Complete profile of PCOS

jaishree9 · Mar 14, 2009

Polycystic ovary syndrome (PCOS)
PCOS is a health problem that can affect a woman's menstrual cycle, ability to have children, hormones, heart, blood vessels, and appearance.
With PCOS, women typically have:

high levels of androgens . These are sometimes called male hormones, although females also make them.

missed or irregular periods

many small cysts in their ovaries. Cysts are fluid-filled sacs

About one in ten women of childbearing age has PCOS. It can occur in girls as young as 11 years old. PCOS is the most common cause of female subfertility & needs many time assisted reproductive techniques.
Factors which play a role in developing PCOSae-
Genes
Women with PCOS tend to have a mother or sister with PCOS.
Insulin
A hormone which metabolizes glucose & produced in pancreas also play a role PCOS.
For many women with PCOS, their bodies have problems using insulin so that too much insulin is in the body. Excess insulin appears to increase production of androgen. This hormone is made in fat cells, the ovaries, and the adrenal gland. Levels of androgen that are higher than normal can lead to acne, excessive hair growth, weight gain, and problems with ovulation.
Sympotoms -
Not all women with PCOS share the same symptoms. These are some of the symptoms of PCOS:

infrequent menstrual periods, no menstrual periods, and/or irregular bleeding Or less flow.

not able to get pregnant because of not ovulating

increased hair growth on the face, chest, stomach, back, thumbs, or toes—a condition called - hirsutism

ovarian cysts

acne, oily skin, or dandruff

weight gain or obesity, usually carrying extra weight around the waist

insulin resistance or type 2 diabetes

high cholesterol

high blood pressure

male-pattern baldness or thinning hair

patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs

skin tags, or tiny excess flaps of skin in the armpits or neck area

pelvic pain

anxiety or depression due to appearance and/or infertility

In PCOS, the ovary doesn't make all of the hormones it needs for any of the eggs to fully mature. Follicles may start to grow and build up fluid. But no one follicle becomes large enough. Instead, some follicles may remain as cysts. Since no follicle becomes large enough and no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman's menstrual cycle is irregular or absent. Plus, the cysts make male hormones, which also prevent ovulation.
sleep apnea—excessive snoring and
Diagnosis-
There is no single test to diagnose PCOS.
medical history,
physical exam, and possibly take some tests to rule out other causes of your symptoms.
pelvic exam to see if ovaries are enlarged or swollen by the increased number of small cysts.
A ultrasound also might be used to examine the ovaries for cysts and check out the endometrium, the lining of the uterus.
The uterine lining may become thicker if periods are not regular. Blood test to check hormone levels and to measure glucose (sugar) levels.
Lack of ovulation is usually the reason for fertility problems in women with PCOS.
Treatment - medications that stimulate ovulation can help women with PCOS become pregnant.
Even so, other reasons for infertility in both the woman and man should be ruled out before fertility medications are used. Also, there is an increased risk for multiple births (twins, triplets) with fertility medications. For most patients, clomiphene citrate is the first choice therapy to stimulate ovulation.
If this fails, metformin taken with clomiphene is usually tried. When metformin is taken along with fertility medications, it may help women with PCOS ovulate on lower doses of medication.
Gonadotropins pituitary hormones that stimulate production of progesrone also can be used to stimulate ovulation.
These are given as shots. But gonadotropins are more expensive and there are greater chances of multiple births compared to clomiphene.
Another option is in vitro fertilization (IVF). IVF offers the best chance of becoming pregnant in any one cycle and gives doctors better control over the chance of multiple births. But, IVF is very costly
Ovarian drilling" is a surgery that brings on ovulation. It is sometimes used when a woman does not respond to fertility medicines. The doctor makes a very small cut above or below the navel and inserts a small tool that acts like a telescope into the abdomen. This is called laparoscopy. The doctor then punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary.
This procedure carries a risk of developing scar tissue on the ovary. This surgery can lower male hormone levels and help with ovulation. But these effects may only last a few months.
This treatment doesn't help with loss of scalp hair and increased hair growth on other parts of the body.
Lifestyle modification.
Keeping a healthy weight by eating healthy foods and exercising is another way women can help manage PCOS. Many women with PCOS are overweight or obese. Eat fewer processed foods and foods with added sugars and more whole-grain products, fruits, vegetables, and lean meats to help lower blood sugar (glucose) levels, improve the body's use of insulin, and normalize hormone levels in your body. Even a 10 percent loss in body weight can restore a normal period and make a woman's cycle more regular.
How does polycystic ovary syndrome (PCOS) affect a woman while pregnant?
There appears to be higher rates of miscarriage, gestational diabetes, pregnancy-induced high blood pressure and premature delivery in women with PCOS.
Metformin also lowers male hormone levels and limits weight gain in women who are obese when they get pregnant.
Women with PCOS have greater chances of developing type 2 diabetes, cardiovascular disease (CVD) so it is Best to start life style modification from an early age to prevent these chronic conditions.

nivedhita · Mar 15, 2009

HI Jaishree

Thanks this is a very useful article on PCOS. If you have more please keep posting. I am suffering from PCOS and right now about few days back I have started with metformin 500 mg (mornings after food ) and krimson 35 in the nights.

thanks

ashwiniramesh · Mar 15, 2009

Vow its wonderful information, even i have pcos and have recently undergone laproscopic drilling and living with hope, that i will also become pregnant one day.

Ashwini

roopanair123 · Mar 16, 2009

hi jaishree

Indeed a very very informative article...thanks very much :thumbsup

aneesbasha · Mar 16, 2009

Hi Jaishree,
Thanks for such a valuable information.
Nice article.

jaishree9 · Mar 16, 2009

Hhi neveditha
Thanks for your feedback & all the best for your Treatment dear.

jaishree9 · Mar 16, 2009

hi asviniramesh
Thanks for your feedback . And Be hopeful ,After treatment you certainly would conceive .all the best

MadhuRao · May 25, 2010

For Friends who are PCOS

Hi!

I found this article and wanted to share with friends who are PCOS.
All the best in your TTC journey and hope this info helps to certain extent. Lets have faith in Almighty and pray to help us come out of TTC soon.

Indian women are increasingly finding themselves falling prey to a reproductory disorder -- here's what you need to know about PCOS.
The most common endocrine disorder in women of reproductive age, polycystic ovary syndrome (PCOS) -- also known as polycystic ovary disease (PCOD) -- causes infertility and other serious health repercussions. In fact, PCOS is believed to be the most commonly found reason for menstrual irregularities in women of reproductive age (12-45 years old). Women can develop PCOS during their teenage or childbearing years.
In India [ Images ], the incidence of PCOS is on the rise, with research finding nearly 35 percent of women suffer from it -- that is roughly one in three, a rather alarmingly high number.
What is PCOS?
Polycystic ovary syndrome (PCOS), formerly known as the Stein-Levanthal Syndrome, is a condition where at least two of the following occur, and often all three:

At least 12 follicles (tiny cysts) develop in your ovaries (polycystic means 'many cysts'). Cysts are fluid-filled sacs.

The balance of hormones that is produced in the ovaries is altered. In particular, your ovaries produce more testosterone (male hormone) than normal.

You do not ovulate each month. Some women do not ovulate at all. (In PCOS, although the ovaries usually have many follicles, they do not develop fully and so ovulation often does not occur.) If you do not ovulate then you do not have a period.

In PCOS, there are many poorly developed follicles (sacs that contain eggs) within the ovaries. The eggs in these follicles do not mature and, therefore, cannot be released from the ovaries. Instead, they form cysts in the ovary.
What causes PCOS?
The exact cause is not totally clear. Several factors probably play a part. These include the following:

Insulin: Women with PCOS have what is called 'insulin resistance'. This means that cells in the body are resistant to the effect of a normal level of insulin. More insulin is produced to keep the blood sugar normal. This raised level of insulin in the bloodstream is thought to be the main underlying reason why PCOS develops.

Luteinising hormone (LH): This hormone is produced in the pituitary gland. It stimulates the ovaries to ovulate and works alongside insulin to promote testosterone production. A high level of LH is found in about 4 in 10 women with PCOS.

Hereditary factors: Your genetic makeup is probably important. One or more genes may make you more prone to develop PCOS. PCOS is not strictly inherited from parents to children, but it may run in some families.

Weight: Being overweight or obese is not the underlying cause of PCOS. However, if you are overweight or obese, excess fat can make insulin resistance worse. This may then cause the level of insulin to rise even further. High levels of insulin can contribute to further weight gain.

What are the symptoms?
Teen girls and young women with PCOS commonly exhibit one or more symptoms. Some of the most common ones include:

Irregular periods that come every few months, not at all, or too frequently.

Infertility, generally resulting from very occasional ovulation.

Extra hair growth on the face or other parts of the body (usually found under the chin, on the upper lip, forearms, lower legs and on the abdomen), called hirsutism.

Acne, oily skin.

Hair loss, appearing as thinning hair on the top of the head.

Weight gain and/or trouble losing weight.

Deepening of voice.

Patches of dark skin on the back of the neck and other areas, called acanthosis nigricans.

What conditions can be associated with PCOS?
Women with PCOS are at higher risk of a number of illnesses, including high blood pressure, high cholesterol, type 2 diabetes and heart disease. Problems with menstrual periods may also cause infertility (the inability to get pregnant) in women who have PCOS and they may also run a higher risk of cancer of the uterus (endometrial cancer).
What can be done to deal with PCOS?

A good diet and exercise habits can help with the symptoms of PCOS and they are an important first step in treating this problem.

A healthy diet includes whole grains, beans, fruit, vegetables and lean protein. Eating a few small meals rather than three big ones may help even out blood sugar levels.

Exercise can help you lose weight and keep it off. It also helps your body use insulin, so it can lower your diabetes risk. Aim for 30 minutes or more a day of activity, such as brisk walking. Talk to your doctor before you start or increase your activity.

Weight loss is key in treating PCOS. Losing even 5 percent to 10 percent of your weight can help restart ovulation, lessen your symptoms and lower your risk of diabetes. Diet and exercise can help you lose weight.

Birth control pills can help regulate your periods and reduce hormone-related symptoms such as acne, hair loss and excess facial and body hair.

Anti-androgen medication such as spironolactone may be used along with birth control pills. It can help reduce unwanted hair growth and acne. It should not be taken during pregnancy.

Metformin, a diabetes medication, can help restore ovulation and control your insulin and blood sugar levels. It's often used to help increase fertility in PCOS, and it may be used along with infertility drugs for this purpose. It may also help with weight loss.

While you can't cure PCOS, you can treat it. A healthy lifestyle is very important, including healthy eating and daily exercise. There are excellent long-term medications to help you manage irregular periods, hair growth and acne.