PCOS

Symptoms

Early signs and symptoms of PCOS usually develop around the time of adolescence. In some women PCOS develops later, such as in cases of substantial weight gain. Diagnosis of PCOS is made when you experience some of these signs:
  • Irregular periods : Infrequent, irregular or prolonged menstrual periods are the commonest sign of  PCOS. For example, you  may have less than nine periods a year, more than 36 days between periods and abnormally heavy or less periods.
  • Excess androgen level : Elevated levels of male hormone/ androgen may result in physical signs, such as excess facial and  body hair & sometimes severe acne and male-pattern baldness.
  • Infertility due to Polycystic ovaries : Your ovaries might be big and contain many follicles that surround the eggs. As a result, the ovaries might fail to function properly .
  • These signs and symptoms are usually more severe if you’re overweight .

When to see a doctor

See your doctor if you are worried about your menstrual periods, if you’re troubled with infertility or if you are embarrassed with signs of excess androgen such as worsening hirsutism, acne and hair loss.

PCOS Strong

Causes

The exact cause of PCOS is not known. Factors that plays an important role include:

  • Excess insulin level : Insulin is the hormone produced in your body that help body cells to use sugar which is it’s primary energy supply. If your body cells become resistant to the action of insulin hormone, then your blood sugar level will rise and your body start producing more insulin. High insulin in blood may increase androgen production, leading to difficulty with ovulation.
  •  Low-grade inflammation : Research has shown that women with PCOS usually have a type of low-grade inflammation that start stimulating polycystic ovaries to produce male hormone androgen, which lead to heart and blood vessel problems.
  •  Heredity : Research suggests that certain genes may be linked to PCOS making it a problem which may run in family.
  • Excess androgen : The body produce high levels of androgen, resulting in coarse facial features unwanted facial hair, acne.

Complications of PCOS can include :

  • Infertility
  • Pregnancy diabetes or pregnancy-induced high blood pressure
  • Repeated abortion or premature birth
  • Liver steatosis – a severe liver inflammation caused by fat accumulation in the liver
  • Metabolic syndrome –  conditions like high blood pressure, high blood sugar, and abnormal cholesterol or blood lipid level that significantly increases risk of heart disease
  • Diabetes or prediabetes
  • Sleep disturbances
  • Depression, anxiety and eating disorders
  • Abnormal menstural bleeding
  • Cancer of the uterus ( endometrial cancer)
  • Increased body weight is associated with PCOS and can worsen complications of the disorder.

Diagnosis

Your Doctor May Then Recommend Following Test

A pelvic examination : The doctor inspects your reproductive organs for any masses, growths or other abnormalities.

Blood tests : Your blood sample may be sent to measure various hormone levels. This test can exclude other various causes of menstrual abnormalities or blood androgen excess that mimics PCOS. additional blood test are done to measure glucose tolerance and fasting cholesterol and lipid levels.

An ultrasound : Your doctor checks the appearance of your ovaries and the thickness of the lining of your uterus. A small wand like device (transducer) is placed in your vagina (transvaginal ultrasound).

If you are already diagnosed as PCOS, doctor might recommend some additional tests for complications.

  • Periodic check-up of blood pressure, glucose tolerance, and cholesterol and lipid levels
  • Screening for symptoms of depression and anxiety
  • Screening for sleep disturbances (obstructing sleep apnea)

Treatment

Treatment focus on managing your concerns, such as infertility, hirsutism, acne or increased body weight. Specific treatment may involve lifestyle changes, medication or both. Doctor may recommend weight loss through a special diet plan combined with specific exercise activities. Even a little reduction in your body weight — for example, losing 4 to 5% of your body weight — may improve your condition. Decreased weight may also increase the effectiveness of medicine that your doctor recommends for PCOS, and also can help with infertility problem.

Medications

To improve your menstrual cycle, your doctor may recommend:

  • Combination OCP (birth control pills) : These Pills that contain estrogen and progestin decreases androgen hormone production and also regulate estrogen. Improving your hormones can lower your risk of endometrial cancer and correct menstural irregularities , excess facial and body hair growth and pimples . Instead of pills, you may use a skin patch or vaginal ring containing same drug.
  • Progestin therapy: Taking progestin therapy can regulate your periods and protect against endometrial cancer. Progestin therapy does not improve androgen levels and not prevent pregnancy. The progestin-only minipill or progestin-containing intrauterine device is an alternative choice.

To Help You Ovulate And Solving Infertility, Your Doctor May Recommend

  • Clomiphene : This oral anti-estrogen medicine is taken during the early part of your menstrual cycle, for stimuating ovaries to form proper egg.
  • Letrozole : This treatment can work to stimulate the ovaries to form proper egg.
  • Metformin : This oral medicine for diabetes helps in improving insulin resistance and lowers blood insulin levels. If you have     prediabetes, metformin can also slow the progression to diabetes and also helps with weight loss.
  • Gonadotropins: These hormones are given by injections for ovulation.

To Reduce Excessive Hair Growth, Your Doctor Might Recommend

Birth Control Pills : Regulates androgen production that causes excessive hair growth

Spironolactone (Aldactone) : This Medicine blocks that effects of androgen on the skin. It is not recommended if you are pregnant or planning pregnancy.

Eflornithine : This cream can slow facial hair growth in women.

Diode Laser : It is  now a gold standard treatment for getting rid from unwanted hair. Multiple sessions are usually required.

Lifestyle And Home Remedies

TO HELP DECREASE THE SYMPTOMS OF PCOS TRY TO

  • Maintain a healthy weight : Weight loss can reduce blood insulin level and also androgen levels and may help in restoring ovulation. Ask your doctor about a weight-control program which also involves dietitian for help in reaching weight-loss goals.
  • Limit carbohydrates : Low carb diet helps in improving insulin levels. Ask your doctor for a low-carbohydrate diet if you have PCOS. Also Choose complex carbohydrates, which tends to raise your blood sugar levels more slowly.
  • Regular exercise : This helps in lowering blood sugar levels. If you have PCOS, increasing your daily physical work and maintaining a regular exercise program may help you keep your weight under control and avoid developing diabetes.

Preparing For Your Appointment

Here’s some information which help you to get ready for your Appointment

WHAT YOU CAN DO
  • List your Symptoms, and also for how long they exist.
  • List all medicines, vitamins and supplements you take.
  • List key personal and medical information, including other medical or surgical conditions, recent life modifications amd stress factors.
  • Keep a record of your menstrual periods.
  • During your Appointment, don’t hesitate to ask other questions as they occur to you.

What To Expect From Your Doctor

Your doctor is likely to ask a number of questions, including; what are your symptoms? How often do they occur?

  • How severe are your symptoms?
  • When did these symptom begin?
  • When was your last menstural period?
  • Have you gained weight since your menstural periods started?
  • How much weight did you gain, and when did you gain it?
  • Things which improve or worsen your symptoms?
  • Do you wish to become pregnant?
  • Has your sister or mother faced similar problems?

So, better prepare these answers before visiting your doctor, which will make the appointment more worthwhile.

A multidisciplinary team of Infertility specialist, Physician, Cosmetologist, Psychologist, Nutritionists and Yoga expert will provide holistic management to women with PCOS.