Everything You Need To Know About Polycystic Ovary Syndrome (PCOS)

Pooja Maheshwary , 29 Sep 2020

PCOS is the most common hormonal disturbance in women of reproductive age. It is estimated that one in five women in India suffers from this condition. And since September is PCOS Awareness Month, we thought we should try to get a better understanding of it and how to manage it in the best way possible along with expert guidance and inputs.

So, we reached out to Dr Roshani Sanghani, Endocrinologist, to know everything about PCOS. Dr Roshani shared the causes, symptoms, risk factors, diagnosis and treatment of PCOS. Scroll down to read all about it.

Causes Of PCOS

PCOS Awareness Month (Image Courtesy: Shutterstock)
PCOS Awareness Month (Image Courtesy: Shutterstock)

The exact cause of PCOS is not clear. However, it is linked to insulin resistance which has a genetic tendency as well as many lifestyle factors. 

Symptoms Of PCOS

Polycystic Ovary Syndrome (PCOS) By Alena Menshikova | www.shutterstock.com
Polycystic Ovary Syndrome (PCOS) By Alena Menshikova | www.shutterstock.com

The symptoms are of two categories. First, let’s talk about what is more obvious to the woman: male and female hormone imbalance. The second is related to the actual underlying cause that is, insulin resistance. 

Symptoms of male-female hormone imbalance include:

  • Irregular periods
  • Irregular ovulation 
  • Reduced fertility 
  • Acne or boils 
  • Hirsutism, that is thick dark hair on areas where women normally have fine hair 
  • Male pattern balding (androgenic alopecia)
  • Greasy scalp 
  • Greasy skin
  • Tendency for dandruff
  • Mood swings
  • Reduced sex drive or libido
  • If the woman does not have periods for many months at a time then there can be an unhealthy uterus lining (endometrium), and 
  • Loss of bone density (osteoporosis) in the long run 

The main female hormones are estrogen and progesterone and the male hormones are testosterone, dihydrotestosterone, DHEAS androstenedione. The pituitary hormones that govern these are LH and FSH.

The symptoms of insulin resistance include:

  • Weight gain especially as inches around the waist 
  • Obesity, although there are women with lean PCOS who have normal weight)
  • Darkening and thickening of the skin in the folds of the neck, armpit and groin (acanthosis nigricans)
  • High triglycerides
  • High blood pressure
  • High uric acid
  • Fatty liver
  • High fasting blood sugar 
  • Gestational diabetes
  • Diabetes
  • As age advances, there’s an increased risk of cardiac disease and endometrial cancer if there were many years of less than 6 periods per year

Diagnosis Of PCOS

Period By Anna Schlosser | www.shutterstock.com
Period By Anna Schlosser | www.shutterstock.com

To make a correct diagnosis of PCOS, an endocrinologist needs to ensure there is no overlap with two rare conditions that can look just like PCOS. This is done by checking 17 hydroxyprogesterone and screening for excessive cortisol secretion. Once these two conditions are ruled out, you can check if the woman has:

  1. Less than six menstrual periods in a year.
  2. Ultrasound (sonography) confirmation of PCOS: immature follicles arranged in a classic pattern of a string of pearls along the border of both ovaries which are also bulky in size.
  3. Excessive male hormone effect (hyperandrogenism)
    • Clinical symptoms of acne, hirsutism, male pattern balding, or
    • Biochemical confirmation of high levels of male hormone on blood testing done in the follicular phase that is the second to the sixth day of the period. If you’ve not been getting periods at all for many months then you can do the blood test at any time without waiting for the next.

In case the woman has two out of the three symptoms mentioned above, she can be diagnosed with PCOS.

Treatment Of PCOS

PCOS Diet Plan (Source: www.shutterstock.com)
PCOS Diet Plan (Source: www.shutterstock.com)

Lifestyle is of utmost importance even if there is a genetic tendency. PCOS is a syndrome, not a disease. It’s something that can be managed and people can live very well even if they have been given this diagnosis. Even if there is a genetic tendency a teenager or a young woman has the ability to take her health in her hands. 

The main pillars of treatment are to fix nutrition by: 

  • Going low carbohydrate without dieting, because dieting is not sustainable.
  • Improving the quality and quantity of sleep. Using social media or studying for exams late at night is bad for skin and hormones.
  • Healthy stress management techniques as chronic stress cause hormone imbalance.
  • A balanced exercise that also focuses on building muscle mass.
  • In some cases, if the patient is overweight, they can follow intermittent fasting under the doctor’s supervision to reverse insulin resistance while making sure their nutrition is balanced. Fasting often doesn’t work for many women but correcting the imbalances in nutrition, sleep, exercise or stress management enables fasting without any issues.

Dr Roshani says,

It’s best to treat PCOS at the root. By working this way we have seen amazing results with our patients and it has been so rewarding to see their skin clear and menstrual cycles improve while getting them off medication. The ones who want to plan babies even conceive! So, have faith ladies, you can conquer your PCOS and have a healthy life. You deserve it!

What worked for you in managing your PCOS symptoms? Please share it with us in the comments below!

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