Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) is one of the most common female endocrine disorders and has a lot of psychological and social impact on a women’s life. It is associated with a hormonal imbalance that can cause a variety of symptoms.

Polycystic Ovary Syndrome is a common disorder in women that can affect from the age of teens till menopause. It occurs in approximately 5% to 10% of women of reproductive age (12–45 years old) resulting in irregular menstruation among other symptoms. The disorder appears to be increasing especially in young and teenagers perhaps related to more sedentary life and eating habits leading to obesity, diabetes and insulin resistance.

Fortunately the treatment is possible. With life style changes, medicinal therapy and exercise one can really improve their health condition.

What are the symptoms of PCOS?

Signs and symptoms vary from person to person, in both type and severity. You may have only a few symptoms or a lot of them. The most common symptoms are:

1. Menstrual irregularity: This may range from short irregular cycles, having menstrual bleeding which stops only with medicines or abnormally delayed or absent menses.

2. Hirsutism: Excessive hair growth on face and other parts of the body due to increased male hormones or thinning hair on the scalp.

3. Acne.

4. Obesity: Problem with easy weight gain. However, not all women with PCOS have weight problems.

5. Infertility: Difficulty in becoming pregnant since there is no ovulation or timely egg release.

Weight reduction is the single most important lifestyle change which can help to restore and correct PCOD. Almost 60-70 % of PCOD women are obese. Stop gaining weight at the starting point by following a proper diet and exercise. The earlier the weight is controlled, sooner the problem may be corrected.

What causes polycystic ovarian syndrome (PCOS)?

The exact cause of polycystic ovary syndrome is unknown but recent studies indicate that lifestyle, environmental and genetic factors can be involved. PCOS seems to run in families, so your chance of having it is higher if other women in your family have PCOS, irregular periods, or diabetes. PCOS can be passed down from either your mother's or father's side. But early diagnosis and treatment may reduce the risk of long-term complications, such as type II diabetes and heart disease.

Factors that play vital role in developing PCOS:

1. A malfunction of the body's blood sugar control system (insulin system) is frequent in women with PCOS, who often have insulin resistance and elevated blood insulin levels, and researchers believe that these abnormalities may be related to the development of PCOS. It is also known that the ovaries of women with PCOS produce excess amounts of male hormones known as androgens. This excessive production of male hormones may be a result of or related to the abnormalities in insulin production. Weight loss has been shown to improve insulin resistance.

2. Normal ovarian function relies on the selection of a follicle in the ovary, which is largely a response to an appropriate signal from substances called follicle-stimulating hormone (FSH) and luteinizing hormone (LH) - two hormones secreted by the pituitary gland. In PCOS, there is a hypersecretion of pituitary luteinizing hormone (LH) and the high levels of both LH and insulin appear to stimulate the ovary to produce excessive male hormones (androgens). Obesity magnifies this effect.

3. Other possible contributing factors in the development of PCOS may include a low level of chronic inflammation in the body and fetal exposure to male hormones.

What conditions or complications can be associated with PCOS?

Women who have been diagnosed with PCOS seem to be at a greater risk of developing endometrial cancer, diabetes, high blood pressure, high cholesterol, and heart disease. Getting symptoms controlled as soon as possible can decrease a woman’s chance of developing any of these other conditions.

Obesity is associated with PCOS. It not only compounds the problem of insulin resistance and type II diabetes, but also imparts cardiovascular risks. PCOS and obesity are associated with a higher risk of developing metabolic syndrome, a group of symptoms, including high blood pressure. It has also been shown that levels of C-reactive protein (CRP), a biochemical marker that can predict the risk of developing cardiovascular disease, are elevated in women with PCOS. Reducing the medical risks from PCOS-associated obesity is possible through proper exercise and dietary lifestyle.

The risk of developing pre-diabetes and type II diabetes is increased in women with PCOS, particularly if they have a family history of diabetes. Several studies have shown that women with PCOS have abnormal levels of LDL (bad) cholesterol and lowered levels of HDL (good) cholesterol in the blood. Elevated levels of blood triglycerides have also been described in women with PCOS.

Changes in skin pigmentation can also occur with PCOS, brown to black pigmentation often seen on the neck, under the arms, or in the groin. This condition is associated with obesity and insulin resistance and occurs in some women with PCOS.

How Does Polycystic Ovarian Syndrome Cause Infertility?

The abnormal hormone levels associated with PCOS lead to problems with ovulation. These irregularities in ovulation are the main cause of infertility.

Because of the menstrual and hormonal irregularities, infertility is common in women with PCOS. Because of the lack of ovulation, progesterone secretion in women with PCOS is diminished, leading to long-term unopposed estrogen stimulation of the uterine lining. This situation can lead to abnormal periods, breakthrough bleeding, or prolonged uterine bleeding in some women. Unopposed estrogen stimulation of the uterus is also a risk factor for the development of endometrial hyperplasia and cancer of the endometrium (uterine lining).

PCOS is also associated with a higher risk of early miscarriage. Research on PCOS has shown that the miscarriage rate may be as high as 20% to 40%, which is twice as high as in the general population.

It is not exactly clear why miscarriage is more common in women with PCOS, but some theories include the following:

• poor egg quality, related to premature or late ovulation

• insulin resistance

• a less-than-favorable environment for an embryo to implant in the uterine lining (due to abnormal hormone levels associated with PCOS)

Treatment for PCOS

As part of polycystic ovary syndrome (PCOS) treatment, medicines can be used to balance hormones or insulin levels. Regular exercise, healthy foods, and weight control are key treatments for PCOS. Getting proper treatment can reduce unpleasant symptoms and help prevent long-term health problems.

Manage PCOS with Dietary and Lifestyle changes:

The first step in managing PCOS is to get regular exercise and eat heart-healthy foods. The main aim of your diet, with regards to PCOS, is to control your weight and minimize the severity of possible symptoms such as hypertension and cardiovascular disease.

The standard healthy diet consists of a good balance of protein, fats, carbohydrates, minerals, vitamins, fiber, and water.

• Eat a heart-healthy diet. Increase the consumption of fruit & vegetables and also intake nuts, beans, and whole grains. Consume foods in limited amount that are high in saturated fat, such as meats, cheese, fried and fatty products.

• Walking is a great exercise that most people can do.

• Most women who have PCOS can benefit from losing weight. Shedding even a modest amount of weight can help. In women with PCOS, losing less than 10% of initial body weight has been shown to increase ovulation frequency, improve fertility, reduce levels of the male hormone testosterone, and cut high levels of blood fats and blood sugar.

• If you smoke, consider quitting. Women who smoke have higher androgen levels that may contribute to PCOS symptoms. Smoking also increases the risk for heart disease.

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