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Polycystic ovary syndrome (PCOS) or also known as Stein-Leventhal syndrome, is one of the most common hormonal endocrine disorders affecting up to almost 27 percent of women during their childbearing years (ages 15 to 44).
PCOS is a group of symptoms known to disrupt ovulation and are characterized by three main features:
cysts in the ovaries
high levels of male hormones (androgen)
irregular or skipped periods
Imbalance of reproductive hormones and metabolism problems may affect a woman’s overall health and appearance. PCOS is also a common and treatable cause of infertility.
“A lot of women suffer from PCOS but aren’t aware of it. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed.”
The exact cause of PCOS is not yet known however there are associations with genetics, excess insulin, and low-grade inflammations.
PCOS often runs in the families. If any of your relatives (mother, aunts, sisters) are affected with PCOS, you are more likely to develop PCOS than someone whose relatives do not have the condition. This family link is the main risk factor.
It could also be related to insulin resistance. Insulin is a hormone that controls the level of glucose in the blood. When you have PCOS, your body may not be able to respond to insulin, which causes your glucose level to be higher. To prevent the glucose levels becoming higher, your body produces even more insulin, which can affect your ovaries and their ability to ovulate (release eggs). High levels of insulin can lead to weight gain, irregular periods, fertility problems and higher levels of testosterone.
Studies have also linked excess inflammation to higher androgen levels in women with PCOS. Being overweight can also contribute to inflammation.
The symptoms vary from woman to woman. Some women experience only mild symptoms, while others can be affected more severely by a wider range of symptoms.
It’s pretty common for it to take women a while - even years - to find out they have this condition.
The most common PCS symptoms are:
Irregular menstrual cycle. Women with PCOS may miss period for several months. Or they may have heavy bleeding during their period ( due to the uterine lining building up for a longer period of time). But some women with PCOS stop having menstrual periods.
Hair growth in unwanted areas. Over 70 percent of women with this condition grow hair on their face and body - including on their back, breasts, and belly. Excess hair growth is called “hirsutism”.
Weight problem. Up to 80 percent of women with PCOS struggle with weight gain or have a hard time losing weight.
Acne. The androgens can make the skin oilier than usual and cause breakouts on areas like the face, chest and upper back.
Headaches. Hormone changes can trigger a headache in some women.
Hair Thinning. Hair on the scalp gets thinner and fall out. This could worsen in middle age.
Darkening of the skin. Dark patches of skin can form in body creases like those on the neck, in the groin and under the breasts.
Feeling tired all the time. You could have a disorder known as sleep apnea that causes you to not feel well-rested after you wake up.
Having trouble getting pregnant. To be pregnant, you have to ovulate. Women who don’t ovulate regularly don’t release as many eggs to be fertilized. PCOS is one of the leading causes of infertility in women.
PCOS can make it harder to get pregnant as it interrupts the normal menstrual cycle, but it does not mean you can’t. Losing weight and lowering blood sugar levels can improve the odds of having a healthy pregnancy.
However having this condition can also increase the risk for pregnancy complications such as premature delivery, miscarriage, high blood pressure, and gestational diabetes.
There is no cure for PCOS. Treatment usually aims to manage the symptoms and consequences of having PCOS. Healthy lifestyle changes ( weight loss and exercise) have been shown to be better than taking medications alone.
Many women with PCOS successfully manage their symptoms and long-term health risks without medical intervention.
Even when there’s no cure for PCOS, some home and lifestyle interventions can make a difference to your overall health in the long-term.
You should aim to maintain a healthy weight, to reduce androgens levels and also reduce the risk of systemic-related diseases such as diabetes and heart diseases.
BMI is the measurement of weight in relation to height and you should aim to keep your BMI between 19 and 25.
If you are overweight (BMI between 25 and 30), it would be helpful to lose weight and maintain your weight at a normal level. If your BMI is more than 30, discuss ways of losing weight with your GP, dietitian or pharmacist.
Other lifestyle changes that can help you lose that extra fat include:
Eating a healthy, well-balanced diet including plenty of fruits and vegetables
Cutting down the amount of sugar, salt and caffeine that you consume
Participate in regular physical activity ( 30 minutes at least three times a week)
Do not smoke, as this increases levels of androgens and the risk of many other diseases
You only have to lose a small amount of weight to make a difference in your symptoms and your health.
See your doctor if you’ve skipped periods or you have other PCOS symptoms like hair growth on your face or body. Also, see a doctor if you’ve been trying to get pregnant for 12 months or more without success.
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References:
Watson, S. (2018). Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment. [online] Healthline. Available at: https://www.healthline.com/health/polycystic-ovary-disease.
womenshealth.gov. (2019). Polycystic ovary syndrome | Womenshealth.gov. [online] Available at: https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome.
Polycystic ovary syndrome: what it means for your long-term health. (2015). [PDF] Royal College Of Obstetricians & Gynaecologists, pp.1-4. Available at: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/gynaecology/pi-pcos.pdf.
Sanyal, S. (2018). Polycystic ovary syndrome (PCOS): Causes, symptoms, and treatments. [online] Medical News Today. Available at: https://www.medicalnewstoday.com/articles/265309.php.
WebMD. (2019). What Are the Symptoms of PCOS?. [online] Available at: https://www.webmd.com/women/symptoms-of-pcos.
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