Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels. Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes them to skip menstrual periods and makes it harder for them to get pregnant.

PCOS also causes hair growth on the face and body and baldness. And it can contribute to long-term health problems like diabetes and heart disease.

Birth control pills and diabetes drugs can help fix the hormone imbalance and improve symptoms. Read on for a look at the causes of PCOS and its effects on a woman’s body.

What is PCOS?

PCOS is a problem with hormones that affects women during their childbearing years (ages 15 to 44). Between 2.2 and 26.7 percent of women in this age group have PCOS (1, 2Trusted Source).

Many women have PCOS but don’t know it. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed (2Trusted Source).

PCOS affects a woman’s ovaries, the reproductive organs that produce estrogen and progesterone —hormones that regulate the menstrual cycle. The ovaries also produce a small number of male hormones called androgens.

PCOS is a “syndrome,” or group of symptoms that affects the ovaries and ovulation. It’s three main features are:

  • Cysts in the ovaries.
  • High levels of male hormones.
  • Irregular or skipped periods.

In PCOS, many small, fluid-filled sacs grow inside the ovaries. The word “polycystic” means “many cysts.”

What causes Polycystic ovary syndrome (PCOS)?

Doctors don’t know exactly what causes PCOS. They believe that high levels of male hormones prevent the ovaries from producing hormones and making eggs normally. Genes, insulin resistance, and inflammation have all been linked to excess androgen production.

Genes Studies show that PCOS runs in families. It’s likely that many genes — not just one — contribute to the condition.

Insulin resistance Up to 70 percent of women with PCOS have insulin resistance, meaning that their cells can’t use insulin properly. Insulin is a hormone the pancreas produces to help the body use sugar from foods for energy. When cells can’t use insulin properly, the body’s demand for insulin increases. The pancreas makes more insulin to compensate. Extra insulin triggers the ovaries to produce more male hormones.
Obesity is a major cause of insulin resistance. Both obesity and insulin resistance can increase your risk of type 2 diabetes.

Inflammation Women with PCOS often have increased levels of inflammation in their body. Being overweight can also contribute to inflammation. Studies have linked excess inflammation to higher androgen levels.

Common symptoms of PCOS

Some women start seeing symptoms around the time of their first period. Others only discover they have PCOS after they’ve gained a lot of weight or they’ve had trouble getting pregnant.

The most common PCOS symptoms are:

  • Irregular periods. A lack of ovulation prevents the uterine lining from shedding every month. Some women with PCOS get fewer than eight periods a year (10Trusted Source).
  • Heavy bleeding. The uterine lining builds up for a longer period of time, so the periods you do get can be heavier than normal.
  • Hair growth. More than 70 percent of women with this condition grow hair on their face and body — including on their back, belly, and chest. Excess hair growth is called hirsutism.
  • Acne. Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back.
  • Weight gain. Up to 80 percent of women with PCOS are overweight or obese.
  • Male-pattern baldness. The hair on the scalp gets thinner and fall out.
  • Darkening of the skin. Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breasts.
  • Headaches. Hormone changes can trigger headaches in some women.

How PCOS affects your body:

Having higher-than-normal androgen levels can affect your fertility and other aspects of your health.

Infertility: To get pregnant, you have to ovulate. Women who don’t ovulate regularly don’t release as many eggs to be fertilized. PCOS is one of the leading causes of infertility in women.

Metabolic syndrome: Up to 80 percent of women with PCOS are overweight or obese (13 Trusted Source). Both obesity and PCOS increase your risk for high blood sugar, high blood pressure, low HDL (“good”) cholesterol, and high LDL (“bad”) cholesterol. Together, these factors are called metabolic syndrome, and they increase the risk of heart disease, diabetes, and stroke.

Sleep apnea: This condition causes repeated pauses in breathing during the night, which interrupts sleep. Sleep apnea is more common in women who are overweight — especially if they also have PCOS. The risk for sleep apnea is 5 to 10 times higher in obese women with PCOS than in those without PCOS.

Endometrial cancer: During ovulation, the uterine lining sheds. If you don’t ovulate every month, the lining can build up. A thickened uterine lining can increase your risk for endometrial cancer.

Depression: Both hormonal changes and symptoms like unwanted hair growth can negatively affect your emotions. Many with PCOS end up experiencing depression and anxiety.

Diet and lifestyle tips to treat PCOS

Treatment for PCOS usually starts with lifestyle changes like weight loss, diet, and exercise.

  • Losing just 5 to 10 percent of your body weight can help regulate your menstrual cycle and improve PCOS symptoms. Weight loss can also improve cholesterol levels, lower insulin, and reduce heart disease and diabetes risks.
  • Any diet that helps you lose weight can help your condition. However, some diets may have advantages over others.
  • Studies comparing diets for PCOS have found that low-carbohydrate diets are effective for both weight loss and lowering insulin levels. A low glycemic index (low-GI) diet that gets most carbohydrates from fruits, vegetables, and whole grains helps regulate the menstrual cycle better than a regular weight loss diet.
  • Exercise is even more beneficial when combined with a healthy diet. Diet plus exercise helps you lose more weight than either intervention alone, and it lowers your risks for diabetes and heart disease

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