Polycystic ovarian syndrome

WHAT IS PCOS ?

As the name suggests, Polycystic ovarian syndrome also known as PCOS is a group of disorders in which the ovaries are enlarged with presence of small follicular cysts. The ovary starts producing excess testosterone. Testosterone is present in males but it is also found in the female body in very small amounts. It is responsible for the male secondary sexual characters like excess hair, etc.

THE STATS ?

One in every 10 women suffers from PCOS. Usually occurs in women in the age group 20s but can happen at any age after puberty. It is the most common endocrine disorder in women of reproductive age group.

The risk is high especially in obese patients.

HOW DOES PCOS DEVELOP?

The main mechanism of PCOS involves –

1. Hypothalamus secretes Gonadotropin releasing hormone (GnRH) which stimulates the pituitary gland to secrete LH, leutinizing hormone. 

2. This excess LH acts on the ovaries resulting in excess testosterone production from the theca cells of ovary and also free testosterone in the blood, which further increases the LH sensitivity towards GnRH.

3. Insulin resistance- high levels of insulin due to obesity which leads to increase in gonadal androgen production.

4. Lack of progesterone contributes to lack of periods.

SYMPTOMS-

1. Irregular menstrual cycle or absence of menstruation (from few to several months). This is called secondary amenorrhea and it is the presenting complain in about 70 percent cases.

2. Too much hair (hirsutism) on face, neck, back, stomach in about 50 percent cases. 

3. Acne is another very common complain in PCOS.

4. Dark patchy skin (acanthosis nigricans) over the neck, inner thighs, armpits.

5. Dull, thin hair, dandruff, oily skin and scalp.

COMPLICATION?

One of the most dreaded complications of PCOS is infertility. Other complications include development of Diabetes Mellitus, Endometrial cancer, Dyslipidemia (Cholesterol problems), Hypertension and Cardiovascular diseases.

LIFESTYLE DISORDER

Almost every 3rd woman I know suffers from PCOS. Some call it a lifestyle disorder. Well, yes to some extent, the junk food tradition has caused obesity  which somehow affects the female reproductive cycle. PCOS is thought to have a dominant mode of inheritance as about 50% of first degree relatives have it.

If you are experiencing absence of periods you should immediately consult a gynaecologist and start a treatment. Lack of awareness about PCOS has led to increase in delayed conception. If treated on time, infertility wouldn’t be a complication.

Exercise has been found very useful in PCOS. Losing roughly about 10% of your current weight will lead to an improvement in the symptoms. Losing weight in PCOS takes time because the high levels on insulin makes it difficult. 

DIET

I wouldn’t say avoid a particular food, because let’s be honest, cuting off pizza totally from the diet, hurts !

Another thing that a lot of my friends avoided was milk and it’s products. I wouldn’t suggest to cut off milk, but limiting it will be a better option.

Bread, maggi, pasta, pizza, basically all junk plus starchy food should be consumed by putting a very strict check on them.

A big NO to sugar and alcohol, they increase weight like no other thing in this entire world !

Several dry fruits contain excess fats and oils, they should be avoided.

Consume as much water as you can without bursting your belly !

Consume green leafy vegetables and lean proteins like fish and chicken.

Also, no to aerated drinks ! 

TREATMENT?

Well it depends on the age and the presenting complain of the patients. 

Drugs that control excess androgen and insulin levels usually form the basis of the treatment. Some doctors also prescribe ovulation inducing medicines and insulin sensitizers. In cases resistant to medical therapy, laparoscopic ovarian drilling and bariatric surgery may be tried.

WHAT WE NEED RIGHT NOW IS MORE AND MORE AWARENESS ABOUT THIS VERY COMMON DISORDER, SO THAT WOMEN CAN BE TREATED ON TIME.