POLYCYSTIC OVARY SYNDROME

Polycystic ovary syndrome (PCOS) is an endocrine disorder that is common among women of reproductive age (age 15 to 44 years). It affects the ovaries and ovulation which is usually seen at early childbearing age. Research found that about 70 percent of women are yet to be diagnosed. The cause of PCOS has not been identified but if it is discovered early and treatment is given alongside weight reduction,  the risk of developing problems such as type 2 diabetes and heart disease will be minimized.

Common Symptoms

The most common signs and symptoms are;

• Irregular Periods: These may include missed periods or cycles that are longer than 35 days.
• Excessive Hair Growth (Hirsutism): This can occur on the face, chest, back, and other areas due to high androgen levels.
• Acne and Oily Skin: Hormonal imbalances can lead to skin issues like acne.
• Weight Gain: Many women with PCOS struggle with being overweight or find it difficult to lose weight.
• Thinning Hair: Some may experience hair loss or thinning on the scalp.
• Infertility: PCOS can disrupt ovulation, making it harder for women to conceive.

Causes

Although the cause is unknown, this disease can be influenced by several factors;

• Genetic: It was found in studies that PCOS is seen in families. Certain genes influence this disease.
• High androgen in the ovary can lead to acne or hairiness
• Inflammation: Studies have shown that women with PCOS have a high amount of inflammation that stimulates the production of excess ovarian androgen.
• Elevated Insulin: Inflammation is generated by excess insulin and this leads to weight gain which is the principal cause of PCOS. It also leads to heart disease and type 2 diabetes.

Diagnosis 

The diagnosis of PCOS is typically made using the Rotterdam Criteria, which requires that a woman exhibits at least two of the following three features:

1. Irregular or absent menstrual cycles.
2. Signs of excess male hormones(such as hirsutism or elevated testosterone levels).
3. Polycystic ovaries visible on an ultrasound.

To confirm the diagnosis, doctors may also perform blood tests to measure hormone levels and rule out other conditions.

Treatment Options 

While there is no cure for PCOS, several treatment options can help manage symptoms:

1. Lifestyle Changes:
   • Diet: A balanced diet low in refined sugars and carbohydrates can help manage insulin levels and weight. Incorporating more fruits, vegetables, whole grains, and lean proteins is beneficial.
   • Exercise: Regular physical activity can improve insulin sensitivity and aid in weight management.
2. Medications:
   • Hormonal Birth Control: Birth control pills can help regulate menstrual cycles and lower androgen levels, reducing symptoms like excessive hair growth and acne.
   • Metformin: This medication can help improve insulin sensitivity and regulate menstrual cycles.
   • Anti-androgens: Medications such as spironolactone can help reduce hair growth and acne.
3. Fertility Treatments:
   • For women trying to conceive, medications like clomiphene citrate can stimulate ovulation. In some cases, assisted reproductive technologies such as IVF may be considered.
4. Mental Health Support:
   • Many women with PCOS experience anxiety or depression due to the emotional and physical effects of the condition. Seeking therapy or joining support groups can provide valuable help.

Complications 

• Infertility
• Sleep apnea causes breathing to pause during the night
• Miscarriage
• Type 2 Diabetes
• Depression
• Endometrial cancer from the endometrium (lining of the uterus or womb)
• Pregnancy-induced high blood pressure.

PCOS Awareness and the Importance of Early Diagnosis

Raising awareness of PCOS is crucial for several reasons:

1. Early Detection and Intervention: Many women with PCOS remain undiagnosed for years, which can delay the management of symptoms and increase the risk of complications such as infertility, type 2 diabetes, and cardiovascular disease. Early diagnosis allows for better symptom management and prevention of long-term health issues.
2. Education on Symptom Management: By educating women about the symptoms of PCOS, healthcare professionals can empower them to seek medical advice earlier and adopt lifestyle changes that can improve outcomes.
3. Mental Health Support: Mental health issues are often overlooked in PCOS management. Providing women with resources for mental health support, such as therapy or support groups, can improve their quality of life and overall well-being.
4. Advocacy and Research: Continued research is needed to better understand the causes of PCOS and to develop more effective treatments. Awareness campaigns can also advocate for better healthcare policies, insurance coverage, and research funding.

Conclusion

PCOS is a complex condition that affects many aspects of a woman’s health, from fertility to metabolic function and mental health. With proper management, many of the symptoms can be controlled, reducing the risk of long-term health complications. Awareness campaigns can play a key role in educating women about the condition, promoting early diagnosis, and ensuring that women receive comprehensive care

References

1. Buggs C, Rosenfield RL. Polycystic Ovary Syndrome in Adolescence. Endocrinology and Metabolic Clinics of North America. 2005;34(3):677-705
2. Barbieri RL, et al. Clinical manifestations of polycystic ovary syndrome in adults. https://www.uptodate.com/home. Accessed April 27, 2017.
3. Daniel A Dumesic, Rogerio A Lobo. Cancer risk and PCOS.  https://www.sciencedirect.com/science/article/abs/pii/S0039128X1300086X 2013
4. Fatimeh R.T and Samira B.G . Polycystic Ovary Syndrome.https://www.intechopen.com/books/contemporary-gynecologic-practice/polycystic-ovary-syndrome- 2015
5. Jones MR, et al. Genetic determinants of polycystic ovary syndrome: Progress and future directions. Fertility and Sterility. 2016;106:25.
6. Teede H, Deeks A, Moran L. Polycystic ovary syndrome, a complex condition with psychological and metabolic manifestations that impacts on health across the lifespan. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909929/ 2010.
7. Teede, H. J., et al. (2018). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction, 33(9), 1602-1618. doi:10.1093/humrep/dey256.
8. Legro, R. S., et al.(2013). Diagnosis and treatment of polycystic ovary syndrome: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 98(12), 4565-4592. doi:10.1210/jc.2013-2350.
9. Wendy A March, Vivienne M Moore, Kristyn J Willson, David I W Phillips, Robert J Norman, Michael J Davies. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. https://pubmed.ncbi.nlm.nih.gov/19910321/ 
10. Zacur HA. Epidemiology, clinical manifestations and pathophysiology of polycystic ovary syndrome. Adv Stud Med. 2003;3:S733-S9