#PCOS – What is Polycystic Ovarian Syndrome?

image: destinationmotherhoodwithjennifer.blogspot.com

What is PCOS?

Polycystic Ovary (Ovarian) Syndrome (PCOS) is a hormonal disorder. Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam.

The signs and symptoms of PCOS

PCOS can be a complex condition to diagnose. There are several symptoms and you don’t have to have them all to be diagnosed with PCOS. ‘Polycystic’ suggests you might have multiple (poly) cysts on your ovaries, however not all women who have PCOS have multiple cysts and not all women who have multiple cysts have PCOS. Many symptoms of PCOS are caused by high levels of androgens circulating in your body, causing ‘hyperandrogenism’. Androgens are also called ‘male’ hormones, and the main one is testosterone. All women produce small amounts of androgens in the ovaries and the adrenal glands. High levels of androgens can prevent ovulation and affect the menstrual cycle.

How is PCOS diagnosed?

Medical history, examination, blood tests and ultrasounds are used to diagnose PCOS. A diagnosis can be made when at least two out of three of the following criteria are met:

Ovaries

  • 12 or more follicles visible on at least one ovary, or
  • The size of one or both ovaries is increased

Androgen

  • High levels of male hormones (androgens) in the blood (hyperandrogenism)
  • Symptoms suggesting high levels of male hormones (e.g. excess hair growth and acne) are present

Menstrual problems

  • Lack of menstrual periods, menstrual irregularity and/or lack of ovulation

Problems associated with PCOS

Weight Many women with PCOS have difficulty managing their weight and increased weight can result in worse physical symptoms.

Fertility

Menstrual problems can make it more difficult for women with PCOS to conceive naturally and some can also have a greater risk of miscarriage. Many women with PCOS have children without the need for medical infertility treatment.

Psychological effects

Depression and anxiety are commonly experienced with PCOS. Nearly half of all women with PCOS will have anxiety, and one third will have depression. This may be due to hormones or the effect of symptoms such as hair growth, weight and acne.

Other health problems linked to PCOS

There is an increased risk of developing a number of complications with PCOS including insulin resistance (your body doesn’t use the available insulin effectively to help keep the glucose levels stable), prediabetes, type 2 diabetes, cholesterol and blood fat abnormalities, and cardiovascular disease (heart disease, heart attacks, stroke).

 

image: pregnancytips.org
image: pregnancytips.org

 

Managing and treating PCOS

A healthy lifestyle is the first step in managing PCOS. Depending on the symptom, other ways may include:

Symptom

Irregular periods

Ways to manage the symptom

Hormonal contraception such as:

  • low-dose oral contraceptive pill
  • progesterone (stimulates the uterus and induces bleeding)
  • hormonal implants
  • vaginal contraceptive rings
  • intra-uterine devices containing progesterone
  • insulin sensitising medications such as Metformin

Symptom

Excess hair

Ways to manage the symptom

  • Waxing, laser hair removal, electrolysis
  • Reduction in the amount of androgens in the body using:

– hormonal contraception

– anti-androgen drugs e.g. cyproteone acetate

– insulin sensitising medications such as metformin

Symptom

Acne

Ways to manage the symptom

  • Topical preparations (creams)
  • Antibiotics
  • Reducing amount of androgens in the body using:

– hormonal contraception

– anti-androgen drugs e.g. cyproteone acetate

  • Insulin sensitising medications such as Metformin
  • Isotretinoin (sold as Roaccutane)

Symptoms

Fertility

Ways to manage the symptom

  • Weight management: losing 5-10% of body weight can help to induce ovulation
  • Monitoring ovulation (e.g. using ovulation predictor kits)
  • Ovulation induction using medications such as clomiphene citrate, metformin, gonadotropins, aromatase inhibitors

Symptoms

Depression & anxiety

Ways to manage the symptom

If you experience extreme feelings and thoughts of fear, sadness, or have lost interest in

your usual activities, it’s important to discuss your mood with your doctor. Treatments are

available, including talk therapy and some medications.

 

*Always seek medical attention from your doctor

Reference:

Jean Hailes: https://jeanhailes.org.au/contents/documents/Resources/Fact_sheets/PCOS.pdf

Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/pcos/basics/definition/con-20028841

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