Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) Treatment

What is Polycystic Ovary Syndrome (PCOS)?

Polycystic Ovary Syndrome (PCOS) may cause infertility in you.  In this medical condition,  your reproductive hormones go imbalanced.  This may also cause issues with your menstruation and make it difficult for you to achieve pregnancy.

If left untreated, it may cause serious health issues like diabetes and heart disease over a period of time. Most of the women having PCOS grow a number of small cysts on their ovaries. That is the reason, it is known as Polycystic Ovary Syndrome.

The cysts, as such, may not cause any harm, but result in hormonal imbalances. With early diagnosis and its treatment, you can control the symptoms and put a stop to long-term issues. Hormones, in fact, are chemical messengers that activate many other processes, including development and energy production. More frequently, the task of one hormone is to signal release of another hormone.

For some reasons, that have not yet been well understood, in PCOS the hormones go imbalanced. One hormonal change leads to a change in another hormone, and then in yet another, making it a vicious circle. Let us understand it with examples:

  • The ovaries normally make a small quantity of male sex hormone, called Androgens, to work in synthesis with the Estrogen. When a woman’s sex hormones get imbalanced, the ovaries begin making more than average amount of androgens with the result that you may stop ovulating; grow extra hair on your face and other body parts. You may even get acne.
  • Similarly, if your body is having problem in using insulin because of insulin resistance, your blood sugar levels will go up. Over a period of time, this will increase your chance of becoming diabetic.

PCOS and Estrogen Dominance

Dominance of estrogen explains a condition, wherein the ovaries produce the excessive or normal amount of estrogen, but have low progesterone in the body for balancing the effects of estrogen in the body. Progesterone to balance estrogen’s effects in your body.

An important reason of low progesterone happens if the follicles do not release eggs.  The follicles, thus, transform into cysts and the usual progesterone rise does not happen.  The deficiency of increasing progesterone indicates the hypothalamus to generate more FSH and LH for stimulating the ovaries to generate more androgens and estrogen, which successively encourage more follicles towards ovulation.

In case these extra motivated follicles also fail to generate a matured oocyte and generate progesterone, the menstrual cycle is prevailed upon by androgen and estrogen generation not including progesterone.  Thus, anovulation gives rise to a condition, known as “Estrogen Dominance”.

Females having Polycystic Ovarian Failure (PCOS) often do not generate adequate progesterone.

 What Causes PCOS?

The exact cause of PCOS is not fully known, but infertility experts believe that genetics and hormonal imbalances play a vital role in developing the disease. PCOS is considered to be running in families. So, your chances of getting it would be higher if other women too in your family are having it or facing irregular periods or afflicted with diabetes.

PCOS can genetically be passed down to you either from your maternal or paternal side. Overproduction of the androgen hormone may contribute to the problem. As explained above, a woman’s body also produces a small amount of male sex hormone, known as androgens.

If you are suffering from the polycystic ovarian syndrome, you tend to produce higher-than-usual amount of androgens. The condition can affect the egg growth and its release during ovulation. Insulin in a body helps in converting sugar and starches into energy. Excessive insulin  helps in increasing androgen (male hormone) levels in the body.

Symptoms of PCOS

PCOS symptoms characteristically begin soon after a woman starts  menstruating. The severity and type of these symptoms differ from person to person. The most common trait of PCOS is having irregular periods. As PCOS is marked by a reduced amount of female sex hormones and higher-than normal amount of male hormone, the women tend to develop some male distinctiveness, such as:

  • Excessive hair on the face, stomach, chest, toes and thumbs
  • Reduced breast size
  • Heavy and deeper voice
  • Thinning of hair in the scalp

Other symptoms may include:

  • Acne
  • Weight gain and trouble in losing weight
  • Pain in pelvic region
  • Anxiety/depression
  • Infertility – Women having PCOS will find it difficult to achieve pregnancy.
  • Irregular menstrual cycle. Most often women having PCOS will have less than nine periods in a year.  While some women will experience even no periods, others will face heavy bleeding.

Besides these symptoms of the disease, some women having PCOS may be experiencing other health problems as well, like hypertension,  diabetes, or/and high cholesterol. These are typically linked to the weight gain among PCOS patients. The symptoms may be mild initially. You may experience a few symptoms or many of these.

How Is PCOS Diagnosed?

There is no specific test for PCOS. For a diagnosis, your treating doctor may evaluate your medical symptoms and  history and carry out some tests to rule out other probable conditions. The treating doctor may also do physical and pelvic examination to examine any sign(s) of PCOS,  like puffed-up ovaries or even a swollen clitoris.

The treating doctor may also take your blood sample for examining your hormone levels and conduct:

  • Thyroid tests to know the amount of thyroid hormone your body produces
  • Fasting glucose investigation to evaluate your blood sugar level
  • Lipid profile diagnosis to examine the cholesterol amount in your blood

A vaginal ultrasound helps your treating doctors to click real time pictures of the organs of  your reproductive system. Following the surgical procedure, called pelvic laparoscopy, your treating doctor will make a small opening in your abdomen to insert a small camera to inspect endometriosis growth on your ovaries. In case of its presence on the ovaries, the treating doctor may take a biopsy (small tissue sample) for further investigations.

How Is PCOS Treated?

PCOS treatment is not much curative. The focus of the treatment  remains on controlling symptoms and  condition management to avoid complications. The treatment varies from one  woman to another, depending on the detailed symptoms. All women having PCOS are prescribed nutritious diet and regular workout, especially those who are found to be overweight.

This can help in regulating your menstrual cycle and lower your blood glucose levels. Women who are not keen on achieving pregnancy are may be prescribed birth controlling pills. These help in treating acne, regulating the menstrual cycle, and lowering  male hormone levels, like testosterone etc., in the body. In case of a woman having PCOS is facing infertility, fertility medicines are given that help in ovulation. Anti-androgens medicines help in reducing male hormone levels.

These fertility medicines help in stopping excessive hair growth and reducing acne. Diabetes medications may also be prescribed to lower blood glucose and testosterone levels. Ovarian drilling may be advised for some women having PCOS. It is a procedure wherein your doctor pierces your ovary with a needle carrying an electric current, to destroy the affected part of the ovary. This is a temporary cure that helps in promoting ovulation and reducing male hormone levels. While going through the treatment, you are advised to refrain from excessive use of alcohol and lifestyle habits, like smoking.

What are the potential complications of PCOS?

Women having PCOS have an increased possibility of developing:

  • High blood pressure, better known as hypertension
  • High cholesterol level
  • Sleep apnea (if a person’s breathing stops intermittently during sleep)
  • Anxiety/depression
  • Heart-attack
  • Diabetes
  • Endometrial cancer (This may be caused by thickening of the uterine lining)
  • Breast cancer

In case you happen to conceive, your treating doctor may refer you to a high-risk pregnancy expert, because of these involved complications.  Women having PCOS run a higher risk of miscarriage, premature delivery or gestational diabetes.

Extra monitoring for these complications is needed during pregnancy. The sooner PCOS is detected and treated, the better would it be for you for handling these complications. You should be avoiding tobacco (smoking) products.  You should be participating in the regular workout to reduce the risk of some of these complications.

You should be discussing with your doctor to know the meaning of PCOS and how can it affect your overall health and how best you prevent and handle these serious complications.

Infertility Treatment FAQs – Part I: What is Infertility?

Infertility Treatment FAQs – Part II: 11- risk factors of  both male and female infertility?

Infertility Treatment FAQs – Part III: What are Female Infertility risk factors?

Infertility Treatment FAQs – Part IV: What are Male Infertility risk factors?

Infertility Treatment FAQs – Part V: What are causes of Female Infertility?

Infertility Treatment FAQs – Part VI: What are causes of Male Infertility?

Infertility Treatment FAQs – Part VII: Female Infertility Symptoms

Infertility Treatment FAQs – Part VIII: Infertility Symptoms in Men

Infertility Treatment FAQs – Part IX: Infertility Treatment in India

Infertility Treatment FAQs – Part X: Evaluating Female Infertility

Infertility Treatment FAQs – Part XI: Evaluating Male Infertility

Infertility Treatment FAQs – Part XII: What infertility treatments are available?

Infertility Treatment FAQs – Part XIII: Male Infertility Treatments and drugs

Infertility Treatment FAQs – Part XIV: Female Infertility Treatments

Infertility Treatment FAQs – Part XV: Assisted Reproductive Technology

Infertility Treatment FAQs – Part XVI:  Gamete Intrafallopian Transfer (GIFT)

Infertility Treatment FAQs – Part XVII: Intrauterine Insemination Infertility

Treatment FAQs – Part XVIII: Zygote Intrafallopian Transfer (ZIFT)

Infertility Treatment FAQs – Part XX: Ovulation Induction (OI)

Infertility Treatment FAQs – Part XXI:  Sperm Morphology

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