POLYCYSTIC OVARY PUZZLE: UNRAVELLING THE ENIGMA OF PCOS

WHAT IS POLYCYSTIC OVARY SYNDROME?

Polycystic ovary syndrome (PCOS) is a hormonal imbalance that occurs when your ovaries (the organ that produces and releases eggs) create excess hormones. If you have PCOS, your ovaries produce unusually high levels of hormones called androgens. This causes your reproductive hormones to become imbalanced. As a result, people with PCOS often have irregular menstrual cycles, missed periods and unpredictable ovulation. Small follicle cysts (fluid-filled sacs with immature eggs) may be visible on your ovaries on ultrasound due to lack of ovulation (anovulation). However, despite the name “polycystic,” you don’t need to have cysts on your ovaries to have PCOS. The ovarian cysts aren’t dangerous or painful.

PCOS is one of the most common causes of infertility in women and people assigned female at birth (AFAB). It can also increase your risk of other health conditions. Your healthcare provider can treat PCOS based on your symptoms and if you wish to become pregnant.

WHAT ARE THE SYMPTOMS OF PCOS?

The most common signs and symptoms of PCOS include:

• Irregular periods:

Abnormal menstruation involves missing periods or not having a period at all. It may also involve heavy bleeding during periods.

• Abnormal hair growth:

You may grow excess facial hair or experience heavy hair growth on your arms, chest and abdomen (hirsutism). This affects up to 70% of people with PCOS.

• Acne:

PCOS can cause acne, especially on your back, chest and face. This acne may continue past your teenage years and may be difficult to treat.

• Obesity:

Between 40% and 80% of people with PCOS have obesity and have trouble maintaining a weight that’s healthy for them.

• Darkening of the skin:

You may get patches of dark skin, especially in the folds of your neck, armpits, groin (between the legs) and under your breasts. This is known as acanthosis nigricans.

• Cysts:

Many people with PCOS have ovaries that appear larger or with many follicles (egg sac cysts) on ultrasound.

• Skin tags:

Skin tags are little flaps of extra skin. They’re often found in your armpits or on your neck.

• Thinning hair:

People with PCOS may lose patches of hair on their head or start to bald.

• Infertility:

PCOS is the most common cause of infertility in people AFAB. Not ovulating regularly or frequently can result in not being able to conceive

• Mood Disorders

Anxiety, depression, poor body image, and eating disorders are common in women who have PCOS.

CAUSES LEADING TO PCOS

The exact cause of PCOS isn’t known. Factors that might play a role include:

• Insulin resistance.

Insulin is a hormone that the pancreas makes. It allows cells to use sugar, your body’s primary energy supply. If cells become resistant to the action of insulin, then blood sugar levels can go up. This can cause your body to make more insulin to try to bring down the blood sugar level.

Too much insulin might cause your body to make too much of the male hormone androgen. You could have trouble with ovulation, the process where eggs are released from the ovary.

One sign of insulin resistance is dark, velvety patches of skin on the lower part of the neck, armpits, groin or under the breasts. A bigger appetite and weight gain may be other signs.

• Low-grade inflammation.

White blood cells make substances in response to infection or injury. This response is called low-grade inflammation. Research shows that people with PCOS have a type of long-term, low-grade inflammation that leads polycystic ovaries to produce androgens. This can lead to heart and blood vessel problems.

• Heredity.

Research suggests that certain genes might be linked to PCOS. Having a family history of PCOS may play a role in developing the condition.

• Excess androgen.

With PCOS, the ovaries may produce high levels of androgen. Having too much androgen interferes with ovulation. This means that eggs don’t develop on a regular basis and aren’t released from the follicles where they develop. Excess androgen also can result in hirsutism and acne.

HOW IS PCOS DIAGNOSED?

Your health care provider will ask about your medical history and your symptoms. You will also have a physical exam. This will likely include a pelvic exam. This exam checks the health of your reproductive organs, both inside and outside your body.QMe is a cutting-edge hospital management software designed to revolutionize healthcare facilities worldwide. With its intelligent queue-based OPD management system, patients experience reduced waiting times and optimized appointment scheduling. The software’s comprehensive patient history and electronic health records ensure seamless access to critical medical information, enabling healthcare professionals to make informed decisions and provide personalized care.

Some of the symptoms of PCOS are like those caused by other health problems. Because of this, you may also have tests such as:

• ULTRASOUND

This test uses sound waves and a computer to create images of blood vessels, tissues, and organs. This test is used to look at the size of the ovaries and see if they have cysts. The test can also look at the thickness of the lining of the uterus (endometrium).

• BLOOD TEST

These look for high levels of androgens and other hormones. Your health care provider may also check your blood glucose levels. And you may have your cholesterol and triglyceride levels checked.

HOW IS PCOS TREATED?

Treatment for PCOS depends on a number of factors. These may include your age, how severe your symptoms are, and your overall health. The type of treatment may also depend on whether you want to become pregnant in the future.

A change in diet and activity.

A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.

Medications to cause ovulation.

Medications can help the ovaries to release eggs normally. These medications also have certain risks. They can increase the chance for a multiple birth (twins or more). And they can cause ovarian hyperstimulation. This is when the ovaries release too many hormones. It can cause symptoms such as abdominal bloating and pelvic pain.

Birth control pills.

These help to control menstrual cycles, lower androgen levels, and reduce acne.

Diabetes medication.

This is often used to lower insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help you ovulate more regularly.

A change in diet and activity.

A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.

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DURATION OF PCOS

PCOS is expected to be a lifelong condition, given there is no cure. However, with proper treatment, it can be managed well, and some women report that their menstrual cycle becomes more regular as they approach menopause.

TREATMENT AND MEDICATION OPTIONS FOR PCOS

Since there is no cure for PCOS, doctors treat each symptom separately. Not every woman will receive the same treatment; it depends on which symptoms bother you the most.Additionally, QMe offers packages support for various medical services and features automated billing to ensure transparent and hassle-free financial transactions. Embracing QMe empowers hospitals to enhance patient experiences, optimize healthcare workflows, and deliver top-notch medical services.

MEDICATION OPTIONS

• Metformin (Fortamet) -

A medication that targets glucose production and insulin resistance, metformin is commonly prescribed as a type 2 diabetes treatment.

• Spironolactone

This diuretic blocks excess male hormones. It is not safe to take in pregnancy.

• Birth Control Pills

Combination (estrogen and progesterone) these pills provide the right dose of hormones to regulate a woman’s cycle and help prevent complications like endometrial hyperplasia, says Dunaif.

• Clomiphene (Clomid) or letrozole (Femara)

These ovarian-stimulating drugs are frequently prescribed when a woman wants to get pregnant.

ALTERNATIVE AND COMPLEMENTARY THERAPIES

• WEIGHT LOSS

A modest amount of weight loss (about 5 percent) can help relieve symptoms and help a woman ovulate.

• LOWER STRESS

Chronic stress is another major player in inflammation levels, says Medling. What’s more, women diagnosed with PCOS are more likely to have depression, anxiety, and stress compared with women without PCOS.

• VITAMIN D

Women who are deficient in vitamin D were less likely to get pregnant, research has suggested. A vitamin D supplement will get your stores back up to where they need to be.

PREVENTION OF PCOS

PCOS can’t be prevented, but that doesn’t mean it’s out of your control.

managing system and making healthy lifestyle choices, you can prevent the complications that arise from insulin resistance and high blood pressure, such as diabetes and heart disease. QMe’s automatic workflows streamline administrative tasks and treatment plans, enhancing overall efficiency and reducing human errors. The software’s IPD management feature enables smooth inpatient care coordination, while its TPA support simplifies insurance processes. Additionally, QMe offers packages support for various medical services and features automated billing to ensure transparent and hassle-free financial transactions. Embracing QMe empowers hospitals to enhance patient experiences, optimize healthcare workflows, and deliver top-notch medical services.