What Is PCOS? Causes, Symptoms & Treatment!
Have you ever considering finding out more about PCOS, which is short for polycystic ovary syndrome? This is most definitely which should concern you if you ever want to become a mother.
Table of Contents
- 1 What Is PCOS?
- 2 What Happens in the Body?
- 3 Causes
- 4 Can Polycystic Ovaries Cause Anxiety?
- 5 Complications
- 6 Symptoms
- 7 Risk Factors
- 8 Diagnosis
- 9 Chances of Becoming Pregnant After PCOS
- 10 Is Polycystic Ovary Syndrome Curable?
What Is PCOS?
Polycystic ovary syndrome represents a common hormonal imbalance which interferes with normal ovulation. Women who suffer of this syndrome don`t have a normal menstrual cycle. This hormonal imbalance also affects other systems of the body, such as cardiovascular and metabolic systems.
Most women with this condition present numerous small cysts (smaller than a pea) in the ovaries in a certain period of time. Still, some women with this affection don`t have polycystic ovaries, but experience other symptoms of this illness.
This syndrome appears predominantly at girls and young women.
What Happens in the Body?
Typically, all women with ovarian hormonal activity present have ovarian follicles in the ovaries` structure (small ovarian cysts) with sizes of up to 20 – 30 mm, inside of which there are oocytes, female sex cells that are born, develop and mature, cells that are then released by breaking the follicles at ovulation. When it comes to PCOS, the follicle doesn`t break, and the egg cannot be released, being accumulated in the ovary.
When the woman suffers of this syndrome, the pituitary gland releases abnormal amounts of luteinizing hormones in the blood stream, perturbing the menstrual cycle. Due to this particular reason, ovarian follicles don`t mature and ovulation doesn`t occur leading to infertility. Some of immature follicles don`t dissolve, but remain in the form of cysts filled with fluid.
In addition, there`s an amount of insulin released in the blood (hormone secreted by the pancreas), which combined with a high level of luteinizing hormones, determine the excessive production of testosterone in the ovaries, which prevents ovulation.
The exact reasons for the development of this disorder are unknown. It`s assumed that a specific role in its development is the genetic predisposition, but the abnormal genes which would cause the development of the disease weren`t found.
According to recent research, another cause of this syndrome may be the functional disorder of the involved enzymes in the synthesis of male sex hormones in the female bodies.
A small number of male sexual hormones (androgens) is produced in the organism of healthy women and this is considered a normal phenomenon. Male hormones are produced in a too large amount in women who suffer from this disorder, which disrupts the function of the ovaries and causes such symptoms like excessive body hair growth, oily skin and acne or hair loss.
In addition, there are also other hormonal disorders in women who suffer of this medical condition when the increase of androgens is involved:
- The body`s tissues become insensitive on insulin, which leads to a disruption of glucose`s metabolism.
- Reduced production of adiponectin – the hormone which regulates the metabolism of fats and glucose.
Acting together, hormonal changes listed above lead to overweight, severe disorder of ovarian function and inability of conceiving a child.
Can Polycystic Ovaries Cause Anxiety?
As mentioned above, this syndrome represents a hormonal imbalance which leads to infertility, excessive facial hair, obesity, and can also cause serious mental health problems that include depression, eating disorders and anxiety.
According to an article posted on Nursing.Columbia.edu, there was a study supervised by Nancy Reame, a professor from Columbia University School of Nursing along with FAAN, MSN and PhD, which evaluated psychological signs in 126 women who were diagnosed with this syndrome. All women filled surveys using a regular tool for evaluating mental health (BSI), and their answers were compared with the responses of women undergoing outpatient psychiatric care or in general population. Professor Reame said the study found that obesity was associated with hostility and menstrual issues and body hair strongly predicted anxiety.
The hormonal disorders described above which appear in women who suffer of this illness, can lead to various complications.
Type 2 Diabetes
As most recent clinical studies show, the risk of developing Type 2 diabetes in women with this syndrome is a few times higher than in healthy women.
For this reason, all women with this syndrome should periodically perform a test to determine blood sugar level.
If you know you are suffering of PCOS, ask your doctor to prescribe you a blood analysis.
Atherosclerosis, Heart Attack, Stroke
In women with PCOS, due to the increased levels of androgens and the low level of adiponectin (which have an antiatherogenic effect), it increases the risk of heart attack, stroke or atherosclerosis. Due to this reason, it`s important as women who confront with this program to perform all necessary actions to reduce the risk of cardiovascular complications.
Endometrial Hyperplasia & Uterine Cancer
Prolonged ovarian function disorder in women with polycystic ovarian syndrome can alter endometrial cell growth, which in turn can cause the development of endometrial hyperplasia and uterine cancer.
The very first symptoms of polycystic ovary syndrome usually occur during puberty, around 14 – 16 years, after menstruation.
Instead of becoming more regular (as in healthy women), the menstrual cycle becomes more unpredictable in women with this disorder, and menstruation start at long intervals of time and often is missing for several months or disappears entirely.
In addition, some minor bleeding or bloody vaginal discharges may occur during irregular menstrual periods, but they aren`t associated with menstruation.
The first symptoms of this medical condition are often missed because most girls and parents consider them normal and they rarely talk to their doctor about them.
Other symptoms of PCOS associated with the increased level of male sexual hormones are:
- Excessive body and facial hair growth (chin, mustache, between breasts, around the nipples or below the navel).
- Pimples (acne).
- Oily skin and greasy hair.
Deregulation of the metabolism of fats and glucose in girls with PCOS often leads to obesity.
It`s important to mention that obesity is one of the factors which contribute at the development of this disease. It was determine in women who suffer of this disorder, adipose tissue can convert female sexual hormones in male sexual hormones, which consolidates the hormonal imbalance.
As the girl grows, the symptoms outlined above remain unchanged or even amplify.
Most often, young women with this medical condition talk to a doctor due to the difficulties in conceiving a child.
The symptoms outlined above may be signs for other diseases, including some very dangerous diseases.
If you notice one or more such symptoms, you should contact your gynecologist right away.
The main risk factor of this syndrome is the family history. Sisters and daughters of women with this particular condition have 50% chances of developing the disease.
A family history may increase the risk of this illness because there`s a close relationship between diabetes and this syndrome. Still, research continues regarding this risk factor.
Long-term use of antiepileptic therapy known as valproate might increase the risk of developing the syndrome.
The diagnosis is based on clinical and imaging examinations:
- Pelvic ultrasound – it plays an essential role.
- Transvaginal probe is generally preferred, because it allows a good visualization of changes in regards of ovarian morphology.
Chances of Becoming Pregnant After PCOS
Without proper treatment, this syndrome reduces significantly the woman`s ability to conceive a child, which most of the time leads to infertility. However, most of the times women who experience this disorder manage to have a normal pregnancy and eventually give birth.
According to clinical observations, a weight loss of 5% – 10% and regular physical activity helps in restore the menstrual cycle and eliminates the infertility at around 30% of women with this disorder.
If diet and physical exercises don`t help, your doctor may prescribe you special medication which stimulates the ovarian function (e.g. clomiphene citrate, gonadotropin for injection). This treatment helps in eliminating infertility at around 50% of women who suffer from this particular syndrome.
In some cases, the doctor prescribes a surgical intervention to overcome infertility, such as additional methods of conceiving a baby (e.g. in vitro fertilization).
During the treatment of polycystic ovary syndrome with preparations that block the action of androgens (spironolactone, finasteride), because the mentioned medication can cause serious deregulations in the development of the fetus.
Is Polycystic Ovary Syndrome Curable?
There`s no cure for now, however, there`re lots of methods you can use to decrease or even eliminate the symptoms of this syndrome. The doctor might provide various drugs which can treat your signs (irregular periods, excess hair, increased blood sugar, acne). Treatments involving fertility are also available to aid women become pregnant. Losing even 5% of extra weight can aid women ovulate in a more regular manner and ease other signs of this illness. The ideal method of doing all this is through exercise and diet.
You might feel that it`s rather hard to lose additional weight and also manage to keep it off, but it`s essential to continue the effort. These efforts may aid decrease the risk of developing severe complications involving your health. The biggest concerned are heart disease, stroke and diabetes.
Numerous observations have shown that around 1 – 3 months of diet and moderate physical exercises contribute in around 30% of cases in significantly reducing the level of androgens in blood, stop the excessive body and facial hair growth and normalizes the menstrual cycle.
Even if the diet changes and physical exercises can be performed at home, talk about all this with your doctor first.
You should in no way try to “accelerate” the treatment by changing something in your diet or sessions of physical exercises, because the effect can be the opposite of the one intended.
How to Organize a Proper Diet?
In order to organize a proper diet, you should:
- Add as many fibers as you can.
- Limit the consumption of sweets, white bread, pasta or sugar.
- Limit the consumption of animal fats (butter, fat meat, milk)
- Instead of animal fats, try to consume vegetal and fish oils.
This diet doesn`t only help in removing this disorder, but also reduce the risk complications quite a lot.
To correct the hormonal disorders which appear with this disease, the doctor can prescribe you some special medication:
Oral contraceptives (birth control pills) – they are used in the treatment of PCOS in women who doesn`t plan to have a child in the near future.
Generally, the medications for this disorder use monophasic oral contraceptives combined with small doses of estrogen: norgestimate, norethindrone, desogestrel, drospirenone or oral contraceptives with antiandrogenic activity.
When used to combat this disorder, oral contraceptives slow facial and body hair growth quite significantly, helps in eliminating acne and regulates the menstrual cycle.
According to some studies, birth control pills also reduce the risk of developing hyperplasia and uterine cancer.
Metformin – – this drug increases the sensibility of tissues to insulin and improves the ovarian function. Metformin shouldn`t be used to treat women with chronic liver diseases, kidney diseases or heart diseases. Often, treatment with this medication can cause nausea, vomiting and diarrhea. In case of such side effects, you should contact your doctor immediately to change the way of administrating this drug.
Spironolactone – is a diuretic which can block the action of androgens and can reduce body and facial hair growth.
Spironolactone may cause the development of congenital defects to the fetus. Due to this reasons, doctors usually prescribe this drug along with birth control pills which allow the exclusion of any possibility of pregnancy during treatment.
The dose and duration of treatment of the drugs specified above are defined by the doctor. Any administration of these drugs on your own intention is forbidden.
At present, there are several types of surgical interventions that are used when it comes to PCOS.
Cuneiform ovarian resection (surgical removal of a part of the ovary) is for now rarely used due to the increased risk of postoperative adhesions.
Electric coagulation or by laser of the ovarian membrane allows the removal of the dense film which is formed on the ovarian surface in women with this syndrome, which in turn makes it possible to improve the functionality of the ovaries and ovulation.
Electric coagulation or by laser is a lot more effective than cuneiform ovarian resection.
Often, surgical intervention in the case of polycystic ovary syndrome is performed by laparoscopy. Such an intervention allows a faster recovery after surgery and reduces the risk of complications.