UNDERSTANDING PCOS

Polycystic Ovary Syndrome, commonly referred to as PCOS, is a hormonal disorder that affects women of reproductive age, typically between 15 and 44 years old. As women approach their late 30s, their reproductive age gradually begins to decline.

What Happens in PCOS?

Women with PCOS often experience the formation of numerous small fluid-filled sacs, or cysts, along the outer edge of their ovaries. These cysts contain immature eggs known as follicles, which fail to mature and release eggs consistently, leading to disrupted ovulation.

Causes of PCOS

The causes of PCOS can vary among individuals, but several contributing factors include:

1. Sedentary Lifestyle: Physical activity is essential for overall health, and a lack of it can lead to hormonal imbalances. A sedentary lifestyle often results in excess calorie accumulation, which gets stored as fat, particularly around the belly and thighs. This can increase androgen production and exacerbate PCOS symptoms.

2. Western Diet: A Western diet rich in complex carbohydrates, saturated fats, and red meat can contribute to low-grade inflammation and oxidative stress. The lack of raw vegetables and fruits further deprives the body of antioxidants, worsening the condition.

• Examples of Dietary Contributors:

• • Complex Carbohydrates: Confectionery, burger buns, white bread, rice, pasta.
  • Saturated Fats: Fried foods, chips, baked goods.
  • Red and Processed Meats: Beef, mutton, sausages, pepperoni.
  • Sugary Beverages: Soft drinks, milkshakes, restaurant-style coffee.

3. HPO Axis Dysfunction: The Hypothalamic-Pituitary-Ovarian (HPO) axis controls the reproductive system. In PCOS, an imbalance in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) leads to increased androgen production and disrupted ovulation.

4. Hormonal Imbalance: Women with PCOS often exhibit elevated levels of androgens (male hormones) like testosterone. This condition, called hyperandrogenism, can result in acne, excessive hair growth, and, in some cases, male-pattern hair loss.

5. Low-Grade Inflammation: Chronic inflammation disrupts the ovarian environment, affecting follicular development and oocyte maturation. Elevated levels of inflammatory markers such as C-reactive protein and interleukin-18 are common in women with PCOS.

6. Insulin Resistance: Insulin resistance—the body’s reduced ability to respond to insulin—is a hallmark of PCOS. To compensate, the body produces more insulin, which stimulates the ovaries to produce excess androgens. This also increases the risk of obesity and type 2 diabetes.

Symptoms of PCOS

1. Menstrual Irregularities:
   • Women with PCOS may experience amenorrhea (missed periods) or heavy menstrual bleeding.
   • Anovulation (failure to release eggs) is another common issue, leading to irregular basal body temperature and absence of cervical mucus.
2. Infertility:
   • PCOS is a leading cause of infertility, accounting for 70% of ovulation disorders.
3. Excessive Hair Growth:
   • About 70% of women with PCOS experience hirsutism (excessive hair growth) on the chin, arms, chest, or abdomen.
4. Weight Gain:
   • Many women with PCOS struggle with weight gain, particularly around the abdomen, due to insulin resistance.
5. Darker Skin Patches:
   • Insulin resistance can cause acanthosis nigricans, which appears as darker, thicker skin on areas like the neck, armpits, or under the breasts.

Diagnosis of PCOS

1. Ultrasonic Examination:
   • An ultrasound checks for the “polycystic” appearance of ovaries, defined by 12 or more follicles per ovary or an ovarian volume exceeding 10 cm³. However, not all women with ovarian cysts have PCOS.
2. Laboratory Tests:
   • Blood tests measure levels of reproductive hormones, including testosterone, LH, FSH, prolactin, and thyroid hormones.
   • Glucose Tolerance Test (OGTT): Assesses insulin resistance.
   • Lipid Profile: Evaluates cholesterol and triglyceride levels, though not essential for diagnosis.

Complications of PCOS

1. Pregnancy Challenges:
   • Women with PCOS face higher risks of miscarriage and pregnancy complications such as gestational diabetes.
2. Diabetes:
   • Insulin resistance in PCOS significantly increases the risk of type 2 diabetes. By age 40, up to 40% of women with PCOS may develop impaired glucose tolerance.
3. Mental Health Issues:
   • The hormonal imbalances and physical symptoms of PCOS can lead to anxiety, depression, and low self-esteem. The frustration of dealing with weight gain, acne, and excessive hair growth often exacerbates these challenges.

Managing PCOS

PCOS is a complex condition, but with proper lifestyle adjustments, dietary changes, and medical intervention, it can be managed effectively. If you suspect you have PCOS, consult a healthcare provider for a comprehensive evaluation and personalized treatment plan.