Understanding Polycystic Ovary Syndrome (PCOS): Causes, Symptoms, and Management

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects women, primarily in their reproductive years. According to the World Health Organization, PCOS affects 8-13% of reproductive-age women worldwide.  PCOS is characterized by a range of symptoms and can have significant implications for a women’s overall health and well-being.

What is PCOS?

PCOS is a complex hormonal disorder that involves an imbalance of sex hormones, specifically an excess of androgens (male hormones) in the female body. This hormonal imbalance disrupts the normal function of the ovaries and can lead to various physical and emotional symptoms. PCOS is often associated with enlarged ovaries containing small, fluid-filled sacs called cysts, which can be seen on an ultrasound, although not all individuals with PCOS will have these cysts.

Causes of PCOS

The exact cause of PCOS is not fully understood, but it is believed to be influenced by a combination of genetic and environmental factors. Insulin resistance, where the body’s cells don’t respond effectively to insulin, is also often a contributing factor. This can lead to elevated insulin levels, which in turn trigger the ovaries to produce excess androgens.

Symptoms of PCOS

PCOS can manifest differently in each individual, and not all symptoms may be present. Common signs and symptoms of PCOS include:

1. Irregular Menstrual Periods: Women with PCOS often experience irregular, infrequent, or prolonged menstrual cycles.
2. Excessive Hair Growth: Due to elevated androgens, individuals with PCOS may develop excess hair on the face, chest, back, or abdomen (hirsutism).
3. Acne and Oily Skin: Increased androgens can lead to acne and oily skin.
4. Scalp Hair Thinning: Some women may notice thinning hair on their scalp, similar to male pattern baldness.
5. Weight Gain: Many individuals with PCOS struggle with weight gain and obesity, which can exacerbate other symptoms and increase the risk of other health issues.
6. Difficulty Getting Pregnant: PCOS is a common cause of infertility due to irregular ovulation or lack of ovulation.
7. Mood Changes: Hormonal fluctuations in PCOS can lead to mood swings, anxiety, or depression.

Diagnosis

Diagnosing PCOS typically involves a combination of medical history, physical examination, blood tests, and imaging studies, such as pelvic ultrasounds. To meet the diagnostic criteria for PCOS, a person must exhibit two out of the following three features:

1. Irregular menstrual cycles or anovulation (lack of ovulation).
2. Clinical or biochemical signs of hyperandrogenism (elevated male hormones).
3. Polycystic ovaries observed on ultrasound.

Management and Treatment

PCOS cannot be cured, but its symptoms can be managed effectively. Treatment aims to alleviate specific symptoms and reduce the risk of long-term health complications. The management options may include:

1. Lifestyle Modifications: Adopting a healthy diet, engaging in regular physical activity, and maintaining a healthy weight can help improve insulin sensitivity and reduce symptoms.

A dietician can assist you with making the necessary diet and lifestyle changes to assist you with managing PCOS.

Did you know that overweight women can significantly improve their PCOS symptoms by losing only 5% of their body weight?  Weight loss can be achieved with a portion-controlled,  balanced diet consisting of:

• plenty of fruit and vegetables,
• wholegrain, low GI carbohydrates
• lean protein such as fish and chicken

PCOS and its medical management are also associated with certain nutrient deficiencies.  A dietician will be able to help you navigate this with the necessary dietary changes and supplementation.

2. Hormonal Birth Control: Oral contraceptives can regulate menstrual cycles, reduce androgens, and alleviate hirsutism and acne.
3. Anti-Androgen Medications: Medications like spironolactone can help reduce excessive hair growth and acne.
4. Fertility Treatments: For those trying to conceive, fertility medications and assisted reproductive technologies (ART) may be recommended.
5. Diabetes Medications: Metformin may be prescribed to manage insulin resistance and lower insulin levels.
6. Psychological Support: Addressing emotional and mental health concerns through therapy or counselling can be essential for overall well-being.

The bottom line is that PCOS may disrupt a women’s menstrual cycle and impact their chances of falling pregnant.  It is also associated with many unwanted symptoms that may affect their self-esteem and their sense of well-being.  Lifestyle modifications with a focus on diet can assist in managing the condition and reducing symptoms.