As a woman’s body repeatedly undergoes cyclic hormonal changes, at a certain stage in the cycle, it is in the best time to conceive. This cycle is more commonly known as the menstrual cycle in women that occurs, mostly every 28 days. During every menstrual cycle, the ovary releases an egg as the oestrogen levels increase. The lining of the womb thickens and prepares itself for the possibility of pregnancy. If this egg is not fertilised, the lining of the womb is shed and exits the body through the vagina, mixed with blood, experienced by women as periods. With hormones acting as chemical messengers, many hormones are responsible for triggering other hormones. Therefore, one hormonal change can trigger another. Since the levels of hormones keeps changing continuously, sometimes this can lead to an imbalance, which can cause polycystic ovary syndrome or PCOS.
PCOS can cause problems with a woman’s ability to conceive. In some cases, it can also lead to changes in the appearance of a woman that she might have a problem in dealing with. In most cases of PCOS, small cysts develop on the ovaries which are related to the hormonal imbalance.
Symptoms of PCOS
Hormonal changes associated with PCOS can lead to menstrual problems like heavy or irregular bleeding and in some cases, no menstrual periods at all. Hair loss from the scalp and increase in facial hair growth with hair growing on the chest, back, thighs or toes can be experienced by a woman suffering from PCOS. Acne and oily skin can also be often attributed to PCOS in women who suffer from these symptoms.
Some women with PCOS can also experience problems like repeat miscarriages or no ovulation. Hyperinsulinemia is also a feature of PCOS. It means that the amount of insulin in the body is high, which can further lead to skin tags and upper body obesity. Skin tags are small soft skin growths, which are harmless and can appear on eyelids, armpits, neck, under breasts and groin folds. Women who experience skin tags do not need to worry as there are several methods of getting rid of them. A woman with PCOS can also experience depression and mood swings and breathing problems while sleeping.
Impact of PCOS
PCOS can cause some reproductive problems that might make it difficult for a woman to conceive.
Endometrial Hyperplasia – This condition can occur when menstrual cycles are not regular. In the long term, it can develop pre-cancerous or cancerous changes and lead to cancer of the uterine lining.
Increased Blood Pressure – PCOS can lead to increased blood pressure during pregnancy or delivery, as well as repeat miscarriages. PCOS patients are also at a higher risk of developing hypertension later on in life.
Gestational Diabetes – The hormonal imbalance associated with PCOS can cause gestational diabetes which involves high blood glucose levels during pregnancy. According to the Centers for Disease Control and Prevention, over 9% of pregnant women experience gestational diabetes.
Vascular problems - The syndrome can also cause heart and blood vessel problems including high cholesterol or high blood pressure, coronary artery disease or hardening of the arteries which can be a precursor for strokes and other cardiac problems.
Infertility – Female infertility occurs when the egg is not released by the ovaries every month.
Tests for PCOS
Doctors do not have one single test to find out if a woman has polycystic ovary syndrome. They will need a medical history and a physical exam for the same.
For the medical history, a woman will have to answer certain questions related to the symptoms of the condition. These include questions about weight changes, skin, menstrual cycle and hair. Information about problem in conceiving (if any) will also help doctors in determining if a woman has PCOS. Since a family history can also lead to the condition, the doctors would want to know about it.
Physical exams, such as check-ups of thyroid gland, belly, hair, skin and breasts, along with the BMI value, can help doctors diagnose PCOS in women. A pelvic exam and blood pressure checks will also be helpful in determining the condition. Pelvic exams may also help doctors in determining if a woman has abnormal or enlarged ovaries. Additionally, blood tests can be done to find out androgen and insulin levels, prolactin, cholesterol and triglycerides, glucose and thyroid-stimulating hormone (TSH) along with the levels of Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH).
To keep the hormones in balance, health experts recommend a healthy diet, abstinence from smoking, regular exercise and good weight control.
A healthy lifestyle can benefit all aspects of life and since the treatment of PCOS depends on the manifested symptoms, maintaining a healthy lifestyle becomes paramount. If a woman is overweight, weight loss can help the hormones get back in balance which can then regularize the menstrual cycle. A healthy diet should include fruits, vegetables, low-fat dairy products and whole grains. Regular exercise can also help in weight reduction. It is also known that the women who smoke have higher levels of androgens (male sex hormones) that can contribute to hormonal imbalance.
Hormone therapy may combine various drugs that help in ovulation with hormones that help correct menstrual cycle problems. Health care providers may also administer drugs to lower androgen levels in women. Women should keep in mind that blood pressure and coronary problems cannot be treated by a hormone therapy. Thus, exercising and a healthy diet are essential.
Other options that can help deal with PCOS include insulin-sensitizing medications, topical anti-hair growth drugs, and acne and hair loss treatments.
Some treatment options for PCOS involve surgeries. Women who experience infertility from PCOS can opt for ovarian wedge resection or laparoscopic ovarian drilling. In ovarian wedge resection, a part of an ovary is removed to regulate hormonal levels and menstrual cycles. Ovulation can also be triggered through laparoscopic ovarian drilling. This is done in cases where women do not respond to fertility and weight loss medicines. In this procedure, electrocauterisation and puncture of a few enlarged follicles/cysts of the ovary is undertaken with the help of laparoscopic instruments.
Women who are diagnosed with PCOS may find it hard to deal with it initially. While, the emotional distress is completely understandable, women should keep in mind that today’s medical science is well equipped to handle such scenarios. They should try to remain stress-free and maintain a healthy lifestyle besides coordinating with their healthcare providers and following the recommended treatment.
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