Polycystic Ovary Syndrome and it’s impact on health

WRITTEN BY: RASHA AMEERA MISKIN CLASS OF 2028

PCOS is the enigmatic labyrinth in the garden of womanhood, but through its twists and turns, I discover the strength to bloom beautifully.

INTRODUCTION

PCOS, which is one of the most common endocrine disorders, characterized by irregular menstrual cycles, hyperandrogenism, and polycystic ovaries. It is one of the most common causes of ovulatory infertility in women of reproductive age. The worldwide prevalence of PCOS ranges from 4 to 21%, while in adolescents this number ranges between 9.1 and 36% (depending upon the diagnostic criteria used). Treatment for PCOS is often done with medication. This cannot cure PCOS, but it helps reduce symptoms and prevent some health problems.

WHAT IS PCOS?

Polycystic ovarian syndrome (PCOS) is a hormonal imbalance that occurs when your ovaries create excess hormones. Women with PCOS have a hormonal imbalance and metabolism problems that may affect their overall health. If you have PCOS, your ovaries produce unusually high levels of male sex hormones called androgens. This results in the reproductive hormones to become imbalanced. As a result, people with PCOS often have irregular menstrual cycles, missed periods and unpredictable ovulation.

The name polycystic ovary syndrome describes the multiple small cysts which may be visible on your ovaries on ultrasound due to lack of ovulation (anovulation). However, despite the name "polycystic," you don’t need to have cysts on your ovaries to have PCOS. The ovarian cysts aren’t dangerous or painful.

SIGNS OF PCOS

The most common signs and symptoms of PCOS include:

• Irregular menstrual cycles: Unusual menstruation involves missing menstrual periods or not having a menstrual period at all. It may also include heavy bleeding during the periods.

• Abnormal hair growth: You may grow excess facial hair or experience heavy hair growth on your arms, chest and abdomen (hirsutism). This affects up to 70% of people with PCOS

• Acne: PCOS can cause acne, especially on your back, chest and face. This acne may continue past your teenage years and may be difficult to treat.

• Obesity: Between 40% and 80% of people with PCOS have obesity and have trouble maintaining a weight that’s healthy for them.

• Darkening of the skin: You may get patches of dark skin, especially in the folds of your neck and armpits.

• Cysts: Many people with PCOS have ovaries that appear larger or with many follicles (egg sac cysts) on ultrasound.

• Skin tags: Skin tags are little flaps of extra skin. They’re often found in your armpits or on your neck.

• Thinning hair: People with PCOS may have hair loss from the scalp.

• Infertility: PCOS is the most common cause of infertility in people. The inability to ovulate frequently can result in not being able to conceive.

WHAT CAUSES PCOS?

The exact reason of PCOS is unknown, but it often runs in families. It is related to abnormal hormone levels in the body, including high levels of insulin. Many women with PCOS are resistant to the action of insulin in their body and, as a result produce higher levels of insulin to overcome this. This adds to the increased production and activity of hormones like testosterone. Women with PCOS are likely to develop serious health problems, especially if they are overweight:

• Diabetes—more than half of women with PCOS develop type 2 diabetes by age 40.

• Gestational diabetes (diabetes when pregnant)—which puts the pregnancy and baby at risk and can lead to type 2 diabetes later in life for both mother and child.

• Heart disease—women with PCOS are at higher risk, and risk increases with age.

• High blood pressure—which can damage the heart, brain, and kidneys.

• Stroke—plaque (cholesterol and white blood cells) clogging blood vessels can lead to blood clots that in turn can cause a stroke.

• PCOS is also linked to depression and anxiety, although the connection is not fully understood. It’s common for women to find out they have PCOS when they have trouble in conceiving, but it often begins soon after the first menstrual period, as young as age of 11 or 12. It can also develop in the 20s or 30s.

HOW IS PCOS DIAGNOSED?

Ultrasound :

• This test is used to look at the size of the ovaries and see if they have cysts. The test can also look at the thickness of the lining of the uterus (endometrium).

• Blood tests look for high levels of androgens and other hormones

TREATMENT FOR PCOS

The treatment in PCOS mainly involves lifestyle changes and medications such as Metformin, Oral contraceptives and Antiandrogens. However, the management of PCOS is challenging.

Making healthy changes such as losing weight if you’re overweight and increasing physical activity can lower your risk for type 2 diabetes, help you better manage diabetes, and prevent or delay other health problems. There are also medicines that can help you ovulate, as well as reduce acne and hair growth. Patients should make sure to talk with their doctor about all their treatment options.