Polycystic ovarian syndrome (PCOS): Everything you need to know about the symptoms, effects, treatment

There have been innumerable cases of PCOS that have come to light in the recent past. Quite a common health condition these days, PCOS leads to hormonal imbalance which can have long term effects and can put a woman at higher risk of several diseases, when left unattended. While the symptoms of PCOS includes obesity, infertility, acanthosis, irregular menstruation cycle and skin issues, it is generally seen among women who are in their reproductive age -- 20s or 30.

Meanwhile, celebrities like Sara Ali Khan and most recently Bigg Boss 13 fame Himanshi Khurana have opened up about their struggles with the disorder. While Sara spoke entivesly about her struggles and weight issues, Himanshi will reportedly be undergoing surgery since her condition has worsened with time.

So, to shed more light on what PCOS is, its symptoms, causes and treatment, DNA exclusively spoke to two doctors, Dr. Archana Dhawan Bajaj, Gynecologists and Obstetrician and IVF Expert, Nurture IVF Centre and Dr Tripti Raheja, Senior Consultant Gynecologist/Obstetrician at Fortis Shalimar Bagh, Delhi, who spoke extensively on the subject.  

What is Polycystic Ovarian Syndrome (PCOS) is?

According to Dr Tripti Raheja, "Women with PCOS produce higher than normal amounts of male hormones. This hormone imbalance causes an ovulation and makes them to skip menstrual periods, in turn, making it harder for these women to conceive." 

Dr Archana explains, "Polycystic ovarian syndrome (PCOS) is a health disorder in which several small, fluid-filled sacs called cysts develops in the ovaries. No ovulation takes place in a woman with PCOS and create problem during childbearing years. It is a condition that affects a woman’s hormone levels. PCOS affects ovaries, women’s reproductive organ that produce estrogen and progesterone — hormones that balance the menstrual cycle. The ovaries also produce male hormones called androgens but in a small amount. Extra androgens disrupt the cycle, so women with PCOS face irregular menses."

- There are two type of hormones which creates right environment for ovulation.  Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) control ovulation. FSH stimulates the ovary to produce a sac that contains an egg known as follicle, and then LH strikes the ovary to release a mature egg, due to PCOS these eggs never mature enough to trigger ovulation.

While speaking about it's symptoms, the doctors mentions that it is mainly associted with irregular periods and obesity.

Symptoms 

- PCOS is mainly associated with obesity and includes symptoms like irregular or delayed periods, weight gain, baldness, acne, heavy bleeding, hirsutism and darkening of skin. It can contribute in other long term health problems like diabetes and heart diseases, hyperlipidemia, endometrial hyperplasia. 

Further explaining the casues, Dr Archana stated that 'insulin resistance' was one of the many causes, while Dr Tipti said that although exact cause is not known, it could be genetic, because of sedentary lifestyle or obesity.

Causes

Insulin resistance: Insulin is a hormone the pancreas secretes to help the body use sugar from foods to produce energy. Women with PCOS have insulin resistance, which means that their cells can’t use insulin properly. When cells can’t use insulin properly, the body increases demand for insulin. Extra insulin triggers the ovaries to produce more male hormones.

Genes: PCOS isn’t a new syndrome, it hadn’t been diagnosed easily. If someone's family is facing obesity and diabetes from many generations then chances of having PCOS are high. 

Inflammation: Being overweight can also contribute to inflammation and have all been linked to excess androgen production. 

Effects 

- Infertility: PCOS is one of the leading cause of Infertility as PCOS women are unable to ovulate due to extra androgen secretion in the body. 

- Metabolic Syndrome: Most women with PCOS are obese and at higher risk of high blood pressure, hyperlipidemia and high blood sugar, all these factors increase the risk for heart diseases and strokes. 

- Endometrial Cancer: During ovulation, the uterine lining sheds. If you don’t ovulate every month, the lining can build up. A thickened uterine lining increases your risk for endometrial cancer. 

- Depression: Both hormonal changes and symptoms like baldness, irregular menses can negatively affect your emotions. Many women with PCOS end up experiencing depression and anxiety.

Sharing tips on how to treat PCOS at home, both Dr Archana and Dr Tripti said that one must begin with a change in lifestyle and losing those extra kilos. 

Treatment at home

- Treatment for PCOS starts with change in lifestyle like weight loss, diet, and exercise. Losing just 7 to 10 percent of your body weight can help in regulating menstrual cycle and improving PCOS. Weight loss can also lower risk of diabetes, it improves cholesterol levels, lower insulin, and reduces risk of heart disease. 

- Low-carbohydrate diets are effective for both weight loss and lowering insulin levels and helps in control PCOS symptoms. A low glycemic index (low-GI) diet that gets most carbohydrates from fruits, vegetables, and whole grains helps in regulating the menses better than a regular weight loss diet.

- 30 minutes of moderate-intensity exercise at least three days a week can help women with PCOS to lose weight which improves ovulation and insulin levels. 

Medical Treatment

- There are many medical treatments for PCOS like birth control pills – taking estrogen and progestin daily can balance normal hormone. It can regulate ovulation, protect against endometrial cancer. 

- Metformin – change in diet and exercise along with metformin improves weight loss, lowers blood sugar, and regulates menstrual cycle. 

- Surgery - to improve fertility, when other methods don’t work. Ovarian drilling is a procedure that makes tiny holes in the ovary with a laser or thin heated needle to restore normal ovulation.