Polycystic ovary syndrome (PCOS) is a condition that causes irregular menstrual periods because monthly ovulation is not occurring and levels of androgens (male hormones) in women are elevated.
20-30yrs back the PCOS was a rare disease, currently it is affecting 15-20 % of the 18-30 years females. This rapid increase in the disease has led to many problems like infertility and diabetes.
PCOS CAUSES
Obesity: Abnormal weight gain is one of the major causes of PCOS. Due to rapid economic transition, life style has been changed in the form of lack of exercises and increased in amount of food consumption.
Genetic: some patients may have family history of PCOS
PCOS SYMPTOMS
The classic symptoms of PCOS, including absent or irregular and infrequent menstrual periods, increased body hair growth or scalp hair loss, acne, and difficulty becoming pregnant
Signs and symptoms of PCOS usually begin around the time of puberty, although some women do not develop symptoms until late adolescence or even into early adulthood. Because hormonal changes vary from one woman to another, patients with PCOS may have mild to severe acne, facial hair growth, or scalp hair loss.
Menstrual irregularity — if ovulation does not occur, the lining of the uterus (called the endometrium) does not uniformly shed and regrow as in a normal menstrual cycle. Instead, the endometrium becomes thicker and may shed irregularly, which can result in heavy and/or prolonged bleeding. Irregular or absent menstrual periods can increase a woman’s risk of endometrial overgrowth (called endometrial hyperplasia) or even endometrial cancer.
Women with PCOS usually have fewer than six to eight menstrual periods per year. Some women have normal cycles during puberty, which may become irregular if the woman becomes overweight.
Weight gain and obesity — PCOS is associated with gradual weight gain and obesity in approximately two third of women. For some women with PCOS, obesity develops at the time of puberty.
Hair growth and acne — Male-pattern hair growth (hirsutism) may be seen on the upper lip, chin, neck, sideburn area, chest, upper or lower abdomen, upper arm, and inner thigh. Acne is a skin condition that causes oily skin and blockages in hair follicles
Infertility — many women with PCOS do not ovulate regularly, and it may take these women longer to become pregnant. An infertility evaluation is often recommended after 6 to 12 months of trying to become pregnant.
Other problems — Women with PCOS are at increased risk of other problems that can impact quality of life. These include:
●Depression and anxiety – There are treatments that can help with these problems, including therapy as well as medications.
●Sexual dysfunction – Women with PCOS are more likely than other women to experience lower sexual satisfaction.
●Eating disorders – These include bulimia and binge eating. Women with PCOS do not appear to be at increased risk of developing anorexia.
If you think you might be experiencing any of these problems, talk with your health care provider. There are often treatments that can help.
PCOS DIAGNOSIS
You may be diagnosed with PCOS based upon your symptoms, blood tests, and a physical examination. Expert groups have determined that a woman must have two out of three of the following to be diagnosed with PCOS:
●Irregular menstrual periods caused by anovulation or irregular ovulation.
●Evidence of elevated androgen levels. The evidence can be based upon signs (excess hair growth, acne, or male-pattern balding) or blood tests (high androgen levels).
●Polycystic ovaries on pelvic ultrasound.
Blood tests for pregnancy, prolactin level, thyroid-stimulating hormone (TSH), and follicle-stimulating hormone (FSH) may be recommended. Insulin levels are not used to diagnose PCOS, partly because insulin levels are high in people who are above normal body weight and because there is no level of insulin that is “diagnostic” for PCOS.
Treatment of PCOS
Life style changes and weight reduction is the main line of treatment. We use some of the drugs used in diabetes to reduce the insulin levels and weight. There is no harm in the use of these drugs to treat PCOS. Along with these medications we use some hormonal pills to reduce hirsutism and male hormone.
Infertility and PCOS
PCOS accounts for main cause of infertility in current scenario. Treatment of PCOS improves the infertility and completion of pregnancy without any complications. It has been also shown that the success of in-vitro fertilization (test tube baby), So it is better to take treatment of PCOS before any infertility treatment.
Dr Manjunath Goroshi Asst Professor Dept of Endocrinology, JNMC and KLES Hospital, Belgaum
