Polycystic ovary syndrome, commonly called PCOS, is a condition in which ovaries have multiple small cysts (fluid-filled sacs), and the ovaries produce excessive androgens (male hormone). Females may present with irregular periods, weight gain, infertility, and male pattern hair growth. Although not life-threatening, PCOs adversely affect endocrine, metabolic, and cardiovascular health. The ovary fails to release eggs and may result in infertility. PCOs may sometimes lead to peritonitis upon rupture or torsion.
Although the exact cause is unknown, a genetic link is suspected; the disease is thought to result from a genetic mutation in autosomal chromosomes that causes enzymatic disturbance in the ovary. Among environmental factors, obesity and insulin resistance have been researched the most. Increased insulin levels disrupt the normal hypothalamus-pituitary axis, which is the control center for sex hormones resulting in hormonal imbalance in females. Fat tissue in obese women provides the source of substrates for androgens production.
Risk factors for Polycystic Ovary Syndrome (PCOS) include:
In the U.S, PCOS is very common, with a prevalence of 4- 12% in women of reproductive age. PCOS is higher in South Asians and Hispanic women. According to (WHO) World Health Organization, PCOS has affected 116 million women worldwide.
Signs and symptoms of PCOs are related to menstrual abnormalities, anovulation, and increased male sex hormone levels. The patients usually present to the clinics when they are young.
The most common complaints are:
Your health care provider will begin with a detailed medical history and physical examination, including a pelvic exam. The triad usually considered as diagnostic includes the presence of multiple cysts on ultrasound, obesity, and hirsutism. You may be advised to undergo some of the tests, which include;
Some other disorders, like PCOs, may present and must be ruled out to make an efficient diagnosis.
The baseline treatment is controlling weight via a diet plan and initiating exercise. Hormonal contraceptives are considered first-line treatment for menstrual abnormalities and hirsutism/acne. Oral contraceptives such as norethindrone, norgestimate, or desogestrel, are most commonly used. Metformin is advised to deal with insulin resistance. While dealing with an infertile patient, clomiphene citrate or gonadotropins are given.
Other medicines may include Antiandrogens, Prednisone, Leuprolide, Spironolactone.
Simple cysts are known to self-cure or reabsorb spontaneously. Sometimes, such cysts are found incidentally during surgery or pelvic examination. They are managed best by being left alone, as even after incision, they can re-occur in younger women.
In cases of resistance, laparoscopic ovarian diathermy is advised. Resection is also recommended for cysts that persist and grow larger than 8cms.
Women suffering from PCOS not only have implications on their reproductive health, but such patients are also at risk of type 2 diabetes, inflammation, and heart disease later in life. PCOS increases the risk of certain cancers, such as endometrium cancer.
Insulin resistance leads to many comorbidities such as hypertension, glucose intolerance, dyslipidemia, and diabetes. If left untreated, patients are at an increased risk for stroke. One should consult a doctor and receive treatment accordingly.
Lifestyle changes are considered the cornerstone of PCOs treatment. One must adopt the following habits to cope with PCOs;
Moderate regular exercise: It has many benefits. It helps burn calories and builds lean muscle mass, decreasing insulin resistance. Exercise also helps lower cholesterol levels.
You may consult a nutritionist to help reduce weight, maintain a healthy balanced diet, or use calorie–counting aids.
Paying attention to portion size and cutting down the excessive intake of sugars and carbohydrates is essential. This will improve fertility and PCOS outcomes and reduce the risk of diabetes, metabolic syndrome, and other complications that result from having untreated PCOS.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 27, 2023.
Polycystic ovary syndrome | Office on Women's Health (womenshealth.gov)
PCOS (Polycystic Ovary Syndrome) and Diabetes | CDC