Polycystic Ovary Syndrome (PCOS)
Polycystic
ovary syndrome (PCOS) is a common hormonal disorder in the women of
reproductive age. PCOS affects female ovaries, reproductive organs that produce
estrogen and progesterone, hormones that control the menstrual cycle. The
ovaries produce a small number of male hormones called androgens. Women with
PCOS may have rare or prolonged menstrual periods or excessive levels of male
hormones (androgens). The ovaries can develop many small collections of fluids
(follicles) and fail to release eggs regularly.
PCOS is a syndrome
or symptom group that affects the ovaries and ovulation. Its three main
elements are:
- Ovarian cysts
- High levels of male hormones
- Irregular or missed periods
Symptoms of PCOS
Symptoms and
signs of PCOS often develop around the first menstrual period during puberty.
Sometimes, PCOS develops later, for example, in response to a significant
weight gain. PCOS diagnosis is made when
at least two signs are observed:
Irregular periods
The menstrual
cycles are rare, irregular or long the most common sign of PCOS. For example,
you may have less than nine periods a year, more than 35 days between periods
and extremely heavy periods.
High level of androgens.
High levels of
male hormone can cause physical symptoms such as excessive facial and body hair
(hirsutism) and, at times, severe pattern baldness and male pattern.
Polycystic ovaries.
These ovaries
can expand and contain follicles that surround the eggs. As a result, the
ovaries cannot function properly.
Causes
Insulin Excess. Insulin is the hormone produced in the pancreas that allows sugar cells to be
used, the body's main source of energy. If the cells become resistant to
insulin, blood sugar levels can increase and the body can produce more insulin.
Increased production of androgen insulin can increase, creating difficulties
with ovulation.
Low Grade Inflammation. This term is used to describe the production of substances in
white blood cells to combat infections. Research has shown that women with PCOS
have low-grade inflammation that encourages polar ovaries to produce androgen,
which can lead to heart problems and blood vessels.
Heredity.
Research suggests that some genes may be associated with PCOS.
High Androgens.
These ovaries produce an extremely high level of androgens, which leads to
hirsutism and acne.
Complications
- Infertility
- Gestational diabetes or high blood pressure induced by pregnancy
- Spontaneous abortion or premature birth
- Non-alcoholic steatohepatitis - a severe inflammation of the liver caused by the accumulation of fat in the liver
- Metabolic syndrome - a group of conditions that include high blood pressure, high blood sugar and abnormal levels of cholesterol or triglycerides that significantly increase the risk of cardiovascular disease
- Type 2 diabetes or prediabetes
- Sleep apnea
- Depression, anxiety and eating disorders
- Abnormal uterine bleeding
- Endometrial cancer
Obesity is
associated with PCOS and can aggravate the complications of the disorder.
Diagnosis
There is no
test to definitively diagnose PCOS. Your doctor can start with a discussion of
your medical history, including menstrual periods and weight changes. A
physical exam will include checking for signs of excessive hair growth, insulin
resistance and acne. So the doctor can recommend:
A Pelvic Exam.
The doctor will visually and manually inspect your reproductive organs to check
for mass, growth or other abnormalities.
Blood Test.
Blood can be analyzed to measure hormone levels. This test can rule out
possible causes of menstrual abnormalities or excess of androgens that mimics
PCOS. Additional blood tests may need to be performed to measure glucose,
cholesterol and triglyceride tolerance.
An ultrasound.
The doctor checks the appearance of the ovaries and the thickness of the lining
of the uterus. A wand-type device (translator) is inserted into the vagina
(transvaginal ultrasound). The transducer emits sound waves that are translated
into images on the computer screen
Treatment
PCOS treatment
focuses on the management of individual concerns, such as infertility,
hirsutism, acne or obesity. Specific treatment may involve changes in lifestyle
or medications.
Lifestyle Change
Your doctor may recommend losing weight through a low calorie diet, combined with moderate exercise. Even a modest reduction in weight, for example the loss of 5% of body weight, could improve your condition. Weight loss can also increase the effectiveness of medications your doctor recommends for PCOS and can help with infertility.
Medications
For the
regulation of menstrual cycle, the doctor may recommend:
Combined Contraceptive Pills.
Estrogen and progestin-containing pills reduce androgen
production and regulate estrogen. The regulation of the hormone can reduce the
risk of endometrial cancer and correct abnormal bleeding, excessive hair growth
and acne. Instead of pills, you can use a plaster or vaginal ring that contains
a combination of estrogen and progestin.
Progestin Therapy.
The intake of progestin from 10 to 14 days every two or two months can
regulate menstruation and protect you from endometrial cancer. Progestin
therapy does not improve androgen levels and does not prevent pregnancy. The
intrauterine device containing the progestin or the device containing the
progestin is a better choice if pregnancy is also to be avoided.
To minimize
excessive hair growth, the doctor may recommend:
Contraceptive Pills.
These pills reduce the production of androgens that can cause excessive hair growth.Spironolactone (Aldactone).
This drug blocks the effects of androgens on the skin. Spironolactone can cause birth defects, which is why effective contraception is required while taking this medicine. It is not recommended if you are pregnant or planning to get pregnant.Eflornithine (Vaniqa).
This cream can slow the growth of facial hair in women.Electrolysis.
A small needle is inserted into each hair follicle. The needle emits an electrical current to damage and eventually destroy the follicle. You may need more treatments.Natural Remedies
To help reduce the effects of PCOS, try:
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