The Hormonal Rollercoaster|Polycystic ovarian syndrome|Sings|Investigations|Treatment

 

Polycystic ovary

Polycystic ovarian syndrome

Polycystic Ovary Syndrome (PCOS)  a hormonal disorder that causes the growth of multiple small cysts on the ovaries(cystic ovaries), which can lead to irregular periods, excess androgen production, and infertility. It is a common health condition that usually affects  women in reproductive age.

According to a systematic review and meta-analysis published in the European Journal of Endocrinology in 2018, the overall prevalence of PCOS in women aged 15-49 years was 10%. The prevalence of PCOS was highest in the Middle East (19%), followed by Asia (11%), Europe (10%), North America (8%), Australia (7%), and South America (5%).

Female ovaries 

The ovaries are a pair of reproductive organs in the female body that produce eggs and sex hormones, including estrogen, progesterone, and testosterone(low levels physiologically). These hormones play important roles in regulating the menstrual cycle, supporting pregnancy, and maintaining bone and cardiovascular health. The ovaries are also responsible for the development and release of an egg each month in a process called ovulation. 

PCOS causes

The exact cause of PCOS is not fully understood, but it is believed that the condition may be related to abnormal insulin levels in the body. Insulin resistance, a condition in which the body is unable to use insulin effectively to regulate blood sugar levels, is commonly observed in women with PCOS. When the body is unable to use insulin properly, it produces more insulin to compensate, which can lead to the production of excess androgen hormones by the ovaries via hypothalamus pituitary ovarian axis involvement.

Studies have found that insulin resistance and high levels of insulin in the body may be a key factor in the development of PCOS.

Genetics also play a role in the development of PCOS, as the condition tends to run in families. 

Other factors that may contribute to the development of PCOS include obesity, sedentary lifestyle, and exposure to certain environmental toxins. 

While the exact cause of PCOS is not fully understood, research suggests that a combination of genetic, environmental, and lifestyle factors may interact to increase the risk of developing the condition.

Symptoms and signs of PCOS

Here are some of the common symptoms and signs of PCOS

Irregular periods: Women with PCOS may experience irregular or missed periods, or may have very heavy or prolonged periods.

Excess hair growth: Women with PCOS may experience excess hair growth on their face, chest, back, or buttocks. This is due to the increased production of androgens, or male hormones, by the ovaries.

Acne: PCOS can cause acne, particularly on the face, chest, and upper back. The excess androgen production can also cause oily skin and hair.

Male-pattern baldness: Women with PCOS may experience hair thinning or baldness on the scalp, similar to male-pattern baldness.

Weight gain: Women with PCOS may struggle with weight gain, particularly in the abdominal area.

Difficulty getting pregnant: PCOS is a common cause of infertility, as it can disrupt ovulation and make it more difficult to conceive.

Darkening of the skin: PCOS can cause areas of skin to darken, particularly in the neck, groin, and under the breasts

Mood changes: Women with PCOS may experience mood swings, depression, or anxiety.

Sleep apnea: PCOS is associated with an increased risk of sleep apnea, a condition in which breathing is temporarily interrupted during sleep.

Headaches: Women with PCOS may experience frequent headaches or migraines.

Insulin resistance: PCOS is often associated with insulin resistance, which can lead to high blood sugar levels and an increased risk of developing type 2 diabetes

High blood pressure: Women with PCOS may have higher than normal blood pressure, which can increase the risk of cardiovascular disease.

It is important to note that not all women with PCOS will experience all of these pcos symptoms.

PCOS diagnostic investigations

When diagnosing Polycystic Ovary Syndrome (PCOS), healthcare providers may conduct several investigations to rule out other conditions and determine if the patient meets the diagnostic criteria for PCOS. Here are some of the investigations that may be performed:

Medical history: The healthcare provider may ask about the patient's medical history, including any previous diagnoses and symptoms.

Physical examination: The healthcare provider may perform a physical examination to check for signs of PCOS, such as excess hair growth or acne.

Blood tests: Blood tests may be performed to check hormone levels, including testosterone and luteinizing hormone (LH). Blood glucose and cholesterol levels may also be checked.

Pelvic ultrasound: An ultrasound of the pelvis may be performed to check for cysts on the ovaries.

Glucose tolerance test: A glucose tolerance test may be performed to check for insulin resistance and prediabetes.

Thyroid function test: A test to check thyroid function may be performed to rule out thyroid disorders that can mimic PCOS symptoms.

Magnetic resonance imaging (MRI): An MRI may be used to obtain detailed images of the ovaries and check for cysts or other abnormalities.

Androgen-secreting tumor testing: If a healthcare provider suspects an androgen-secreting tumor is the cause of high androgen levels, testing may be performed to check for the presence of the tumor.

Genetic testing: In rare cases, PCOS may be caused by a genetic condition, and genetic testing may be used to identify any underlying genetic abnormalities

Transvaginal ultrasound: In some cases, a transvaginal ultrasound may be performed to obtain more detailed images of the ovaries and check for cysts.

Endometrial biopsy: An endometrial biopsy may be performed to check for abnormal cells in the lining of the uterus, which can be a sign of hormonal imbalances associated with PCOS.

Hormone challenge test: In some cases, a hormone challenge test to check how the body responds to different hormones.

It is important to note that not all of these investigations may be necessary for every patient and that the specific investigations performed may vary based on the individual circumstances and signs of pcos in individual .

PCOS Treatment

The treatment of Polycystic Ovary Syndrome (PCOS) focuses on managing symptoms and reducing the risk of long-term health problems, such as diabetes and heart disease. The specific treatment plan will depend on the patient's individual circumstances and symptoms. Here are some common treatments for PCOS:

Lifestyle changes: Making lifestyle changes, such as maintaining a healthy diet and exercise routine, can help manage weight, reduce insulin resistance, and regulate menstrual cycles.

Medications: There are several medications that may be used to treat PCOS symptoms, including

Birth control pills or other hormonal contraceptives to regulate menstrual cycles and reduce androgen levels.

Metformin, a medication used to treat type 2 diabetes, which can help reduce insulin resistance and regulate menstrual cycles.

Clomiphene citrate, a medication used to induce ovulation in women trying to conceive.

Letrozole, another medication used to induce ovulation

Anti-androgen medication: If excessive hair growth or acne is a symptom of PCOS, anti-androgen medication may be prescribed to reduce the effects of androgen hormones.

Surgery: In rare cases, surgery may be recommended to remove cysts or other abnormalities in the ovaries.

Fertility treatments: For women trying to conceive, assisted reproductive technologies, such as in vitro fertilization (IVF) or intrauterine insemination (IUI), may be recommended.

PCOS treatment is often a lifelong process that may involve a combination of treatments. Regular follow-up with a healthcare provider is important to monitor symptoms and adjust treatment as necessary. Additionally, lifestyle changes, such as maintaining a healthy diet and exercise routine, can help manage symptoms and improve overall health.

PCOS complications

Polycystic Ovary Syndrome (PCOS) can lead to several complications.

Infertility: PCOS can cause irregular or absent menstrual periods, making it more difficult to become pregnant. Additionally, high androgen levels can interfere with ovulation.

Diabetes: Insulin resistance, which is common in PCOS, can lead to prediabetes and type 2 diabetes.

Metabolic syndrome: PCOS is often associated with metabolic syndrome, a cluster of conditions that increase the risk of heart disease, stroke, and diabetes.

Sleep apnea: Women with PCOS are at an increased risk of sleep apnea, a condition that causes interrupted breathing during sleep.

Depression and anxiety: Women with PCOS may be at an increased risk of depression and anxiety, in part due to the hormonal imbalances and associated symptoms.

Endometrial cancer: Prolonged or irregular menstrual cycles, which are common in PCOS, can increase the risk of endometrial cancer.

Regular follow-up care and monitoring can help prevent or identify any potential complications.