Understanding Polycystic Ovarian Syndrome (PCOS): Causes, Symptoms, and Managing the Condition

Oct 30, 2024

3 min read

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Hormonal imbalance PCOS — Understanding PCOS: Symptoms, Causes, and Management.

What is PCOS?

Polycystic Ovarian Syndrome (PCOS) is one of the most common hormonal disorders affecting women of reproductive age, with approximately 10% of women worldwide experiencing it. PCOS occurs when the ovaries produce excessive amounts of male hormones (androgens), which can disrupt normal ovulation and lead to the development of multiple cysts in the ovaries.

While the term "polycystic" refers to the presence of cysts, not every woman with PCOS has ovarian cysts, and not every woman with cysts has PCOS.

Common Symptoms of PCOS

Women with PCOS can experience a wide range of symptoms, including:

Weight gain, especially around the abdomen - however many women have lean PCOS ( TOF - Thin Outside, Fat Inside)
Menstrual Irregularities:
- Irregular periods or no periods at all
- Heavy, light, or irregular periods
- Mid-cycle spotting
- Delayed or early periods (over 5 days off schedule)
Estrogen Dominance:
- Migraines or headaches
- Water retention and bloating
- Joint pain or body aches
- Mood swings, depression, or anxiety
- Tender, painful breasts
- Heavy or painful periods
Hyperandrogenism (Excess Androgen):
- Excess body hair (hirsutism)
- Hair thinning or loss
- Oily skin and acne
- Hidradenitis Suppurativa (painful boils in areas like the underarms, groin, or under the breasts)
Insulin Resistance:
- Dark patches of skin in areas like the neck, armpits, or groin (Acanthosis Nigricans), usually in skin folds
Reproductive Health:
- Infertility or difficulty conceiving
- Pregnancy complications: gestational hypertension, gestational diabetes, miscarriages, premature birth, and sleep apnea
Skin tags (small, benign growths) on the neck or armpits

Causes of PCOS

The exact cause of PCOS is still unknown, but several factors contribute to its development, including:

Insulin Resistance: Insulin, a hormone that helps cells use sugar for energy, can be less effective in women with PCOS. To compensate, the body produces more insulin, which leads to the production of more androgens, disrupting ovulation.
Genetics: PCOS tends to run in families, suggesting a hereditary link.
Hormonal Imbalance: High levels of androgens (male hormones) disrupt normal ovulation and menstrual cycles.
Excess Androgen: High androgen levels prevent regular ovulation and lead to symptoms like acne and hirsutism.
Inflammation & Oxidative Stress: Low-grade, chronic inflammation linked to excess androgen production.
Environmental Factors: Diet, stress, environmental toxins like Bisphenol A (BPA), and epigenetics can worsen or trigger PCOS.

Potential Complications of PCOS:

Nonalcoholic Steatohepatitis (NASH): Liver inflammation linked to obesity and insulin resistance.
Metabolic Syndrome: Includes high blood pressure, high blood sugar, and elevated cholesterol.
Cardiovascular Risks: Increased likelihood of heart disease.
Type 2 Diabetes or Prediabetes.
Endometrial Cancer: Due to irregular menstruation and unbalanced hormone levels.

Diagnosis of PCOS:

To diagnose PCOS, doctors may recommend the following tests:

Hormone level tests (FSH, LH, Prolactin, Testosterone)
Blood glucose and insulin levels (Fasting and Post-Prandial)
Ultrasound to examine the ovaries
People diagnosed with PCOS should undergo - Regular screenings for blood pressure, cholesterol, glucose tolerance, and mental health (depression, anxiety)

Managing PCOS:

Lifestyle Modifications:
- Prioritize Sleep: Consistent sleep schedules help regulate hormones.
- Yoga & Stress Management: Mind-body practices can reduce symptoms and improve mental health.
Dietary Changes:
- Foods to Eat: Lentils, broccoli, raw carrots, soy, inositol-rich foods.
- Foods to Avoid: White rice, cakes, cookies, fries, chips, high-glycemic fruits like pineapple or watermelon.
- Avoid BPA: Found in plastics and food packaging, it can exacerbate PCOS.
- Watch for Glycotoxins: These are found in processed meats, fried foods, and certain dairy products, and can worsen insulin resistance and inflammation.
Exercise:
- Aim for 150 minutes of moderate exercise or 75 minutes of intense activity weekly.
- Losing 5-10% of body weight can have a significant impact on PCOS symptoms.
Pharmacotherapy:
- Metformin: Helps improve insulin sensitivity.
- Spironolactone: Reduces excess androgen effects like hirsutism.
- Clomiphene: Used to induce ovulation.
- Oral Contraceptives: Regulate menstrual cycles and reduce androgen levels.
- Inositol Supplements: A natural option to improve insulin sensitivity and regulate cycles.
Emerging Therapies: Research suggests drugs like Simvastatin, Astaxanthin, and Berberine may help manage symptoms.
Cosmetic Treatments: Dermatological procedures for acne, hair thinning, and unwanted hair are available to manage cosmetic concerns related to PCOS. Work with a dermatologist to create a personalized plan.

Conclusion:

If you're experiencing symptoms of PCOS, early diagnosis and proactive management can greatly improve your health. By focusing on lifestyle changes, proper diet, regular exercise, and medical treatment, you can manage the symptoms and lead a healthier, more fulfilling life.

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