Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment

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Polycystic ovarian syndrome, often known as PCOS, is a condition that can alter the quantities of hormones that are produced by a woman’s ovaries.

PCOS causes a woman to create significantly higher levels of male hormones than is typical. This hormonal imbalance causes women to go without menstruation, which makes it more difficult for them to conceive a child in the future.

In addition to this, people who have PCOS tend to experience increased facial and body hair development. In addition, it may play a role in the development of chronic diseases such as diabetes and heart disease.

Birth control pills and diabetes medications (which tackle insulin resistance, a sign of PCOS) can help improve symptoms and correct the hormone imbalance that causes them.

Continue reading for a look at some of the possible causes of PCOS as well as some of the possible repercussions of PCOS on the body of a woman.

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What is PCOS?

PCOS is a hormonal condition that impacts women when they are in the childbearing years of their lives (ages 15 to 44). PCOS affects anywhere from 2.2 percent to 26.7 percent of women in this age range.

There are a lot of ladies who are unaware that they have PCOS. According to the findings of one study, up to seventy percent of women with PCOS had not received a diagnosis.

Ovaries are the reproductive organs of a woman that are affected by polycystic ovary syndrome (PCOS). Ovaries are responsible for the production of estrogen and progesterone, which are hormones that control the menstrual cycle. Androgens are male hormones, and the ovaries are responsible for producing a very minute amount of them.

Eggs are produced by the ovaries, which are then fertilized by the sperm of a male. Ovulation is the process that occurs once a month when an egg is released.

Ovulation is regulated by two hormones called follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both of which are produced by the pituitary gland.

After being stimulated by FSH to generate a follicle, which is a sac that houses an egg, the ovary is next triggered by LH to produce an egg that is mature enough to be released.

Ovulation and the ovaries are both impacted by the condition known as polycystic ovary syndrome (PCOS). The following are its three primary attributes:

cysts developing in the ovary

excessive amounts of male hormones, periods that are erratic or not occurring at all.

Ovaries affected by polycystic ovary syndrome develop an abnormally high number of tiny sacs filled with fluid. The phrase “many cysts” is what the word “polycystic” refers to.

These little sacs, also known as follicles, each hold a developing egg within their interior. The eggs never develop to the point where they can stimulate ovulation.

The lack of ovulation causes changes in the levels of estrogen, progesterone, follicle-stimulating hormone, and luteinizing hormone. The levels of progesterone are significantly lower than normal, whilst the levels of androgen are significantly greater than normal.

Due to the disruption of the menstrual cycle caused by the presence of extra male hormones, women who have PCOS have fewer periods than normal.

PCOS is not a recently discovered condition. In the year 1721, Italian physician Antonio Vallisneri was the first to describe its symptoms.

During the years in which they are able to bear children, up to roughly 27 percent of women are affected by polycystic ovary syndrome (PCOS) (4). It is characterized by the presence of cysts in the ovaries, elevated levels of male hormones, and unpredictable menstrual cycles.

What causes it?

PCOS is a condition for which doctors are unsure of the specific reason. They believe that excessive amounts of male hormones inhibit the ovaries from creating hormones and eggs in a regular manner. Also, they believe that this prevents the ovaries from functioning properly.

There is a connection between having too much testosterone in the body and certain genes, insulin resistance, and inflammation.

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Genes

According to studies, PCOS tends to run in families.

It is quite likely that several genes, rather not just one, are responsible for the disorder.

Insulin resistance

Insulin resistance is present in up to 70 percent of women who have polycystic ovary syndrome (PCOS), which means that their cells are unable to utilize insulin effectively.

Insulin is a hormone that is produced by the pancreas, and its primary function is to assist the body in extracting energy from the sugar that is consumed.

The requirement for insulin in the body becomes up when cells are unable to make proper use of insulin. In order to make up for it, the pancreas produces extra insulin. When there is an excess of insulin in the body, it causes the ovaries to create more male hormones.

Insulin resistance is largely brought on by obesity, which is a key contributor. Insulin resistance and obesity are two factors that can raise a person’s chance of developing type 2 diabetes.

Inflammation

Inflammation is typically elevated in the bodies of women who suffer from polycystic ovary syndrome (PCOS). Having a weight problem can also play a role in the development of inflammation. According to a number of studies, elevated levels of inflammation are connected to androgen production.

PCOS is a condition for which doctors are unsure of the specific reason. They believe that it is caused by a combination of variables, including genes, insulin resistance, and greater levels of inflammation throughout the body.

Common symptoms of PCOS

When some women get their first period, they may notice the beginnings of their symptoms. Some people don’t find out they have PCOS until after they’ve acquired a significant amount of weight or after they’ve struggled to become pregnant.

The following is a list of the most prevalent PCOS symptoms:

Irregular periods. When ovulation does not occur, the uterine lining does not shed as it normally would each month. Some women who have PCOS have fewer than eight cycles per year, and others never receive their periods at all.

Heavy loss of blood. Because the uterine lining has more time to develop up, the periods that you do receive may be heavier than usual. This is because of the longer time period over which they build up.

Hair growth. More than seventy percent of women who have this disorder develop hair on their faces as well as other parts of their bodies, including their backs, bellies, and chests (11). Hirsutism is the medical term for excessive hair growth.

Acne. The skin on places such as the face, chest, and upper back may become more prone to acne as a result of male hormones, which may also make the skin oilier than normal.

Weight increase. Women who have PCOS have a much higher risk of being overweight or obese than other women (11).

Male pattern baldness. The hair on the scalp becomes less dense and may fall out altogether.

Skin that has become darker. Crevasses on the body, such as those on the neck, in the crotch, and under the breasts, are prone to the development of dark patches of skin.

Headaches. Headaches are a common symptom that can be brought on by hormonal shifts.

PCOS can cause disruptions in the menstrual cycle, which can result in fewer cycles overall. Acne, increased hair growth, patchy dark skin, and weight gain are some of the additional signs of the illness.

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How PCOS affects your body

Androgen levels that are too high can have a negative impact on a woman’s fertility, in addition to other aspects of her health.

Infertility

Ovulation is a necessary step in the conception process. Women who don’t ovulate on a consistent basis don’t produce as many eggs that can go on to be fertilized by sperm. PCOS is one of the most common reasons why women are unable to have children.

Metabolic syndrome

Women who have PCOS have a much higher risk of being overweight or obese than other women (13Trusted Source). Obesity and polycystic ovary syndrome (PCOS) both increase the risk for:

high blood sugar

hypertension; high blood pressure

low levels of the “good” cholesterol, HDL

excessive levels of the “bad” LDL cholesterol

These factors, when combined, are referred to as a metabolic syndrome, and they are associated with an increased risk for the following conditions:

heart disease diabetes stroke

Sleep apnea

This disorder causes recurrent pauses in breathing during the night, which disrupts sleep. Sleep is disrupted because of this ailment.

Overweight women are more likely to suffer from sleep apnea, and this risk increases significantly if the woman also has PCOS. When compared to women who do not have PCOS, those who are obese and have a history of sleep apnea have a risk that is anywhere from five to ten times higher.

Endometrial cancer

The uterine lining will shed at the time of ovulation. When you don’t ovulate once a month, the lining of your uterus can get thicker.

Your chance of developing endometrial cancer may be higher if you have a thicker uterine lining.

Depression

Negative emotional effects can be caused by hormonal shifts as well as symptoms like increased hair growth that you do not want. Eventually, depression and anxiety affect a significant number of people who have PCOS.

Hormonal imbalances have the potential to adversely impact a woman’s health in a variety of ways. Infertility, metabolic syndrome, sleep apnea, endometrial cancer, and depression are all conditions that might be made more likely by having PCOS.

How PCOS is diagnosed

PCOS is a condition that is commonly diagnosed in female patients who exhibit at least two of the following three symptoms:

elevated androgen levels

irregular menstrual cycles

cysts developing in the ovary

Your doctor ought to additionally inquire as to if you’ve experienced signs such as acne, increased hair development on the face and body, and weight gain.

During a pelvic exam, your ovaries and other portions of your reproductive tract can be evaluated for any potential issues that may exist. During this portion of the exam, your physician will examine your ovaries and uterus for any signs of growth by inserting gloved fingers into your vagina.

Blood tests look for male hormone levels that are significantly higher than average.

In addition, blood tests to analyze your levels of cholesterol, insulin, and triglycerides may be recommended in order to assess the likelihood that you will develop linked illnesses such as coronary disease or diabetes.

An ultrasound examines your ovaries and uterus by using sound waves to search for abnormal follicles and other issues that may exist there.

PCOS is only diagnosed when at least two of the disease’s three primary symptoms are present in a woman: high androgen levels, irregular menstrual periods, and cysts in the ovaries. It is possible to confirm the diagnosis with a pelvic exam, blood tests, and an ultrasound.

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Pregnancy and PCOS

PCOS causes disruptions in the usual menstrual cycle and makes it more difficult to conceive children. Problems conceiving a child are experienced by between 70 and 80 percent of women who have PCOS.

This illness may also raise the likelihood of having difficulties during pregnancy.

Women who suffer from polycystic ovary syndrome (PCOS) have a higher risk of having a premature delivery than women who do not have the illness. They also have an increased likelihood of having a stillbirth, high blood pressure, and developing gestational diabetes.

However, pregnancies are possible for women with PCOS who undergo reproductive therapies that aim to improve ovulation. It is possible to boost your chances of having a safe pregnancy by reducing your blood sugar levels and losing some weight.

PCOS can make it more difficult to conceive a child and can also raise the risk of experiencing difficulties during pregnancy or losing the baby. Your chances of having a healthy pregnancy can improve if you lose weight and undergo other therapies as well.

Diet and lifestyle tips to treat PCOS

Changing one’s lifestyle to lose weight, eat healthier, and get more exercise is often the first step in treating polycystic ovary syndrome (PCOS).

A modest weight loss of between 5 and 10 percent of your total body mass can assist in the regulation of your menstrual cycle and the improvement of PCOS symptoms (11, 20Trusted Source). Losing weight can also help:

decrease levels of bad cholesterol.

reduce insulin levels

decreasing the likelihood of developing heart disease and diabetes.

Your illness can benefit from any diet that leads to weight loss on your part. However, some diets might be more beneficial than others in some respects.

Studies that compared various diets for the treatment of PCOS came to the conclusion that diets low in carbohydrates were most successful for achieving both weight loss and a reduction in insulin levels.

A diet with a low glycemic index (low GI) that receives the majority of its carbohydrates from fruits, vegetables, and whole grains helps manage menstrual cycle symptoms more effectively than a standard diet for weight loss.

There have been a few studies that have found that if women with PCOS exercise for at least three days per week for a total of thirty minutes at a low level, it can help them lose weight. Exercise helps people lose weight, which in turn improves their ovulation and insulin levels.

When coupled with a nutritious diet, physical activity provides even more of a return on investment. Diet and exercise together can help you lose more weight than either strategy can on its own, and it can also reduce your risk of developing diabetes and cardiovascular disease.

There is some evidence to suggest that acupuncture can assist with the improvement of PCOS; nevertheless, this area of study has to be expanded.

Changing lifestyle factors, such as nutrition and exercise, is the first step in treating PCOS. If you are overweight, losing as little as five to ten percent of your body weight will help ease the symptoms you are experiencing.

Common medical treatments

The menstrual cycle can be normalized with the use of birth control pills and other drugs, and PCOS symptoms like excess hair growth and acne can be treated.

Birth control

Using progestin on a regular basis can:

Bring the hormone balance back to normal.

ovulation can be regulated, and symptoms such as excessive hair growth can be relieved.

prevent the development of endometrial cancer.

These hormones can be administered in the form of a tablet, a vaginal patch, or a vaginal ring.

Metformin

Metformin, also known as Glucophage and Fortamet, is a medication that is employed in the treatment of type 2 diabetes. PCOS is another condition that can be treated with this supplement.

According to the findings of one study, taking metformin in conjunction with making changes to food and exercise leads to greater improvements in weight loss, reductions in blood sugar, and the return of normal menstrual cycles than making diet and exercise modifications alone.

Clomiphene

Clomiphene, also known by its brand name Clomid, is a fertility medicine that can increase a woman’s chances of becoming pregnant.

When talking about how to plan a family, it is essential to bear in mind that the use of clomiphene raises the risk of having twins or other multiple births. This is something that should be kept in mind at all times.

Hair removal medications

A combination of treatments can help remove undesirable hair or prevent new hair from sprouting in its place.

Eflornithine cream, which is sold under the brand name Vaniqa, is a pharmaceutical product that reduces the rate at which hair grows. Electrolysis and laser hair removal are two methods that can be used to remove unwanted hair from the face and body.

Surgery

In the event that other forms of treatment are unsuccessful, fertility surgery may be considered. Ovarian drilling is a technique that uses either a laser or a thin needle that is heated to make very small holes in the ovary in order to reestablish regular ovulation.

RECOVERY OF A NORMAL MENSTRUAL CYCLE MAY BE POSSIBLE THROUGH THE USE OF BOTH birth control pills and the diabetes medication metformin. Clomiphene and surgery both have been shown to boost fertility in PCOS patients. Women may find relief from undesirable hair growth with the use of hair removal drugs.

When to see a doctor

If any of the following apply, you should see a physician:

You haven’t had your period in a while, but you’re not pregnant either.

You have PCOS, and one of its symptoms is increased hair growth, particularly on your face and body.

You have been trying to conceive for longer than a year, but so far, your efforts have been unsuccessful.

You may have diabetes if you experience symptoms such as excessive thirst or hunger, hazy eyesight, or a loss of weight for no apparent reason.

Do not wait a full year before seeing a professional for an evaluation if you are attempting to conceive a child and your periods have already become irregular or are completely gone.

Also, keep in mind that if you do not want to get pregnant, having periods that are irregular or not occurring at all are not methods of birth control in and of themselves.

Even with all of these factors, it is possible that a woman could still become pregnant. Even if you have PCOS, it is in your best interest to utilize some form of birth control in this scenario.

If you have PCOS, you should schedule routine appointments with your primary care physician. You will need to undergo routine examinations in order to screen for diabetes, high blood pressure, and any other potential issues.

You can search for endocrinologists in your region using the FindCare function on Healthline if you are concerned about your PCOS but do not already have one.

Make an appointment with your primary care physician if you have not had a period for an extended period of time or if you have additional PCOS symptoms, such as increased hair growth on your face or body. Consult a medical professional as well if you have spent at least a year trying to conceive but have been unsuccessful.

Conclusion

PCOS can cause a woman’s menstrual periods to become irregular, which can make it more challenging for her to conceive a child. The presence of undesirable symptoms, such as increased hair growth on the face and body, is another consequence of having high amounts of male hormones.

Adjustments to a patient’s lifestyle are typically the first line of treatment that medical professionals propose for polycystic ovary syndrome (PCOS).

The symptoms of PCOS can be treated with weight loss, which also increases a woman’s chances of becoming pregnant. Both watching what you eat and getting plenty of cardiovascular activity are highly effective means of weight loss.

In the event that modifications in lifestyle are ineffective, medication may be an alternative. Metformin and birth control pills both have the ability to return menstrual cycles to a more regular pattern and alleviate the symptoms of PCOS.