PCOS – Polycystic Ovarian Syndrome
Last updated on November 24th, 2024 at 10:58 am
Polycystic Ovary Syndrome, abbreviated as (PCOS) is a condition where a woman produces small but numerous cysts (fluid-filled sacs) in her ovaries.
This, as a result, stimulates the formation of cysts and consequently the over-production of male sex hormones namely “Androgen” in the case of women, which is normally present in a small amount.
This sex hormone can impair the woman’s menstrual cycle and bring about other symptoms of PCOS. Although medications can be used to mitigate and reduce these symptoms, they cannot cure PCOS.
Ovaries produce and release an egg for fertilization which needs to meet with male sperm for the process to complete.
But if the eggs are not fertilized, it is flushed out of the system during the menstrual cycle due to the hormonal action of estrogen once every month.
Women who are unable to produce enough of this hormone may not be able to flush out eggs and thereby ovulate and consequently form cysts instead.
These cysts in turn produce male sex hormone called androgen and hence develop this condition of PCOS.
Prevalence in Nepal and Worldwide
Anovulation, a condition where a woman cannot ovulate to release an egg from the ovary, is primarily associated with PCOS, with a prevalence estimated at up to 10% of women worldwide with an upward trend.
A study suggests that almost 72% of menstrual disturbances (resulting from anovulation) in women are estimated to have been associated with PCOS.
The recent surge in the prevalence of PCOS in younger women in Nepal (women less than 35 years of age) has been a growing concern, a study suggests.
Causes
Although the exact reason for PCOS is yet not clear, it is highly linked to insulin resistance in women. As a result, many patients with PCOS are associated with type II diabetes as well.
This was recorded and acknowledged for the first time by Archard and Thiers in 1921 with a case of a bearded diabetic woman showing the association between glucose intolerance and hyperandrogenism.
In short, when the body is unable to process insulin (a hormone that breaks down blood sugar) appropriately, it starts to build up in the body and causes androgen (male sex hormone) to go up as well, leading consequently to PCOS and its associated symptoms.
Thus, in many cases, PCOS runs through the families and is noted to have diabetes problems along with obesity also adds up to increasing the insulin levels in the body.
Some of the most important causes thus can be summarized as
- Insulin resistance
- Increased level of androgen
- Family history of having PCOS
- Being overweight
Who is at most risk?
Women who come from a family with a diabetic record and predisposed genetics to have PCOS that runs through their family are more prone to have PCOS. Along with women who have diabetes and are overweight.
Thus, to sum up, women who have unhealthy lifestyle choices that make them overweight and consequently insulin resistant (mostly seen with the patients with diabetes) are more prone to PCOS, along with the inherited family history.
Symptoms
Generally speaking, women with PCOS are likely to have irregular menstrual cycles and tend to miss their periods more often. Moreover, excess hair growth is also seen in women with PCOS since it is related to the over-production of the male sex hormone androgen.
Additionally, weight gain, acne (skin condition where red pimples appear on the skin), and infertility are also associated with PCOS.
Similarly, many reports suggest that women with PCOS can be at a higher risk of type II diabetes, high blood pressure, heart problems, and endometrial cancer (cancer of the inner lining of the uterus).
But in short, these three would be the tale-tell symptoms of PCOS.
- Missed/Irregular periods
- Higher levels of male sex hormones (androgen) in blood
- Multiple small cysts in the ovaries
Diagnosis
If you miss your periods regularly and have excess weight gain or excess hair growth, it’s time that you take it seriously and seek medical attention since all of these symptoms point toward PCOS.
A gynecologist might ask you generally about your symptoms and your previous medical history. Then he will take a physical examination of your pelvic area, including your reproductive organs (internal and external).
Request an appointment with Senior Gynecologist at Clinic One Kathmandu >>>
Finally, if he is convinced, he might suggest you do some tests such as ultrasound and/or blood tests to confirm your condition.
1. Ultrasound:
This test uses sound waves to produce images of your internal organs that are visualized on computer screens to notice any anatomical changes.
A doctor investigating whether you have PCOS or not might suggest you do an ultrasound of your internal organs to look for the development of any cysts therein and the size of your ovaries. Moreover, your doctor might also look for any changes in the thickness in the lining of the epithelium of your uterus.
2. Blood Tests:
As with many cases of PCOS, overproduction of a male-sex hormone called androgen is noticed, and hence the blood test might particularly check the levels of androgen in blood.
Along with the glucose levels which are thought to shoot up due to the correlation between PCOS and type II diabetes.
Moreover, your cholesterol and triglyceride levels might also get checked to confirm the presence of PCOS.
Complications of PCOS
Some of the most noted complications of PCOS are infertility, type-II diabetes, high blood pressure, heart problems, problems with blood vessels, and uterine cancer.
Moreover, excess hair growth, acne, and weight gain are also associated symptoms of PCOS, and women who have these physical symptoms might have low self-esteem and confidence in their life which could generally negatively affect other avenues of their life.
Prevention
Since obesity and excessive weight gain, along with other unhealthy lifestyle choices are precursors to diabetes and PCOS, hence adopting healthy living choices may prevent the onset of PCOS along with reducing the severity of the disease.
Although, there may not be one sure way to prevent this disease, taking small steps in a positive direction in terms of diet and activities such as eating healthy food, having a regular exercise routine, and managing your weight can help reduce the severity of the symptoms.
Treatment of PCOS
Treatment of PCOS may largely depend on your age, severity of your symptoms, and overall health.
Thus, the choice of treatment will largely depend on your particular case and whether you have a desire for future pregnancies or not.
But some of the treatment choices be discussed below.
Medications to cause Ovulation
These include certain medications which stimulate hormones to release eggs from the ovary.
But this might have certain risks because ovarian hyper-stimulation may cause higher levels of too many hormones, leading to multiple births (twin formation), abdominal bloating, and pelvic pain.
- Birth control pills: These might help reduce androgen levels, and control menstrual cycles.
- Diabetes medications: These are primarily used to lower insulin resistance in PCOS patients, along with reducing androgen levels, ovulating regularly, and slowing hair growth rate.
Doctors of choice for PCOS Treatment in Kathmandu Nepal
You might want to visit the “Gynecologist” to diagnose and treat PCOS along with other female reproductive problems like irregular menstruation, infertility, STIs, family planning, etc.
We have senior gynecologists at “Clinic One”. Please book an appointment if you suspect having one of these symptoms for proper PCOS treatment in Kathmandu Nepal.
Call us at 01-5400400 / 98633936960 to book an appointment for treatment of PCOS at Clinic One.
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Request an appointment below!
References
Centre for Disease Control and Prevention (CDC) (2020), Article on PCOS and Diabetes
Cleveland Clinic (2021), Newsletter on Polycystic Ovary Syndrome (PCOS)
John Hopkins Medicine, Article on Polycystic Ovary Syndrome (PCOS)
Mahendra Raj Pandey (2020) Clinical profile of PCOS patients at a tertiary care center in Gandaki Province of Nepal, Asian Journal of Medical Sciences
Prof Dr. S. Mishra (2013), Review article on Polycystic Ovary Syndrome (PCOS), Journal of Universal College of Medical Sciences