Polycystic Ovarian Syndrome (PCOS): Causes, Symptoms and Treatment - Carefirst: Online Doctor Consultation

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• By Dr. Ambika Shankar (MBBS, MS Obstetrics and
  Gynecology), Senior Consultant (Obstetrics and
  Gynecology). Dr. Ambika Shankar has expertise in
  High-risk Obstetrics, Contraception and Family
  planning, Hormonal problems like PCOS, Adolescent
  and menopausal issues, Menstrual problems- heavy
  menstrual bleeding, irregular periods, painful
  periods, missed periods, etc, Foetal medicine,
  Advanced Obstetric and Gynae ultrasonography and
  Infertility.
• What is Polycystic Ovarian Syndrome (PCOS)/PCOD
• Have you ever had trouble losing weight or suffer
  from anxiety or depression? Have you experienced
  chronic acne, put up with troublesome periods, or
  even experienced infertility?
• If you are facing a combination of these
  symptoms, you may be suffering from PCOS
  (Polycystic Ovarian Syndrome). Every other woman
  coming to a gynecologist nowadays has PCOS.
• Polycystic Ovarian Syndrome (PCOS) is a problem
  with hormones that happens during the
  reproductive years. Polycystic ovarian syndrome
  is the most common endocrinopathy affecting
  4-12 of the reproductive age group women. It not
  only has an adverse effect on fertility but also
  on the quality of life. In fact, South Asian
  women are more predisposed. In India, the
  prevalence is 4 - 22.
• What is PCOS?
• PCOS or polycystic ovarian syndrome is a disorder
  where the ovaries fail to release an egg every
  28-35 days i.e., there is no ovulation causing
  accumulation of unruptured follicles giving its
  characteristic appearance polycystic. As a
  result, the ovaries produce an excess of only
  certain hormones estrogen and androgens causing
  menstrual irregularities and a plethora of other
  symptoms, which well talk about in the post.
• It is mainly caused due to imbalance in the
  hormones in the hormonal axis involving our
  hypothalamus, pituitary, and ovaries these are
  the organs producing the hormones needed to
  maintain a normal menstrual cycle.
• Are PCOS and PCOD different?
• Polycystic Ovarian Syndrome (PCOS) or Polycystic
  ovarian disease (PCOD). People confuse these two
  conditions to be different. However, PCOS was
  earlier referred to as
• PCOD.

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• known as a polycystic ovarian disease (PCOD). A
  significant percentage of the female population
  showed symptoms of androgen excess, such as
  hirsutism, acne, and oily skin. Many women also
  had associated insulin resistance, excess insulin
  levels in the blood, and excess levels of
  cholesterol. Given this condition had
  multi-systemic involvement, it was re-termed as
  Polycystic Ovarian Syndrome (PCOS)
• What causes PCOS in women? Causes of PCOS
• Polycystic Ovarian Syndrome is caused by a
  hormonal imbalance that affects various processes
  in the body. At this point, we do not fully
  understand what initially contributes to the
  imbalance. However, certain factors predispose a
  woman to develop PCOS.
• Family history-polygenic genetic predisposition.
• Insulin resistance when the cells in your
  muscle and liver dont respond to the hormone
  insulin secreted by your pancreas, it leads to
  high levels of unused sugar in the blood and can
  be a risk factor for developing PCOS.
• Obesity or higher than normal body weight also
  predisposes to PCOS
• Stress affects the hypothalamic-pituitary-ovarian
  axis and disrupts the normal menstrual cycle.
• You may have the genetic predisposition but its
  your lifestyle that precipitates it.
• So, how do you know that you have PCOS?
• Symptoms of PCOS
• Irregular periods your menstrual cycle is not
  regular, and you may skip your periods in
  between or might have them twice in a month
• Long prolonged periods of missed periods followed
  by heavy bleeding or scantly bleeding
• Unusual gain in weight. And the difficulty in
  losing weight
• Sudden periods of intense craving for food

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though signs of extra androgen and menstrual
abnormalities must be present as well. Some
women with PCOS do not have cystic ovaries at all.

• Complications of PCOS
• Higher than normal levels of estrogen and
  androgens (male hormones) for long associated
  with PCOS can lead to complications like
• Abnormal uterine bleeding bleeding from the
  uterus other than your periods or bleeding that
  lasts longer than usual
• Infertility or inability to conceive despite
  carefully timed unprotected sex for a year or
  longer
• Repeated miscarriages
• Increased risk for high blood pressure, high
  blood sugar, and heart diseases
• Sleeping disorder where breathing starts and
  stops repeatedly while you are in bed, known as
  sleep apnea
• Depression, persistent feelings of sadness and
  loss of interest in life and other activities,
  which seriously impairs day-to-day life
• Endometrial cancer cancer affecting the inner
  lining of the womb

Pregnancy PCOS PCOS is one of the common
reasons for difficulty in conception by women.
Thats because ovaries are not releasing eggs
every cycle due to hormonal imbalance. when there
is no egg, how can you get pregnant? However,
with the right treatment, women with PCOS can get
pregnant and deliver a healthy baby. A study
revealed a 44.6 success rate in pregnancy with
PCOS.
How do you treat PCOS? Though there is no
permanent cure for PCOS, there are various ways
to manage the symptoms and control the
complications. Lifestyle changes remain the
mainstay of treatment as mentioned
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• below. If you are obese or overweight maintaining
  a healthy weight through food and exercise is
  crucial even a 5 10 weight reduction can make
  a major impact
• Regular exercise for 30-40 minutes every day can
  manage weight and mood issues associated with
  hormonal imbalances in PCOS. Choose exercises of
  your choice like yoga, Pilates, brisk walking,
  etc.
• 8 hours of sleep.
• Eat a diet rich in whole grains, fruits, and
  vegetables, and low in processed products can
  help keep your blood sugar low.
• Include lots of fruits like oranges, cherries,
  blueberries, and green vegetables in your diet.
  Nuts like almonds and pistachios are also healthy
  sources of fiber
• Opt for whole grains to regulate your blood sugar
  and get healthy carbs
• Consume fish high in Omega-3 fatty acids like
  salmon, mackerel, and sardines
• Avoid foods rich in refined carbohydrates like
  white bread and muffins, sugar-laden food and
  drinks, processed and red meat, and foods made
  with white flour
• Always read your food labels while buying them
  and beware of sugars various names like
• fructose, sucrose, dextrose, and high fructose
  corn syrup. Avoid buying such food items.
• Adopting a disciplined and healthy lifestyle is
  the way to control PCOS. It needs a lot of
  determination, but the devil called PCOS can be
  controlled when we control our vices.
• The right diagnosis and the right treatment are
  needed with consistency and PCOS has both
  short-term and long-term effects.
• What should you do if you suspect you have PCOS?
• You may make an appointment with your doctor and
  discuss the symptoms and the challenges being
  faced. Your doctor may like to order some blood
  tests to assess your hormone levels. PCOS may
  sometimes need short-term implementation of
  hormonal supplements. with proper treatment,
  women can usually manage their symptoms, and many
  are able to get pregnant if they decide to do so.

Book an appointment for a virtual consultation
with our experienced gynecologists at CareFirst
for understanding and manage your menstrual
problems.