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Polycystic ovary syndrome (PCOS) is a hormonal disorder in women that you don’t hear about often, despite 12.6% of the women population in Malaysia suffering from it.
The 3 main features of PCOS are:
This means your ovaries do not regularly release eggs (ovulation). 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.
If you have PCOS, you have high levels of "male" hormones in your body, which may cause physical signs such as excess facial or body hair. This is known as hirsutism. You are also likely to get moderate to severe acne that does not seem to respond to acne and antibiotic creams.
In PCOS, your ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not actually have cysts if you have PCOS).The follicles are underdeveloped sacs in which eggs develop. In PCOS, these sacs are often unable to release an egg, which means ovulation does not take place.
If you have at least 2 of these features, you may be diagnosed with PCOS.
Other symptoms that are also seen in PCOS include:
Weight gain/obesity — Approximately 30 to 75 percent of women with PCOS are obese.
Infertility— As we mentioned above, since many women with PCOS do not ovulate regularly, it may take these women longer to become pregnant. Fortunately, treatments are available for women with PCOS who would like to get pregnant. An infertility evaluation is often recommended after 6 to 12 months of trying to become pregnant.
Sleep apnea — Sleep apnea is a condition that causes brief spells where breathing stops (apnea) during sleep. Patients with this problem often experience fatigue and daytime sleepiness. In addition, there is evidence that people with untreated sleep apnea have an increased risk of insulin resistance, obesity, diabetes, and cardiovascular problems, such as high blood pressure, heart attack, abnormal heart rhythms, or stroke. We wrote an article on sleep apnea before.
Insulin resistance — Insulin resistance is when cells in your muscles, fat, and liver don’t respond well to insulin and can’t easily take up glucose from your blood. Study found that adolescents with PCOS tend to experience insulin resistance. As a result, women with PCOS are at a higher risk for diabetes; approximately 10 percent of women with PCOS will have type 2 diabetes mellitus by 40 years of age (4,5,6).
Increased risk of heart diseases, which is due to obesity, insulin resistance and untreated sleep apnea in women with PCOS. (7)
Depression and anxiety (8)
The causes of PCOS are not completely understood. Although PCOS is a hormonal disorder, its impacts on health have effects far beyond the reproductive systems. If PCOS is not treated properly, it can affect a woman’s enjoyment and productivity in life.
While there is no cure for PCOS, the symptoms can be treated with various medications. Speak to your doctor if you think you have PCOS.
Generally, women with PCOS are treated with the following:
Oral contraceptives (OCs) — It is used for regulating the menstrual periods in women with PCOS. It can also reduce or slow hair growth and improve acne in PCOS, while providing protection from pregnancy. OCs also can reduce the risk of endometrial cancer in PCOS patients.
Progestin — While it doesn’t improve acne, reduce hair growth or offer pregnancy protection, this hormone pill is also used to treat PCOS and can reduce risk of endometrial cancer.
Spironolactone — For PCOS patients who are satisfied with the effects of OCs, doctors can recommend spironolactone for reducing hair growth and acne.
Weight loss — It is one of the most effective approaches for managing insulin abnormalities, irregular menstrual periods, and other symptoms of PCOS. For example, many overweight women with PCOS who lose 5 to 10 percent of their body weight notice that their periods become more regular. Weight loss can often be achieved with a program of diet and exercise. We encourage you to work with a healthcare professional on losing weight using healthy and sustainable methods.
Metformin — Metformin is a medication commonly used in the treatment of type 2 diabetes. In the case of PCOS, doctors may recommend it to PCOS patients for the sake of improving the effectiveness of insulin produced by the body.
Clomiphene — It is a US Food and Drug Administration (FDA)-approved oral medication that is used to treat infertility. Clomiphene stimulates the ovaries to release one or more eggs. It triggers ovulation in approximately 80 percent of women with PCOS, and approximately 50 percent of these women will become pregnant.
Do not get these medications on your own without a healthcare professional’s advice. If you have any doubts about these medications or the symptoms you experience, always speak to a healthcare professional.
If you have any questions related to PCOS, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.
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UpToDate - Definition, clinical features, and differential diagnosis of polycystic ovary syndrome in adolescents
UpToDate - Treatment of polycystic ovary syndrome in adults
UpToDate - Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics)
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