Polycystic Ovary Syndrome: Causes, Diagnosis, and Treatment

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Polycystic ovary syndrome (PCOS): Causes and Treatment

Polycystic ovary syndrome (PCOS) is a medical condition that affects the hormonal balance in the body. It can cause irregular menstrual cycles, excessive hair growth, acne, and fertility issues. Managing PCOS depends on the individual’s reproductive aspirations, and those affected by it have an increased risk of developing diabetes and hypertension.

PCOS is caused by hormonal disturbances that usually arise during a woman’s reproductive years. It can cause irregular menstrual cycles, an excess of male hormones, and the formation of cysts on the ovaries. These cysts can cause fertility issues as the underdeveloped eggs within them often fail to undergo regular ovulation.

Risk of Diabetes and Hypertension

PCOS can also elevate an individual’s risk of developing diabetes and hypertension, among other health issues. However, remedies for associated symptoms are available, and it is possible to achieve conception with pharmaceutical interventions to enhance fertility.

Approximately 10% of the global female population is affected by PCOD, a close cousin to PCOS. These conditions can cause a range of health complications, such as diabetes, infertility, acne, and excessive hair growth. However, the remedy for these disorders lies in diet and lifestyle choices, making it a solvable riddle with practical solutions.

What is polycystic ovarian syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is a hormonal imbalance that occurs when your ovaries (the organ that produces and releases eggs) produce redundant hormones. However, your ovaries produce surprisingly high levels of hormones called androgens, if you have PCOS.

This causes your reproductive hormones to become imbalanced. As a result, people with PCOS have frequent irregular menstrual cycles, missed ages, and changeable ovulation. Small follicle excrescences (fluid-filled sacs with immature eggs) may be visible on your ovaries on ultrasound due to a lack of ovulation. Still, despite the name” polycystic,” you don’t need to have excrescences on your ovaries to have PCOS.

The ovarian excrescences aren’t dangerous or painful. PCOS is one of the most common causes of gender inequality in women and people assigned female at birth (AFAB). It can also increase your risk of developing other health conditions. Your healthcare provider can treat PCOS based on your symptoms and if you wish to become pregnant.

PCOS (Polycystic Ovary Syndrome) and Diabetes

Polycystic Ovary Syndrome (PCOS) stands as a prevalent contributor to female infertility, affecting approximately 6% to 12% of women in the United States who are of reproductive age, totalling up to around 5 million individuals. However, PCOS extends beyond mere fertility concerns, becoming a lifelong health challenge that persists long after childbearing years.

Women grappling with PCOS often exhibit insulin resistance, a condition wherein their bodies produce insulin but struggle to utilize it effectively. This condition elevates the risk of developing type 2 diabetes. Moreover, they tend to have heightened levels of androgens, typically male hormones but also present in females. Elevated androgen levels can hinder the release of eggs (ovulation) and lead to irregular menstrual cycles, acne, thinning scalp hair, and the unwanted growth of excess facial and body hair.

Health Complications Caused by Polycystic Ovary Syndrome (PCOS)

Notably, women with PCOS can encounter serious health complications, particularly if they are overweight.

  • Diabetes: More than half of women with PCOS develop type 2 diabetes before reaching the age of 40.
  • Gestational Diabetes: This condition, which occurs during pregnancy, not only places the pregnancy and the baby at risk but can also result in type 2 diabetes later in life for both the mother and child.
  • Heart Disease: PCOS amplifies the risk of heart disease, with this risk escalating with age.
  • High Blood Pressure: Elevated blood pressure can inflict harm on the heart, brain, and kidneys.
  • Cholesterol Imbalances: PCOS contributes to high LDL (“bad”) cholesterol levels and low HDL (“good”) cholesterol levels, elevating the risk of heart disease.
  • Sleep Apnea: This disorder disrupts breathing during sleep and heightens the risk of heart disease and type 2 diabetes.
  • Stroke: The buildup of plaque (comprising cholesterol and white blood cells) in blood vessels can result in blood clots, potentially leading to a stroke.

Polycystic ovary syndrome (PCOS) Vs. Depression and Anxiety

Furthermore, PCOS has been associated with depression and anxiety, although the precise nature of this connection remains incompletely understood.

The exact causes of PCOS remain elusive, but elevated androgen levels are believed to play a pivotal role. Factors such as excess weight and family history, which are intertwined with insulin resistance, can also contribute to its development.

The relationship between weight and PCOS is intricate and not yet fully comprehended. While being overweight is linked to PCOS, many women of average weight also grapple with this condition, and conversely, not all overweight women develop PCOS.

Family history can be a significant factor. Women with a family history of PCOS or type 2 diabetes, especially if their mother or sister has experienced these conditions, are more susceptible to developing PCOS.

Additionally, insulin resistance is influenced by lifestyle choices, mainly if a woman is overweight due to an unhealthy diet and lack of physical activity. It’s worth noting that insulin resistance can run in families. Losing weight often proves beneficial in alleviating symptoms, irrespective of the underlying cause of insulin resistance.

PCOD vs. PCOS: Causes and Treatment

Polycystic Ovarian Disease (PCOD) is a condition that affects women, where the ovaries produce immature eggs that eventually develop into cysts, on the ovaries.

Polycystic Ovary Disorder (PCOD) is a condition that impacts the organs of females. These organs regulate cycles and the production of hormones such as estrogen, progesterone, inhibin, and relaxation. The presence of several eggs causes the ovary to swell and release levels of male hormones, leading to infertility.

PCOD affects 5–10% of women in their childbearing years (between 12 and 45 years old). Its prevalence varies across regions; it affects around 22% of women in China and Sri Lanka.

This hormonal imbalance in PCOD results in symptoms including menstruation, absence of ovulation, difficulty conceiving, weight gain, acne, and hirsutism. If left untreated, PCOD (also known as polycystic ovarian syndrome or PCOS) can give rise to health complications such as diabetes, obesity, heart disease, and high cholesterol.

What does PCOD stand for?

PCOD, known as polycystic ovary syndrome, is a hormonal disorder that typically affects women during their reproductive years. This condition’s main feature is the over-secretion of androgens, which are male hormones, by the ovaries. As a result, various symptoms arise, such as irregular periods, excessive hair growth, zits, and weight gain.

Common Signs and Symptoms of PCOD or PCOS

Typically, the indications and symptoms of PCOD tend to emerge during the menstrual cycle, in puberty. However, it is also possible for PCOD to develop as a result of weight gain over time. The manifestations of PCOD differ from woman to woman; however, some common indicators include:

  • Irregular menstrual cycles
  • Excessive facial, chest and back hair growth
  • Acne
  • Uncontrolled weight increase
  • Infertility issues
  • Skin darkening on neck, underarms and groin regions
  • Volatile mood swings
  • Extreme fatigue

Are there any known reasons behind PCOD?

While the exact cause of PCOD remains uncertain, experts believe it occurs due to a mix of genetic predisposition and environmental influences. Such factors could encompass:

  • Family history presence
  • Insulin resistance problems
  • Being overweight or obese
  • High-stress levels encountered regularly
  • Certain medications being taken for other health concerns

How does one diagnose an individual with PCOD?

Medical professionals typically diagnose patients with PCOD after evaluating their symptoms during a physical examination. In addition to these, doctors may also ask for blood samples to measure hormone levels or even request ultrasound scans to identify if cysts have formed on the ovaries.

What treatment methods exist for PCOD?

Unfortunately, there’s no known cure for this condition; nevertheless, there are several treatments that can significantly reduce its symptoms, thereby enhancing the quality of life. These treatment options vary from patient to patient but generally include:

  • Medications meant to stabilize hormone production
  • Weight management programs designed especially for such individuals
  • Regular exercise routines

Polycystic Ovary Syndrome: Overview

Polycystic Ovary Syndrome (PCOS), also called Stein-Leventhal Syndrome, is a disorder characterized by irregular, abnormal, or absent menstruation; excessive amounts of body hair; excessive body weight, and decreased fertility.

The syndrome is caused by elevated levels of testosterone and other hormones, which disrupt the normal menstrual cycle. Immature cysts remain on the ovaries, giving them a characteristic “string of pearls” appearance. A faulty response to insulin is also suspected but this does not explain all cases of the syndrome.

It’s estimated that this condition affects 6% to 10% of premenopausal women of all races and ethnicities, beginning between puberty and the early 20s.

Common Symptoms for Polycystic Ovary Disorder (PCOD)

  • Irregular Menstruation. The most common symptom of PCOS is irregular menstruation, which can take several forms:
  • Oligomenorrhea: 8 or fewer periods per year.
  • Polymenorrhea: too many periods with excessive bleeding and periods that may stop and start.
  • Amenorrhea: no menstrual cycles at all.

Infertility.

The three types of menstrual disorders have the same underlying cause: the ovaries don’t release an egg each month. Women with PCOS do not ovulate regularly, and while fertility experts do assist many women with PCOS in becoming pregnant, PCOS may account for as many as half of all cases of infertility.

  • Hirsutism. Excessive or coarse, thick hair on the face, arms, legs, abdomen, and pubic area are also symptoms of PCOS. Changes in hair are stimulated by the free androgens in the system, which are present because of the hormonal imbalance.
  • Thinning hair. Male-pattern hair loss is also related to the excess androgens associated with PCOS.
  • Skin abnormalities. The skin abnormalities associated with PCOS can take several forms, including skin flaps or small tags of skin in the armpits or neck area and acanthosis nigricans, which darkens and thickens the skin, usually on the neck or in the underarms or groin. This condition results from excess insulin in the bloodstream.
  • Weight gain. Many women with PCOS experience weight gain, have a high hip-to-waist ratio (“apple” rather than “pear” shape) and have more than normal difficulty losing weight.

PCOS also has a complex relationship with depression and anxiety. Depression is not considered a symptom of PCOS per se, but the range of physical, cosmetic and physiological symptoms experienced by PCOS sufferers present a suite of underlying causes. In some women, correction of insulin-related problems through diet, exercise, and medication helps to alleviate depression and anxiety.

Diagnosis for Polycystic Ovary Disorder (PCOD)

A diagnosis of PCOS is made based on the range of symptoms and the patient’s menstrual, reproductive, and medical history (including any diabetes or insulin-related symptoms), blood tests to determine hormone levels, a physical examination, and a diagnostic ultrasound.

Blood tests indicate PCOS when the ratio of luteinizing hormone (LH) to Follicular Stimulating Hormone (FSH) is equal to or greater than a 3:1 ratio and there are elevated levels of androgens, including free and total testosterone. Glucose and insulin tests can be used to screen for insulin resistance and type II diabetes.

Many women with PCOS have insulin-related problems, and some research indicates that this may be the root of the problem. The blood is also tested for lipids to find the levels of cholesterol and triglycerides. High levels of LDL (“bad cholesterol”) are common with PCOS, and this suggests that women with PCOS are at higher risk for heart disease.

Ovarian cysts are no longer the basis for a definitive diagnosis of PCOS (it is possible to have polycystic-appearing ovaries without actually having PCOS); many physicians rely on ultrasound imaging to confirm their diagnosis.

Treatment Options for Polycystic Ovary Syndrome (PCOS)

PCOS can be treated by a family physician or gynaecologist, but the patient may also be referred to a doctor who specializes in hormonal disorders, such as an endocrinologist, reproductive endocrinologist, or fertility specialist.

Many standard therapies for PCOS treat specific symptoms but might not address the underlying causes. Oral contraceptives have traditionally been used to regulate menstrual cycles. Anti-androgenic agents such as spironolactone block the effects of androgens (male hormones, including testosterone) and can reduce unwanted hair growth and acne. Assisted reproduction techniques, like oral and injectable medications that stimulate ovulation and in vitro fertilization, enable women with PCOS to become pregnant.

New treatments aim at the insulin resistance that might be a root cause of PCOS. Many new therapies are designed to lower insulin levels and thus reduce testosterone production.

Drug Therapy

New evidence suggests that using medications that lower insulin levels in the blood may be effective in restoring menstruation and reducing some of the health risks associated with PCOS. Lowering insulin levels also helps to reduce the production of testosterone, diminishing many of the symptoms associated with excess testosterone: body hair growth, hair loss, acne, obesity, and cardiovascular risk.

Metformin (sold as Glucophage) is a diabetes drug that improves both glucose tolerance and insulin sensitivity. About one-third of patients on Glucophage experience gastrointestinal symptoms (diarrhea, nausea, vomiting, abdominal bloating, flatulence, and loss of appetite), but these are usually temporary and disappear after 1 to 4 weeks.

Pioglitazone (ACTOS) was developed for use in type II diabetes and works primarily by improving insulin sensitivity and glucose tolerance. There were few notable side effects in clinical trials. Another added benefit seen with Pioglitazone is the reduction of triglyceride levels.

Rosiglitazone (Avandia) also works by improving insulin sensitivity. A low incidence of side effects was noted in clinical trials.

There are several excellent online resources for people who want to learn more about PCOS. The Polycystic Ovarian Syndrome Association website has information for patients (some of which we have barely summarized here), as well as extensive listings of ongoing clinical trials, research studies, and support groups all over the US.

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