Polycystic ovary syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.
Although PCOS is not completely reversible, there are a number of treatments that can reduce or minimize symptoms. Most women with PCOS are able to lead a normal life without significant complications.
PCOS Causes
Reproductive system abnormalities -In women with PCOS, multiple small follicles accumulate in the ovary. None of these small follicles/cysts are capable of growing to a size that would trigger ovulation. As a result, the levels of estrogen, progesterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) become imbalanced.
Androgens e.g testosterone normally produced by the ovaries and the adrenal glands may become increased in women with PCOS because of the high levels of LH but also because of increased levels of insulin that are usually seen with PCOS
Metabolic system abnormalities — The metabolic system controls the processing of carbohydrates, fats, and proteins. Important hormones in the metabolic system include insulin, glucagon, glucagon-like peptides, and many others.
PCOS is associated with elevated levels of insulin in the blood. Insulin is a hormone that is produced by specialized cells within the pancreas; insulin regulates blood glucose levels.
PCOS Symptoms
Menstrual irregularity - Women with PCOS usually have fewer than six to eight menstrual periods per year. Some women have normal cycles during puberty, which may become irregular if the woman becomes overweight.
Irregular or absent menstrual periods can increase a woman's risk of endometrial overgrowth (called endometrial hyperplasia) or even endometrial cancer.
Weight gain and obesity- PCOS is associated with gradual weight gain and obesity in approximately one-half of women. For some women with PCOS, obesity develops at the time of puberty.
Hair growth and acne- Male-pattern hair growth (hirsutism) may be seen on the upper lip, chin, neck, sideburn area, chest, upper or lower abdomen, upper arm, and inner thigh. Acne is a skin condition that causes oily skin and blockages in hair follicles.
Infertility- Many women with PCOS do not ovulate regularly, and it may take these women longer to become pregnant.
Heart disease- Women who are obese and who also have insulin resistance or diabetes might have an increased risk of coronary artery disease, which increases the risk of having a heart attack.
Both weight loss and treatment of insulin abnormalities can decrease this risk. Other treatments (eg, cholesterol-lowering medications [statins], and treatments for high blood pressure) may also be recommended.
Sleep apnea- Sleep apnea is a condition that causes brief spells where breathing stops (apnea) during sleep. Sleep apnea may occur in up to 50 percent of women with PCOS.
Depression and anxiety- There are treatments that can help with these problems, including therapy as well as medications.
Sexual dysfunction– Women with PCOS are more likely than other women to experience lower sexual satisfaction.
Eating disorders– These include bulimia and binge eating. Women with PCOS do not appear to be at increased risk of developing anorexia.
How is PCOS treated?
The most common treatment is to take birth control pills. But there are other treatments that can help with symptoms, too.
Birth control pills – This is the main treatment for PCOS. The pills don't cure the condition. But they can improve many of its symptoms, like irregular periods, acne, and facial hair. Birth control pills also lower your risk of cancer of the uterus.
Anti-androgens – These medicines block hormones that cause some PCOS symptoms like acne and facial hair growth. Spironolactone (brand name: Aldactone) is the one that many doctors use.
Progestin – This hormone can make your periods regular, but only if you take it regularly. It also lowers the risk of cancer of the uterus. Most doctors use medroxyprogesterone (brand name: Provera) or natural progesterone (brand name: Prometrium).
Metformin (brand name: Glucophage) – This medicine can help make your periods more regular. But it works only in about half of the people who try it. In people with diabetes, this medicine helps to lower blood sugar levels.
Medicated skin lotion or antibiotics to treat acne.
Laser therapy or electrolysis to remove extra hair.
Weight loss — For women with PCOS who are overweight or obese, weight loss is one of the most effective approaches for managing insulin abnormalities, irregular menstrual periods, and other symptoms of PCOS.