PCOS or Polycystic Ovary Syndrome is a common hormonal disorder that is said to affect menstruating women between 11 to 45 years of age. Dr Priyanka Batra, Senior Consultant, Gynaecology and Gynae Oncology, Medanta – The Medicity, confirms that on a daily average, approximately 20 percent of the women she sees, come with signs and symptoms of PCOS. 

So, what is PCOS? It is a hormonal disorder that occurs when there is an imbalance in the level of estrogen and progesterone, the sex or reproductive hormones in a woman’s body. This imbalance creates cysts in the ovaries which disrupt its functions of making the egg, that is released each month during the menstrual cycle. With PCOS, the development of the egg can be disrupted or it may not be released during ovulation, as it should.

 

Doctors say PCOS is adversely affected by bad food habits, lack of exercise, mental stress, erratic sleep and meal timings which disturb the body clock. Hence social factors play an important role in the presentation and worsening of PCOS.

 

Factors That Escalate PCOS

 

Family history:

If immediate family members have PCOS, there are higher chances of being detected with it.

  
Insulin resistance:

Insulin is the hormone produced by the pancreas that converts sugar in the blood into stored energy. When the body becomes resistant to insulin, blood sugar levels stay high and the conversion to energy does not occur. This is a vicious cycle and leads to even more production of insulin. When the body secretes too much insulin, it activates more androgen (male hormone) production that may affect the ovaries. Ovulation or formation, growth and rupture or release of the egg may be impacted. 

 Obesity:

Excess fat in the body increases insulin resistance and leads to worsening of PCOS.

 

How Is PCOS Detected

Symptoms often start appearing when a girl hits puberty or a few years later. These symptoms differ from person to person; it must be remembered that each patient is unique and may have some complaints, but not all of them.

 
Common reasons young girls and women seek medical help for are:

 

 

• Irregular, delayed or heavy periods
• Abnormal and excessive hair growth on the face, breasts, mid line of the stomach, back, thumbs, or toes (also known as hirsutism)
• Scalp hair loss
• Pigmentation around the base of the neck
• Weight gain
• Acne
• Infertility 

Hormone levels, diabetes and lipid profile screenings and tests such as ultrasounds must be done to support the diagnosis. The clinical presentation combined with test results often confirms the diagnosis of PCOS.

 

Complications of PCOS 

If PCOS remains undetected and untreated, there are certain long-term complications. These include:

 

 

• Diabetes
• High blood pressure
• Anovulation (failure of the ovaries to release egg cells)
• Infertility
• Unusual uterine bleeding
• Depression and anxiety
• Obesity
• Uterine cancer

 

 

How is PCOS managed?

Amid talking to two young women diagnosed with PCOS, Dr Shradha Chaudhari, Senior Consultant, Gynaecology and Gynae Oncology, Medanta clears the air about this disorder. PCOS is chronic in nature just like diabetes and blood pressure. It cannot be cured. However, it can be ‘managed and controlled.’

Dr Chaudhari says there are six main mantras every PCOS patient must follow.

 

Weight control

 

Since weight gain worsens PCOS, it is advised to keep weight in check. Doctors say that more often than not, menstrual cycles get somewhat regulated once women maintain healthy weight. Body mass index (BMI) must be around 22.

 

Regular lifestyle

This means eating and sleeping at a regular time on a daily basis. Creating a timetable helps. Fixed meal timings and sleep/wake timings allow the body to secrete hormones in the correct amounts, at the right time.

 

Exercise

 

Taking up any physical activities like swimming, cycling, walking will help the body. One must dedicate at least 30 minutes daily to a good physical workout.

 

Diet

 

Diet and nutrition play a vital role in managing this disorder. Dr Chaudhari believes that a healthy diet plan along with a dietician’s advice can help women with PCOS to understand foods that are good or bad for them.

 

Stress reduction

 

Mental and physical stress can cause hormones to be secreted in an erratic fashion, worsening signs and symptoms of PCOS. Effort must be made to reduce this trigger.

 

Menstrual calendar

It is important to know that one must not wait for periods endlessly. Periods should happen at least once in 60 days. Women who do not get periods for long intervals are at higher risk of developing uterine cancer in later life.

 

Role of Medication

According to Dr Chaudhari, medications for this disorder are tailored as per each patient’s needs. Medicines can be used to induce periods, regularize periods, control acne and unwanted body hair and keep blood glucose and insulin levels in check. It must be remembered that while on medicines, there will be relief. However, on stopping medicines, symptoms reappear. Girls require medication for period issues, weight issues and for unwanted body hair and acne. If planning a baby, a woman may need expert opinion and assisted reproductive techniques. However, spontaneous conception is not uncommon among women with PCOS.

Women with heavy or prolonged periods must seek the opinion of a gynaecologist. Diabetes and a deranged lipid profile (excess levels of cholesterol and triglycerides levels) must be watched for and screened annually.

To summarize, Dr Chaudhari adds that being aware of PCOS and good self-discipline is the key to its successful management throughout life.