As many of you may be aware, September is polycystic ovarian syndrome (PCOS) awareness month. This post will be dedicated to explaining the basics of PCOS. Just a note that the information provided here is general, if you think you may be suffering from PCOS please contact your physician.
Let's start with the basics. Normally, every month a number of eggs are recruited in the ovaries which fight for the resources (hormonal signals) to grow. Out of these multiple eggs, one, and in some cases two, become the dominant follicles and begin to develop more prominently than the other eggs. These dominant eggs mature and are the ones that will ovulate with the hopes of becoming fertilized by a sperm cell. The eggs which were recruited but did not become the dominant follicle do not receive the signals they need and slowly diminish. Now in PCOS, the dominant follicle never forms, so all of the recruited eggs continue to fight for the necessary signals but none of them are able to mature and become the dominant egg.
1 in 10 women suffer from PCOS. It is the leading cause of female infertility due to the underdeveloped eggs not having the potential to ovulate and become fertilized. Due to the irregular/no ovulation, the chances of natural pregnancy are reduced. It may also increase chances of pregnancy complications such as high blood pressure, gestational diabetes and premature delivery. However, with infertility interventions and lifestyle changes, a healthy pregnancy can be achieved. Not only had PCOS been linked to infertility, it can also increase chances of obesity, type II diabetes, cardiovascular disease and potentially endometrial cancer. It is important to seek professional help if you think you may be suffering from PCOS.
Some of the most common symptoms of PCOS include irregular periods/no periods, difficulty getting pregnant, excessive hair growth (hirsutism), and weight gain. PCOS is diagnosed when at least two of the following are present:
1- Irregular periods
2- Excessive androgen levels
3- Polycystic ovaries
These are usually examined through pelvic exams, blood tests and ultrasound exams.
Although not a lot is known about what causes PCOS, there are some speculations towards which factors can play a role in its development. Some studies have shown that PCOS can run in families and that more than one gene may play a role. Other studies have shown a link between insulin resistance and PCOS. Insulin resistance causes a buildup of insulin which triggers the ovaries to produce more androgen (male hormone) and this in turn disrupts the menstrual cycle. Since insulin resistance is more commonly found with obesity, chances of PCOS increases in obese individuals. Some studies have also shown a correlation between inflammation and PCOS.
There are some treatment options for PCOS, starting with lifestyle changes such as:
- weight loss - can improve insulin resistance, cholesterol levels and risks of diabetes. Some diets that have shown to be more beneficial are low-carbohydrate diets and low-glycemic index diet.
- exercise - moderate intensity physical exercise for at least 3 days a week can help with weight loss and improve ovulation
- some evidence has been provided that acupuncture could be beneficial, however more research is required.
Besides lifestyle changes, there are some medical treatments that could be helpful:
- birth control - to restore hormonal balance
- metformin - can improve insulin levels
- clomiphene - helps with ovulation and can increase chances of pregnancy
- assisted reproductive technologies - can help with infertility and increase chances of pregnancy
- ovarian drilling - this is a more invasive approach which entails using a laser to create holes on the ovary to restore proper functioning
If you think you may be suffering from PCOS, discuss this with your physician. They will be able to provide more personalized information and diagnosis. A PCOS diagnosis can be challenging but with the current medical advances in the field of women's reproductive health and infertility, the chances of treatment and pregnancy have increased. There is always hope, you just have to try and maintain optimistic. If you want more information on PCOS or to become more involved, please visit the national polysystic ovary syndrome association (https://pcoschallenge.org/)
