What to do with PCOS?

Emobileclinic Trending Topic: Polycystic Ovarian (ovary) Syndrome (PCOS)

Polycystic ovarian syndrome is a complex condition in which a woman’s ovaries are generally bigger than average. Polycystic means the ovaries have many cysts or follicles that rarely grow to maturity or produce eggs of being fertilised. The term polycystic ovaries describes ovaries that contain many small cysts (about twice as many as in normal ovaries), usually no bigger than 8 millimetres each, located just below the surface of the ovaries. These cysts are egg-containing follicles that have not developed properly due to a number of hormonal abnormalities.

PCOS is relatively common, especially in infertile women. It affects mostly women of reproductive age (between late adolescence and menopause). A significant number of these cases remain undiagnosed.

Symptoms of polycystic ovarian syndrome

Women who have PCOS may experience:

Irregular menstrual cycles

Amenorrhoea

Excessive hair growth and acne 

Reduced fertility

Mood swing in addition to anxiety and depression

Obesity

Causes of PCOS

PCOS is a hormonal condition commonly involving high levels of insulin or male hormones known as ‘androgens’, or both. The cause of this is unclear.

In some women, PCOS runs in the family, whereas for others, the condition only occurs when they are overweight.

Long-term health risks of PCOS

PCOS is associated with long-term health risks. Research shows that PCOS is related to insulin resistance and the development of diabetes, especially if women are overweight.

Diagnosis of PCOS

Diagnosis of PCOS is likely to involve:

Medical history: the doctor will ask about your menstrual periods, weight changes, and other symptoms.

Physical examination: the doctor will want to measure your blood pressure, body mass index (BMI), and waist size. He or she also will check the areas of increased hair growth. You should try to allow the natural hair to grow for a few days before the visit.

Pelvic examination: the doctor might want to check to see if your ovaries are enlarged or swollen by the increased number of small cysts.

Blood tests: the doctor may check the androgen hormone and glucose (sugar) levels in your blood.

Vaginal ultrasound (sonogram): doctor may perform a test that uses sound waves to take pictures of the pelvic area. It might be used to examine your ovaries for cysts and check the endometrium. This lining may become thicker if your periods are not regular.

Early diagnosis is important as it can allow symptoms to be managed and may prevent the development of long-term health problems such as diabetes.

Treatment of PCOS

Depending on the problems, management of PCOS can include lifestyle modifications, weightreduction, and treatment with hormones or medications. Research has shown that even a five to 10 per cent loss of weight in those who are overweight can restore normal hormone production and help regulate periods and improve fertility.

It is important that a multidisciplinary approach be used to manage and treat PCOS.  For all women with PCOS, it is important to relieve symptoms and reduce the risk of diabetes by preventing weight gain through a healthy lifestyle, or by losing weight if you are already overweight.

PCOS treatments include:

Oral contraceptive pill – if you are suffering from irregular, heavy periods, the oral contraceptive pill is often prescribed for contraception, to regulate the cycle, reduce hirsutism (excess hair) and acne, and prevent the lining of the womb from thickening excessively

Medication to block hormones such as testosterone (for example, spironolactone) – these may be used to reduce excess hair growth or scalp hair loss.

Infertility medications – if infertility is a problem, clomiphene citrate (sold as Clomid) or metformin may be taken orally to bring about ovulation (egg production)

Psychological counselling.

 PCOS and Pregnancy

Pregnant women with PCOS appear to have higher rates of:

Miscarriage

Gestational diabetes

Pregnancy-induced high blood pressure (preeclampsia)

Premature delivery

Babies born to women with PCOS have a higher risk of spending time in a neonatal intensive care unit or of dying before, during, or shortly after birth. Most of the time, these problems occur in multiple-birth babies (twins, triplets).