excessive production of a male hormone which then leads to PCOD.

The exact reason for PCOS is still a mystery for doctors. They believe that the high levels of male hormones in women are responsible for the improper function of ovaries in producing hormones and making eggs normally. In addition genes, inflammation, and insulin resistance have also been linked to excess androgen production.

Genes

It is reported in some studies that PCOS runs in families. It is also reported that a single gene is not responsible for this, many genes are involved in causing this condition.

Insulin resistance

According to some studies, up to 70 % of women with PCOS have impaired insulin function, i.e. insulin resistance. Insulin is a hormone produced by the pancreas, to help the body use sugar from foods for energy. When the insulin is not used by cells properly, the body’s demand and the supply from the pancreas both increase. Extra insulin triggers the ovaries to produce more male hormones. The major cause behind insulin resistance is obesity. Obesity and insulin resistance, together with lead to type2 diabetes.

Inflammation

Women suffering from PCOS normally have increased levels of inflammation in their bodies. Being obese or overweight can also contribute to inflammation. Excess inflammation is linked with higher levels of androgen in some studies.

In short:

The exact reason behind PCOS is not known now. Doctors believe some factors behind this like genes, insulin resistance, and higher levels of inflammation in the body.

Common symptoms of PCOS

The symptoms are visible in some women from their first period while others came to know about it after they’ve gained a lot of weight or they’ve had trouble getting pregnant.

In short:

PCOS can disturb the normal menstrual cycle, resulting in very fewer periods. Some other symptoms associated with PCOS are acne, hair growth, weight gain, and dark skin patches.

Effects of PCOS On your body

There are various areas in your body, which can get affected by PCOS.

Infertility

Proper ovulation is of utmost importance for getting pregnant. Women not ovulating regularly don’t release as many eggs to be fertilized. One of the leading causes of infertility is PCOS.

Metabolic syndrome

According to a few studies, approx. 80% of women with PCOS are overweight or obese. PCOS with obesity increases the risk of insulin resistance, high blood pressure, low HDL, and high LDL. These metabolic syndromes increase the risk of heart disease, diabetes, and stroke.

Sleep apnea

This condition causes repeated pauses in breathing during the night, which interrupts sleep. Repeated pause in breathing during the night is observed in females with PCOS. This causes interrupted sleep. Although sleep apnea is common among overweight females, the risk increases 5 to 10 times in obese women with PCOS, as compared to those without PCOS.

Endometrial cancer

The uterine lining sheds during ovulation. Women not ovulating every month, build up the lining thicker. A thickened uterine lining increases the risk of endometrial cancer.

Depression

Various symptoms associated with PCOS like unwanted hair growth, acne, and excessive hair fall can affect your emotions negatively. Many women with PCOS end up experiencing depression and anxiety.

In short:

A woman's health can be affected in many ways due to hormonal imbalance. PCOS increases the risk for infertility, metabolic syndrome, sleep apnea, endometrial cancer, and depression.

How PCOS is diagnosed

When at least two of the under given symptoms are found in a woman, doctors diagnose it as PCOS:

. Cyst in ovaries

. Irregular periods.

. high levels of androgen

Your doctor may ask you whether you’ve had other symptoms like hair loss, weight gain, body hair growth, or acne. By pelvic examination, your doctor can search for any problems with your ovaries or other parts of the reproductive tract. Gloved fingers are inserted into your vagina to check for any growths in your ovaries or uterus.

Blood tests are performed to check the levels of male hormones. You may also be suggested by your doctor for some other tests like cholesterol, insulin, and triglyceride levels to evaluate your risk for related conditions like heart disease and diabetes. An ultrasound can be suggested to look for abnormal follicles and other problems with your ovaries and uterus.

In short:

The main symptoms of PCOS are high androgen levels, irregular periods, and cysts in the ovaries. If you have more than two of them, the doctor will diagnose it as PCOS. Following that, a pelvic exam, blood tests, and ultrasound can confirm the diagnosis.

Pregnancy and PCOS

The normal menstrual cycle is interrupted in the condition PCOS, and it becomes difficult to conceive. According to some studies, about 70-80% of women with PCOS have fertility-related issues. If they become pregnant, this can increase their pregnancy complications.

Women with PCOS have a greater (approx. double than normal women) chance of giving birth to a premature baby. The chance of miscarriage, high blood pressure, and gestational diabetes also increases. However, fertility treatments related to improving ovulation can be helpful for women with PCOS to become pregnant. Weight loss and normal blood sugar levels also increase the odds of getting pregnant.

In short:

There is an increased chance of infertility in women with PCOS. It can also increase pregnancy complications and miscarriage. Weight loss, fertility-related treatments, and normal blood sugar levels can improve your odds of having a healthy pregnancy.

Common medical treatments

Birth control pills and other medicines can help in the regulation of the menstrual cycle and the treatment of PCOS symptoms like hair growth and acne.

Birth control

Daily intake of estrogen and progestin can help restore a normal hormone balance, regulate ovulation in relieving symptoms like excess hair growth, and protect against endometrial cancer.

Metformin

Metformin is a drug used in the treatment of type 2 diabetes. It also treats PCOS by improving insulin levels. In addition to making dietary changes and exercises, metformin improves weight loss, lowers blood sugar, and restores a normal menstrual cycle better than changes to diet and exercise alone.

Clomiphene

Clomiphene is a fertility drug, which can help women with PCOS in getting pregnant. But, it can increase the chance of twins and other multiple births.

Hair removal medicines

Few treatments help stop the growth of unwanted hair. Eflornithine (Vaniqa) cream is a prescription drug that slows hair growth. For the removal of unwanted hair from the face and body, laser hair removal or electrolysis can be beneficial.

Surgery

To improve fertility, surgery can also be an option if other treatments don’t work. Ovarian drilling is a procedure that makes tiny holes in the ovary with a laser or thin heated needle to restore normal ovulation.

In short:

Birth control pills and metformin tablets can help restore a normal menstrual cycle. To improve fertility Clomiphene and surgery may be beneficial. Hair removal medicines and laser hair removal may help you get rid of unwanted hair growth.

When to see a doctor for PCOD

Consult with your doctor if:

1. You have symptoms of diabetes, such as excessive thirst or hunger, blurred vision, or unexplained weight loss.

2. You’ve missed your periods and you’re not pregnant.

3. You have symptoms like hair growth on your face and body.

4. You’ve been trying to conceive for more than 12 months but haven’t been successful.

If you are diagnosed with PCOS, be in regular contact with your primary doctor. You’ll need regular tests for diabetes, high blood pressure, and other possible complications.

In short:

Consult your doctor, if you have symptoms like skipped periods, and hair growth on your face and body. Also contact your doctor, if trying to conceive for more than 12 months and not getting success.

The bottom line

PCOS can disturb the menstrual cycle of a woman and make it difficult to get pregnant. High levels of male hormones result in unwanted symptoms like hair growth on the face and body.

Weight loss tips for women with PCOS:

It is very difficult for women with PCOS to lose weight because of related conditions like hormonal imbalances, insulin resistance, and inflammation. Even a small weight loss of approximately 5% can improve insulin resistance, hormone levels, menstrual cycles, fertility, and overall quality of life in women with PCOS.

Let’s discuss some weight loss tips which can be helpful for you:

The Bottom Line

Weight loss is very difficult for women with PCOS. A healthy diet low in inflammatory foods like refined carbs and highly processed foods but rich in whole foods, protein, healthy fats, and fiber may enhance weight loss. Certain supplements may also help in this regard. Lifestyle modifications like regular exercise, stress management, and proper sleep are very important for weight loss. If you have PCOS and struggle to lose weight, try the above tips.

Some Natural Ways to Help Treat Polycystic Ovary Syndrome (PCOS)

The main symptoms of PCOS include:

1. weight gain

2. irregular periods

3. acne

4. ovarian cysts

5. thinning hair

The causes of PCOS are complicated, but insulin resistance and hormone regulation are key factors. You may be able to manage these factors and reduce your symptoms through lifestyle changes and dietary supplements, but there’s no one-size-fits-all approach to treatment. You should always talk with your doctor before trying any alternative treatment. They can discuss possible dosages, side effects, and interactions.

Let’s discuss some natural ways for PCOS management:

Diet changes

Diet affects the problem in two major ways first a good diet led to PCOS weight management and second it maintains the insulin level of the body (One is a significant symptom of the ailment and the other is a major reason behind the disease). Here dietplusminus has listed some of the diets which will help everyone fight the disease and control the symptoms to a great extent.

The most significant one is opting for a proper diet. Whether it is diabetes, blood pressure or any other disease diet plays a major role because anything we eat has a direct effect on our body so, going for a healthy and proper diet can help a lot with this problem also. Dietplusminus is here to help.

The key to dietary management is eating the right foods and avoiding certain ingredients.

Low Glycemic index (GI) diet

A diet in which less amount of Glycemic is present may help a lot in this case. A diet with low GI is digested slowly inside the body meaning, that they do not lead to rising the insulin level, which is necessary to be balanced. Nuts, fruits, starchy vegetables, and whole grains all come in a low GI diet.

Less inflammatory diet

Inflammation of tissues is a major cause of the disease so, ingesting an inflammatory diet can do worse. Berries, fish, and leafy green vegetables can help to reduce symptoms.

Dietary approaches to stop hypertension (DASH Diet)

It includes fruits, vegetables, low-fat dairy products, etc. DASH diet is highly recommended for PCOS.

. Balance carb and protein intake

. It’s all about whole foods

. Add in some fiber to help with digestion

. Cut out coffee

. Consider soy products

. Up your magnesium intake

. Up your iron intake

. Aim for anti-inflammatory

Supplements

Supplements claim to help in hormone regulation, insulin resistance, and inflammation mostly associated with PCOS. Some of the supplements to be added are inositol, chromium, cinnamon, turmeric, zinc, evening primrose oil, Combined vitamin D and calcium, Cod liver oil, and Berberine.

Adaptogen herbs

A higher level of male sex hormone called androgens builds up in your body when your body is unable to proper regulation of insulin. Adaptogen herbs claim to aid your body in balancing these hormones. Some of them are:

1. Chasteberry,

2. Tribulus Terrestris,

3. Ashwagandha,

4. Holy basil,

5. Maca root, and

6. Licorice root.

Probiotics

In addition to helping in digestion and maintaining a healthy gut, probiotics can play an important role in treating PCOS. They can also help in the regulation of sex hormones like androgen and estrogen and can also help reduce inflammation.

Maintain a healthy weight

It’s very important to maintain a healthy weight. It can help you in decreasing insulin resistance, regulate your period, and reduce the risk of conditions associated with PCOS. You can try a low-carb diet for maintaining a healthy weight.

Balance your exercise

In maintaining a healthy weight, exercise is very crucial. But remember too much exercise also be harmful and may disrupt your hormones. So talk to your doctor about a healthy balance.

Practice good sleep hygiene

Sleeping disturbances are twice common in women with PCOS. Sleep is directly connected with stress levels. Lower stress level helps proper regulation of cortisol, which in turn balances your hormones. To up your sleep hygiene:

•             Avoid stimulants and rich, fatty foods before bedtime.

•             a regular bedtime routine is necessary.

•             Aim for eight to ten hours of sleep per night.

Reduce stress

Stress reduction is very crucial for the proper regulation of cortisol. You can try yoga, getting enough sleep, caffeine cut, and self-care for reducing your stress level.

Limit or avoid endocrine disruptors

Some chemicals or ingredients can interfere with or block your natural hormonal reactions. Such chemicals mimic female and male sex hormones, confusing your reproductive system. These chemicals or ingredients are called endocrine disruptors and they can increase the risk of PCOS symptoms.

Consider acupuncture

It is shown in some studies that acupuncture can be efficiently used as an alternative treatment for PCOS. Acupuncture may help PCOS by:

•             improving your sensitivity to insulin

•             increasing blood flow to your ovaries

•             helping with weight loss

•             reducing cortisol levels

Be cautious

You should always talk to your doctor before starting any alternative therapy. Some treatments that claim to be miracles for PCOS can impact your fertility or may lead to other complications.

Talk with your doctor

Talk to your doctor and make a treatment plan before considering any natural treatment options for PCOS.

Frequently asked questions and answers on Polycystic Ovarian disease:

Are PCOS and PCOD the same?

Both PCOS and PCOD diseases are associated with ovaries. PCOS is an endocrine system disorder while PCOD is a condition developed by a hormonal imbalance.

Is PCOS dangerous?

Mostly, in women with PCOS, there are several small cysts, or water-filled sacs growing on ovaries. Although, these cysts are not harmful, but can lead to an imbalance in hormone levels. Women with PCOS may also experience menstrual cycle abnormalities, increased androgen (sex hormone) levels, excess hair growth, acne, and obesity.

Is PCOS curable?

The symptoms of PCOS can be managed, but the disease cannot be cured. Treatment options also vary from person to person because someone with PCOS may experience a range of symptoms, or just 1.

Are PCOS periods painful?

Normally, women with PCOS have irregular periods, which may be infrequent and/or prolonged. When women with PCOS have a menstrual period, they often experience heavy bleeding, clots, and severe period pain. As PCOS progresses, symptoms like period pain will get worse as well.

Are PCOS babies healthy?

Polycystic ovarian syndrome, or PCOS, is a common hormonal condition in women. It’s difficult to become pregnant for women with PCOS who are at higher risk of developing complications during pregnancy. However, by managing the symptoms, many women with PCOS can become pregnant and have healthy babies.

Are PCOS and pregnancy symptoms the same?

Except for a missed period or morning sickness, most early pregnancy symptoms are frustratingly similar to regular symptoms of an impending period. These include common symptoms such as increased fatigue and sore or tender breasts.

Are PCOS and diabetes related?

More than 50% of women with PCOS develop type 2 diabetes by age 40. Gestational diabetes puts the pregnancy and baby at risk and can lead to type 2 diabetes later in life for both mother and child.

Are PCOS and thyroid-related?

Both genetic and environmental factors are believed in contributing to thyroid disorders in PCOS. Hypothyroidism is known to cause PCOS- overall worsening of PCOS and insulin resistance.

Can PCOS be reversed?

Unfortunately, there is no cure for PCOS, but overweight and obese women can help balance their hormone levels by losing weight. The main line of treatment in the case of PCOS is to manage symptoms. A wide range of treatment options can help prevent any potential problems.

Can PCOS cause cancer?

PCOS increases the risk of some types of cancer. According to some research,  For instance, research has shown that the risk of cancer of the endometrium, the inside lining of the uterus, may be higher in women with PCOS as compared to women without it.

Can PCOS cause miscarriage?

One of the worst complications of PCOS is miscarriage. Women with PCOS are three times as likely to miscarry in the early months of pregnancy as are women without PCOS. Some research shows that metformin may reduce the risk of miscarriage in pregnant women with PCOS.

Can PCOS cause constipation?

Women with PCOS often report similar symptoms to those with IBS, including bloated feelings, constipation and/or diarrhea, and stomach and pelvic pains.

Can PCOS cause back pain?

Women with PCOS may experience low back pain, sacral pain, and lower quadrant abdominal pain. A thorough study of patient history will be needed to give that pain a gynecologic/metabolic connection.

Can PCOS be cured by yoga?

Although yoga cannot cure PCOS, it may help relieve some of the symptoms.

Did I ovulate with PCOS?

Due to hormonal imbalances, women with PCOS often have irregular menstrual cycles because either they don't ovulate or ovulate only occasionally.

Where did PCOS come from?

PCOS is caused by an imbalance in the hormones in your brain and your ovaries. PCOS usually happens when a hormone called LH or levels of insulin are too high, which then causes the ovaries to make extra amounts of testosterone.

Do PCOS cysts go away?

These cysts are harmless and will disappear naturally on their own after a few months. Usually, they don’t need any medical attention.

Does PCOS cause breast tenderness?

Women with PCOS are at increased risk of water retention and breast tenderness.

Does PCOS affect pregnancy?

Refer to question number 11.

Do PCOS cysts burst?

PCOS cysts can contribute to hormonal imbalances, but the cysts themselves are usually harmless. PCOS cysts are different than the kind of ovarian cysts that grow, rupture, and cause pain.

Does PCOS cause hair loss?

While many patients with PCOS grow thicker hair on their face and body, some experience hair thinning and hair loss, which is referred to as female pattern hair loss.

Does PCOS cause weight gain?

PCOS affects 1 out of every 10 women during their reproductive years. Women with PCOS often experience issues with hormonal imbalances, metabolism, and, as a result, weight gain.

Does PCOS cause weight loss?

Either women with PCOS produce too much insulin, or the insulin they produce does not work properly. The inability of insulin to function normally is one reason why women with PCOS tend to gain weight or have a hard time losing weight.

Does PCOS cause infertility?

Irregular periods and ovulation are common in women with PCOS. This can lead to Infertility. PCOS is one of the most common causes of infertility in women.

A woman who has PCOS?

Women with PCOS have hormonal imbalance and metabolism problems that may affect their overall health and appearance. PCOS is also a common and treatable cause of infertility.

Have PCOS and can't lose weight?

PCOS affects your body's secretion and use of insulin. Your cells become resistant to insulin signals and this prompts your pancreas to produce even more insulin. If you are gaining lots of weight or can't lose weight without significant changes in diet or exercise routines, excess insulin could be the culprit.

What to do when trying to get pregnant with PCOS?

You can get pregnant with PCOS. You will likely need to have moderate weight, balance your blood sugar levels, and treat other PCOS symptoms with healthy lifestyle changes and medications. In some cases, fertility medications alone will help you get pregnant. If that doesn't work, you may need IVF treatment.

Have PCOS but no symptoms?

If you have polycystic ovaries on scan but regular periods and no symptoms, then you are normal. It is important to note that the fluid-filled structures in the ovaries associated with PCO are not technically cysts. Ovaries contain follicles where the ova/eggs develop and they are naturally filled with fluid.

How PCOS is detected?

Doctors diagnose PCOS if women have at least two of three main symptoms — high androgen levels, irregular periods, and cysts in the ovaries. A pelvic exam, blood tests, and ultrasound can confirm the diagnosis.

Is PCOS genetic?

It is seen in studies that if any relatives, such as your mother, sister, or aunt, have PCOS, the risk of you developing it is often increased. This suggests there may be a genetic link to PCOS, although specific genes associated with the condition have not yet been identified.

Should patients with PCOS avoid dairy?

Women with PCOS have the propensity to develop insulin resistance and the ingestion of dairy can lead to higher levels of insulin. So, depending upon the case, dairy may be avoided.

Should PCOS patients take metformin?

Metformin is an effective ovulation induction agent for non-obese women with PCOS and also offers some advantages over other first-line treatments for non-ovulation infertility such as clomiphene. For clomiphene-resistant women, metformin alone or in combination with clomiphene is an effective next step.

Should PCOS patients avoid gluten?

Reducing the consumption of gluten or avoiding it could potentially lessen inflammation in PCOS, but more research is needed before recommending gluten-free diets to all women with the disease.

Suffering from PCOS, should I take birth control?

Mostly, who use the pill to treat their PCOS a combination pill, containing estrogen and progestin, is the best choice. The hormones in this type of pill work to prevent ovulation, decrease ovarian cysts and decrease the hormone-related side effects of PCOS.

What to eat, when suffering from PCOS?

Patients with PCOS should have a diet including these:

. natural, unprocessed foods.

. high-fiber foods.

. fatty fish, including salmon, tuna, sardines, and mackerel.

. kale, spinach, and other dark, leafy greens.

. dark red fruits, such as red grapes, blueberries, blackberries, and cherries.

. broccoli and cauliflower.

Where does PCOS acne occur?

PCOS-related acne mainly occurs in the "hormonally sensitive," area, especially the lower third of the face. This includes your cheeks, jawline, chin, and upper neck.