ALL ABOUT PCOS

What is PCOS?

Polycystic Ovary (Ovarian) Syndrome (PCOS) is a hormonal disorder. It affects 12-18% of women of reproductive age and up to 21% in some high-risk groups, such as Indigenous women[1].

PCOS can be a complex condition to identify because there are several symptoms and you don't have to have all of them to be diagnosed with PCOS. Very few women have the same set of symptoms. The name 'polycystic' suggests you might have multiple 'cysts' on your ovaries, but not all women who have PCOS have multiple 'cysts' and not all women who have multiple 'cysts' have PCOS. The term 'cysts' is a bit misleading. The cysts are actually not cysts but partially formed follicles that each contain an egg.

How PCOS occur ?

PCOS is caused by an imbalance in the hormones (chemical messengers) in your brain and your ovaries. PCOS usually happens when a hormone called LH (from the pituitary gland) or levels of insulin (from the pancreas) are too high, which then causes the ovaries to make extra amounts of testosterone.

Many of the symptoms of PCOS are caused by high levels of androgens circulating in your body, causing 'hyperandrogenism'. Androgens are also called 'male' hormones, and the main one is testosterone. All women produce small amounts of androgens in body tissues including the ovaries and the adrenal glands. High levels of androgens can prevent ovulation and affect the menstrual cycle.

The hormone insulin is also thought to be an important part of the development of PCOS. Insulin is needed in the body for control of blood sugar, and 'insulin resistance' is thought to be a key part of the development of PCOS. Insulin resistance means that some parts of the body are 'resistant' to insulin, meaning that more insulin than usual is needed to keep blood sugar in the normal range. This means that insulin levels are often high or the body doesn't respond normally to insulin. This in turn can affect the function of the ovaries, including hormone and egg production.

Symptoms of PCOS may include:

v Excess facial and/or body hair (hirsutism)

v Acne on the face and/or body

v Scalp hair loss (alopecia)

v Darkened skin patches (acanthosis nigricans)

v Mood changes

v Depression

v Anxiety

v Sleep apnoea

v  Irregular periods or no periods at all.

v  Difficulty getting pregnant (because of irregular ovulation or failure to ovulate)

v  Thinning hair and hair loss from the head.

v High stress levels

v Infertility

v High cholesterol and triglycerides

v Dark patches of skin

v Male pattern balding

v Type 2 diabetes

v Pelvic pain

v Polycystic ovaries. Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.

PCOS symptoms present in many different ways. Some women will have only some, or mild symptoms, whereas others will have severe symptoms. 

Periods During PCOS

Although some women with PCOS have regular periods, high levels of androgens and also the hormone insulin can disrupt the monthly cycle of ovulation (when eggs are released) and menstruation.

If you have PCOS, your periods may be 'irregular' or stop altogether. In some girls PCOS is a cause of periods failing to commence. The average menstrual cycle is 28 days with one ovulation, but anywhere between 21 and 40 days is considered 'normal'. An 'irregular' period cycle is defined as either:

Eight or less menstrual cycles per year Menstrual cycles longer than 40 days.

Risk factors

PCOS is thought to have a genetic component. People who have a mother or sister with PCOS are more likely to develop PCOS than someone whose relatives do not have the condition. This family link is the main risk factor.

Some other risk factors are as follow:

v Obesity

v Smoking

v Hypertension

v Dyslipidemia

v C-reactive protein

v Homocysteine

v Family  h/o CVD

v Metabolic Syndrome

v T2DM

v Overt renal disease

v Overt vascular  disease

How is PCOS Diagnosed? 

·         A pelvic exam. The doctor visually and manually inspects your reproductive organs for masses, growths or other abnormalities.

·         Blood tests. Your blood may be analyzed to measure hormone levels. This testing can exclude possible causes of menstrual abnormalities or androgen excess that mimics PCOS. You might have additional blood testing to measure glucose tolerance and fasting cholesterol and triglyceride levels.

·         An ultrasound. Your doctor checks the appearance of your ovaries and the thickness of the lining of your uterus. A wandlike device (transducer) is placed in your vagina (transvaginal ultrasound). The transducer emits sound waves that are translated into images on a computer screen.

Treatment

PCOS treatment focuses on managing your individual concerns, such as infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication.

Lifestyle changes

Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight — for example, losing 5 percent of your body weight — might improve your condition. Losing weight may also increase the effectiveness of medications your doctor recommends for PCOS, and can help with infertility.

Medications

To regulate your menstrual cycle, your doctor might recommend:

·         Combination birth control pills

·         Progestin therapy

Lifestyle and dietary changes you can Adapt

Be Activate 

 Improvements in insulin and hormonal responses through exercise can significantly improve reproductive function in women with PCOS

Aim to find an aerobic or resistance based activity that fits within the confines of your daily routine, preferably in a supportive, like minded environment

Find a friend, or join a women’s based exercise group to enhance the psychological benefits of exercise

Long term lifestyle and exercise maintenance will help improve the symptoms of PCOS as well as reduce the risk for developing diabetes.

Maintain your Ideal Body weight

 Modest weight loss will not cure PCOS, but it will help. Weight loss can restore the normal function of the ovaries and result in normal hormone production. This may in turn lead to improvements in symptoms of PCOS, such as excess facial and body hair growth, acne or scalp hair loss.

A large number of research studies have shown it only takes a modest amount of weight loss of 5-10 kg or 5-10% of initial body weight to:

·         reduce insulin resistance by about 50%

·         restore ovulation

·         regulate menstrual cycles

·         reduce pregnancy complications

·         improve fertility

·         improve health during pregnancy

·         improve the health of a child during pregnancy

·         improve emotional health (self-esteem, anxiety, depression)

·         reduce risk factors for diabetes and heart disease

Avoid processed food

In general, people on a PCOS diet should avoid processed and following foods widely seen as unhealthy. These include

·        Refined carbohydrates, such as mass-produced pastries and white bread.

·        Fried foods, such as fast food.

·        Sugary beverages, such as sodas and energy drinks.

·        Processed meats, such as hot dogs, sausages, and luncheon meats.

·        Solid fats, including margarine, shortening, and lard.

·        Excess red meat, such as steaks, hamburgers, and pork.

Try to Take a Healthy Balanced Diet

PCOS patients should take a healthy balanced diet including all nutrients in required amount.

Their diet should include following foods for sure to relieve PCOS symptoms :

·         Dark leafy greens, including kale and spinach

·         Blueberries, blackberries, and cherries

·         Dark red grapes

·         Nutrition-dense vegetables, such as broccoli and cauliflower

·         Beans and lentils

·         Green tea

·         Red wine, in moderation

·         Avocado and coconut

·         Olives

·         Extra virgin olive oil

·         Walnuts, pistachios, pine nuts, and almonds

·         Cold water fish, including salmon and sardines

·         Turmeric and cinnamon

·         Dark chocolate

·         Spices and herbs

I hope above blog on PCOS helps you in some or the other way. 
If you want to ask any other queries related to PCOS or anything else you can write in a comment section, I will get back to you with an answer. 
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