Polycystic Ovarian Syndrome (PCOS) is a disorder that affects over 10% of women of reproductive age. Its exact cause is unknown, but it causes the ovaries to develop numerous follicles (collections of fluid that surround the eggs) without releasing them regularly.
The signs and symptoms of PCOS center around 3 key features: Irregular periods (too few times, too far in-between and too heavy); excess androgen levels (excess hair on the face and body, darkening of the skin, severe acne and male pattern baldness) and polycystic ovaries (enlarged ovaries with many follicles).
Common factors that increase the risk of PCOS are insulin resistance, high levels of insulin, obesity and genetics.
Diagnosis of PCOS is made using blood tests and radiological tests. The blood tests used are thyroid functions tests, serum prolactin and testosterone levels, serum insulin and insulin-like growth factor 1 levels, lipid panels, glucose levels, Follicular stimulating and luteinizing hormone levels. The radiological tests available include trans-vaginal ultrasonography and pelvic CT scan/ MRI.
Upon diagnosis of PCOS, there are four lines of management: lifestyle modification, medical treatment, supportive treatment and surgical treatment. The lifestyle modifications are a low-carbohydrate high-fiber diet, thrice-weekly moderate-intensity exercise and loss of 5 – 10% of body weight.
Medical management involves the use of oral contraceptives to induce regular menses, androgen-blocking agents to reduce the effects of excess testosterone, anti-hyperglycemic agents to lower blood sugar levels, ovulogens to induce ovulation if fertility, and acne medications.
Supportive treatments include tweezing, shaving, waxing, threading and laser removal of excess hair. Surgical therapy involves either laparoscopic ovarian drilling of the ovary or cutting off pieces of the ovary.
The most important aspect of PCOS is to establish an early diagnosis and institute treatment early in order to avoid a myriad of potential complications such as infertility, gestational diabetes, high blood pressure, pre-eclampsia, premature birth, early pregnancy loss, fatty liver, syndrome X, Type 2 diabetes, sleep apnea, depression, anxiety and cancer of the endometrium. Of these complications, difficulty in conceiving is the most common, affecting up to 80% of patients with PCOS.
Overall, PCOS is a condition that significantly disrupts a woman’s life and reproductive career. However, the silver lining lies in the potential for early diagnosis and effective treatment in order to avoid the numerous undesired effects.
If you suspect that you or those around you may have PCOS, seek the attention of your gynecologist as soon as possible so that treatment can be instituted as early as possible.