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Polycystic ovarian syndrome (PCOS)

Polycystic ovarian disease is a set of symptoms due to a hormone imbalance in women. Polycystic ovarian disease (PCOD) is also known as polycystic ovarian syndrome (PCOS) or hyperandrogenic anovulation (HA) or Stein–Leventhal syndrome
Polycystic ovarian disease is a set of symptoms due to a hormone imbalance in women. Polycystic ovarian disease (PCOD) is also known as polycystic ovarian syndrome (PCOS) or hyperandrogenic anovulation (HA) or Stein–Leventhal syndrome. This syndrome is characterized by the presence of numerous small fluid filled swellings called cysts in one or both ovaries. PCOS is a common endocrine disorder of females between the age of 18 years and 44 years. Up to 25% of the women have multiple fluid-filled cysts in their ovaries; however, many of these women don’t develop PCOD. It is one of the most common cause of infertility. With no known exact cause PCOS is due to a combination of genetic and environmental factors.

 

What is Polycystic ovarian syndrome (PCOS)?

PCOS is a disease of ovaries mainly caused due to hormonal imbalance in females of reproductive age group. The ovaries have cystic swellings and get enlarged producing excess amounts of androgen and estrogenic hormones. There are anovulatory menstrual cycles and irregular or infrequent periods. All these may finally lead to infertility.

Causes of Polycystic ovarian syndrome (PCOS)

The exact causes of this hormonal disorder are not yet known. The researchers suggest that it is a genetic disease. So females whose mother or sister has PCOD are more likely to have it. Polycystic Ovarian Syndrome can be considered as an endocrine disorder.
Polycystic ovaries develop when the ovaries are stimulated to produce excessive amounts of male hormones (androgens), specially testosterone, by either one or a combination of the following :

  • The release of excessive luteinizing hormone (LH) by the anterior pituitary gland.
  • Through high levels of insulin in the blood in women whose ovaries are sensitive to this stimulus.

Signs and Symptoms of Polycystic ovarian syndrome (PCOS)

  • Cysts on ovaries
  • Menstrual disorders- The patient may have no menstrual periods(Amenorrhoea) or few menstrual cycles(Oligomenorrhoea) or Increased bleeding.
  • Hairfall
  • Hirsutism - Male pattern of hair growth.
  • Type 2 diabetes
  • Infertility- Due to absence of ovulation
  • Oily skin, acne and dandruff
  • Obesity- Due to insulin resistance
  • Breathing problems while sleeping (obstructive sleep apnea)- This is linked to both obesity and insulin resistance.

Complications of Polycystic ovarian syndrome (PCOS)

  • Cholesterol and lipid abnormalities
  • Cancer of the uterine lining (endometrial cancer)- It is caused by exposure to continuous high levels of estrogen. It is one of the late complications.
  • Depression and anxiety
  • Metabolic syndrome — a cluster of signs and symptoms that indicate a significantly increase risk of cardiovascular disease.
  • High blood pressure

Diagnosis of Polycystic ovarian syndrome (PCOS)

Not everyone with PCOS has polycystic ovaries (PCO), nor does everyone with ovarian cysts have PCOS.

  • Detailed medical history- Emphasis on amount and duartion of menstrual cycle is important.
  • Ultrasonography of the Pelvis- Pelvic ultrasound shows presence of enlarged ovaries with small cysts on them. This is one of the best diagnostic modality though it does not confirm the disease.
  • Physical Examination- Pelvic examination is done to find out whether the ovaries are enlarged or not.
  • Hormone levels
  • Blood Glucose Levels

Risk factors for Polycystic ovarian syndrome (PCOS)

  • Family History Of PCOS: Positive family history is the main risk factor for Polycystic Ovarian Syndrome. A female can acquire it either from the side of father or mother.
  • Patients with diabetes or family history of diabetes: A strong relation between diabetes and PCOS increases the chances of PCOS in women with diabetes.
  • Medication: Long-term use of the seizure medicine has been linked to an increased risk of PCOS.

Differential Diagnosis of Polycystic ovarian syndrome (PCOS)

There are a number of diseases which have clinical presentation similar to PCOS. They need to be differentiated for proper diagnosis and treatment. These diseases are listed below:

  • Hypothyroidism
  • Congenital adrenal hyperplasia
  • Cushing's syndrome
  • Hyperprolactinemia
  • Androgen secreting neoplasms
  • Other pituitary or adrenal disorders

Pregnancy and Polycystic ovarian syndrome (PCOS)

Women with PCOS are at higher risk for certain problems during pregnancy-

  • Miscarriage- early loss of pregnancy
  • Pregnancy-induced hypertensive disorders
  • Gestational diabetes- Diabetes during pregnancy
  • The birth of small-for-gestational-age (SGA) babies

Management of Polycystic ovarian syndrome (PCOS)

PCOS can be managed by the following lifestyle modifications:

  • Weight Loss
  • Stress management
  • Balanced diet

Diet in Polycystic ovarian syndrome (PCOS)

  • Less sugar and Carbohydrate
  • More fiber.
  • Lower glycemic index foods such as whole grains (jowar, bajra, whole wheat).
  • Food with low Saturated Fats
  • Wheat, Oat flakes
  • Fresh fruit, Fruit juices, lots of vegetables, Legumes and Nuts
  • Prefer food with protein

 

Updated: March, 20 2015
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