PCOS – Its Diagnosis and Treatment
Dr. Rafeekha P
KIMSHEALTH Trivandrum
Obstetrics & Gynecology
PCOS – Its Diagnosis and Treatment
Polycystic ovary syndrome or PCOS is an increasingly common problem in females and has to do with hormones that have gone out of balance. Most females with PCOS develop small cysts in their ovaries which may not necessarily be harmful, but they sure do lead to hormonal imbalances. This can result in irregular or abnormal periods, reduced fertility, acne and excessive hair growth.
Treatment usually includes a changeover into a healthier lifestyle and diet, weight loss and treatment of individual symptoms. A number of long-term health problems can also arise, including heart disease, hypertension, high cholesterol and diabetes, so a change in lifestyle is strongly recommended. However, early detection and treatment is the best way of preventing long-term effects.
Causes
Females possess two marble-sized ovaries that are involved in producing eggs as well as estrogen and progesterone hormone production. To a smaller level, they also produce androgen, the male hormone. It’s believed that the cells in females with PCOS are insulin resistant, hence inducing more insulin production and consequent over-stimulation of ovaries to produce androgens. This results in problems with follicle maturation, resulting in anovulatory cycles, period irregularity or absence of periods altogether and an inability to get pregnant. Insulin resistance may also lead to weight gain and diabetes in later stages. The luteinizing hormone (LH) is also found to be raised along with the insulin, resulting in excessive hair on the body and thinning of hair on the scalp and sometimes changes in the voice if left untreated. Though it’s still not very clear, it’s believed that hereditary factors also play a role, with PCOS being passed down from either father or mother’s side.
Symptoms
In some people there are no symptoms initially or very mild ones only. Others may develop some of the following:
- Acne
- Excessive hair on the face and body, especially the chest, belly and back
- Thinning scalp hair
- Irregular periods, light periods, heavy periods or no periods at all
- Inability to get pregnant
- Change in voice, becoming deeper with time
- Depression, when the changes become too obvious
Diagnosis
This includes detailed history of menstrual cycles, physical examination for body hair, blood pressure and BMI. The blood is also checked for blood sugar and insulin and LH hormone levels. The final test will be an ultrasound scan of the pelvic area which will confirm the presence of multiple cysts in the ovary and indisputably confirm the diagnosis of PCOS.
Treatment
A complete change in lifestyle is usually recommended ranging from exercise, diet and weight control being the key changes.
- Include moderate to vigorous activity in your daily regime; walking is a great way to exercise.
- Indulge in a heart-healthy diet rich in fruits, vegetables, legumes, nuts and cereals. Cut down on the delicious meats, cheese and fried foods.
- It will also help to lose some weight since as little as 5kg can mean the difference between a better control over the hormones and menstrual cycles.
- Quit smoking (if you are a smoker) as female smokers have higher androgen levels.
Your doctor may also prescribe birth control pills and/or metformin to help regulate the cycles and symptoms. It’s important to continue follow-up and have regular check-ups for related long-term health problems. And if you are feeling depressed, it always helps to talk about it with someone who cares….
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