Women with PCOS do not ovulate regularly, which complicates conception – making it next to impossible to do so without medical intervention

‘Irregular periods’ is a term casually looked at. Perhaps, we need to zoom in a little. Polycystic Ovarian Syndrome (also known as Polycystic Ovarian Disease/ PCOD) at young age could also be of concern in later life.

What is Polycystic Ovarian Syndrome (PCOS)?

PCOS is a hormonal imbalance in women that occurs during their childbearing years of 15 to 44. Women with PCOS produce more male hormones than necessary and this throws their system off balance, delaying periods and making it difficult for them to conceive. PCOS can also lead to diabetes and weight gain.

A Close look at Hormonal Activity in Women

The two main female hormones are Progesterone and Oestrogen which are produced in the ovaries, along with a small amount of the male hormone Androgen. During ovulation, the ovaries release a mature egg into the fallopian tube. Should this egg go unfertilized, then the thick inner lining of the uterus is shed in the form of menstrual periods. However, in the case of a woman with PCOS, the hormonal imbalance results in the arrest of egg growth and thereby prevents ovulation. These result in follicles with immature eggs, seen as many small, fluid-filled sacs inside the ovaries (often referred as polycystic). Excess male hormones in PCOS prevents ovulation and thereby disrupt the menstrual cycle leading to delay/ lack of periods

Symptoms of PCOS

• One of the most common symptoms is IRREGULAR PERIODS. In many cases, women skip their menstrual periods altogether for months in a row, when they have PCOS.
• Heavy bleeding when they eventually get their period.
• Excessive hair growth on the face and body
• Acne
• Male Pattern Baldness.
• Darkening of the skin in body creases like behind the neck, in the groin and under the breasts.

Causes for PCOS

• Genetic factors are believed to be one of the causes as studies show that PCOS often runs within the families.
• Higher levels of Androgen resulting in a haphazard menstrual cycle. Excess male hormones prevent ovulation and hence periods can get disrupted.
• Insulin Resistance, which leads to higher levels of Insulin also cause excess production of androgen which hampers ovulation.
• Obesity, which in turn causes inflammation is also linked by some studies to higher androgen levels that hampers ovulation.

Health Hazards caused by PCOS

• In most cases PCOS can lead to Infertility. Women with PCOS do not ovulate regularly, which means their ovaries are not producing mature eggs for fertilization, hence causing a delay in conception. PCOS is one of the leading causes for Infertility in Women.
• Metabolic Syndrome occurs in obese women with PCOS. Metabolic Syndrome is a cluster of conditions such as increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels which in turn increases your risk for cardiovascular disease.
• Obese women who have high insulin levels present with PCOS and Type 2 Diabetes.
• Endometrial Cancer is another rare complication of PCOS. The uterine walls thicken each time the body readies for implantation of a fertilized egg. During ovulation, the uterine lining is shed, but when ovulation does not happen the uterus does not receive a cue to shed. The lining can build up and can increase your risk for Endometrial Cancer.

PCOS: Tests & Treatment

A Pelvic Ultrasound will reveal the presence of cyst like structures in the ovaries, which will point to PCOS. A blood test will give the doctor a concrete idea on your hormonal levels – specifically Androgen levels.

Treatment options include taking birth control pills to regularise your periods and ensure that your uterine lining is shed regularly. However, if you are trying to conceive, your doctor might prescribe a pill to trigger your ovaries into producing a fertilisable egg, helping you keep track of your ovulation days.

Anti-androgen pills will reduce hair growth on the face and body and reduce balding.

Another pill that might be prescribed is Metformin which is ideally used to treat Type 2 Diabetes. Given that insulin levels are higher for women with PCOS, Metformin serves to lower it, which in turn lowers androgen levels.

Losing weight is also a good way to lower blood glucose levels, improve the way the body uses insulin, and helps hormones reach normal levels.

Of course, all these medications should be taken only under medical supervision as prescribed by a qualified Doctor.

Though there is no permanent solution currently for PCOS, please consult your gynaecologist to find out how best you could manage the condition. Dr. KMH’s centre for reproductive medicine comprises the best gynaecologists and fertility specialists who will help you through PCOS and assist you in planning your conception.

Every problem has a solution, and here we are to offer you one!