Polycystic ovary syndrome (PCOS) is a hormonal condition wherein the female body produces excessive amounts of male sex hormones. It is a common condition in women, especially those with excess weight and/or who are obese. This disorder causes the ovaries to produce more androgens, which are the male sex hormones. Polycystic ovary syndrome can cause infertility and menstrual problems.
Polycystic ovary syndrome (PCOS) is a condition that is characterized by chronic anovulation, hyperandrogenism, and polycystic ovaries. It can affect women of any age, but it is most commonly seen in those between ages 15 and 40. PCOS can be a problem if left untreated for long periods of time. It may cause infertility in some women and also increase the risk of diabetes, high blood pressure, heart disease, stroke, obesity, depression, and anxiety.
There are three types of polycystic ovary syndrome:
Hyperandrogenic PCOS is a very common endocrine disorder with a prevalence of approximately 5% in women. The clinical features of PCOS are hyperandrogenism and oligomenorrhea/amenorrhea, and the latter is one of the most common symptoms. It has been shown that a significant number of women with PCOS have an increased risk for:
2) Non-Hyperandrogenic PCOS.
PCOS without hyperandrogenism (PCOS-AN). It occurs in approximately 15% of women with PCOS. These women are usually normoandrogenic; they have normal menstrual cycles and they are not overweight. The clinical features in these patients include amenorrhea, infertility, hirsutism, acne, and alopecia. As such, these women can be treated by means of oral contraceptives and/or clomiphene citrate alone or combined with metformin.
3) PCOS with and without hirsutism.
polycystic Ovary Syndrome with hyperinsulinemia and acanthosis nigricans (PASHI-AN). This is a subgroup of PCOS that shows the characteristic of insulin resistance, and as such, it is also associated with metabolic syndrome. In addition, this subgroup is also more likely to develop type 2 diabetes mellitus.
Women with this condition have all the above symptoms but do not have the degree of hyperandrogenism that is seen in women with type 2 . Although they are at increased risk for metabolic disorders such as diabetes and cardiovascular disease, women with type 3 Polycystic ovary syndrome (PCOS) tend to be leaner than those with type 2.
There is much controversy regarding the best treatment for women who are affected by polycystic ovary syndrome (PCOS). There are two main areas on which research has focused:
The most important consideration is to determine whether or not there is an increase in symptoms and/or the severity of these symptoms that require intervention. For example, if one woman experiences menstrual irregularities such as amenorrhea but her partner does not experience any symptoms, she would not require treatment. On the other hand, if one woman experiences hyperandrogenism but her partner does not experience any symptoms, she might benefit from treatment.
Signs and symptoms of Polycystic ovary syndrome (PCOS)
The most common symptoms of PCOS are hirsutism, amenorrhea, and acne. Amenorrhea can be a single or recurrent menstrual cycle. It is characterized by the absence of menstruation for three consecutive months or the presence of menorrhagia and dysmenorrhea. The main manifestations of hirsutism are hypertrichosis and increased hair growth in various areas, including the face, abdomen, and legs. In addition to these signs, PCOS patients may have male pattern alopecia (androgenic alopecia) or oily skin (acanthosis nigricans). Furthermore, other signs such as clitoromegaly can be found in some women with PCOS. Other signs such as obesity and insulin resistance may also be present. in simpler terms, these symptoms exhibit:
- Increase in body hair growth, facial hair growth, and acne (usually mild)
- Infertility (more common in the later years of life)
- Irregular menstruation (with a longer interval between periods and/or bleeding during the menstrual cycle)
- Acne and other skin problems (such as dark skin patches, large pores, oily skin)
- Hormonal imbalance can affect the bones, brain, liver, pancreas, muscles, etc.
Excessive weight gain or obesity especially around the waistline; is usually more common in women with PCOS than those without PCOS. Other possible signs are diabetes mellitus, heart disease, and high blood pressure. A history of pregnancy loss is also a risk factor for developing polycystic ovary syndrome. Signs can be found on their own or as part of other diseases.
Why polycystic ovary syndrome causes irregular periods
Regular menstruation and ovulation are signs of an established menstrual cycle and the ovaries working properly.
With polycystic ovary syndrome (PCOS), there are increased levels of luteinizing hormone and a group of male sex hormones (androgens) in the body. These hinder the development of an egg and its release from the ovary (ovulation). The absence of ovulation, and the hormonal imbalance associated with it, also affect the endometrium (the uterine lining). Without the needed stimulation, it develops slowly and periods come much later, with up to 90 days between cycles.
Diagnosis of Polycystic ovary syndrome (PCOS)
The diagnosis of PCOS can be made on the basis of a physical examination, endocrine investigations, and ultrasound studies. The clinical features that are typically found in PCOS patients include hirsutism, acne, alopecia, and obesity. The main causes of hirsutism are hyperandrogenism and hyperinsulinemia (PASHI-AN). Although it is not possible to make a definite diagnosis on the basis of a clinical examination alone, some clinical features can help physicians reach an early diagnosis. Women with these features should have their serum levels of testosterone checked by an endocrinologist or their general practitioner for confirmation. In addition to these factors, endocrinologists may request other laboratory tests such as measuring basal follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin, where values above the normal range would lead to an increased likelihood of PCOS. Other possible laboratory tests for PCOS include a glucose tolerance test and measuring insulin, where a high value is indicative of insulin resistance. In addition to this information, physicians can also request abdominal ultrasound studies for women with hirsutism. A polycystic ovary can be detected on ultrasound if it has a diameter over 2–3â€‰cm.
Treatment of Polycystic ovary syndrome (PCOS)
Management of PCOS patients should start with lifestyle modifications that include weight loss (by means of dieting or exercising), reduced caloric intake, and daily oral contraceptive pills. When these measures do not lead to a reduction in body weight and endocrine dysfunction, drug therapy should be added. The treatment of PCOS depends on the severity of the disease. According to the 2003 ESHRE/ASRM guidelines, hirsutism can be classified into three grades (none, mild, severe) based on a scale that includes assessments of hair length, hair density, and skin greasiness. There is some disagreement among endocrinologists as to whether mild hirsutism is also considered a diagnostic criterion for PCOS (and vice versa). However, it has been recommended that PCOS patients should have a serum testosterone level below 5â€‰nmol/l or dihydrotestosterone concentration below 3â€‰nmol/l in order to treat them effectively.
A very effective treatment for polycystic ovary syndrome is low-dose metformin. Metformin is a drug that can be taken orally. It can lower insulin levels and improve insulin sensitivity, which is the way that your body uses glucose or sugar to store energy. Metformin also helps reduce weight in women with PCOS by reducing their appetite and increasing their metabolism. It may be used in combination with contraceptive pills, fertility drugs, or other treatments to improve the success of conception.
What supplements can help with Polycystic ovary syndrome (PCOS)?
Dietary supplements do not treat the causes of Polycystic ovary syndrome (PCOS), but they can help relieve its symptoms and contribute to the main (hormone) therapy.
Women with Polycystic ovary syndrome (PCOS) should pay attention to the following elements (and products containing them):
- Inositol (vitamin B8) restores ovulatory activity, lowers testosterone levels, and regulates insulin production (oranges and fresh green peas)
- Vitamin D improves insulin sensitivity and stress resistance (mushrooms and eggs)
- Vitamin C boosts immunity (dog rose and citrus fruits)
- Omega-3 lowers testosterone levels, regulates the menstrual cycle, and improves skin and hair condition (fish oil, fatty fish, seafood, flaxseed, chia seeds, and walnuts)
- Folic acid increases fertility (green fruits and vegetables)
- Zinc prevents the accumulation of dihydrotestosterone (formed from testosterone) that provokes hair loss (seafood)
- Magnesium improves metabolism and helps fight stress (beans, sesame seeds, and pumpkin seeds)
- Chromium regulates blood sugar levels (spinach, peanuts, sesame, and beets)
The dosage of the supplements and the course of administration must be prescribed by a doctor. Self-medication can be dangerous.