Introduction
Polycystic Ovarian Syndrome (PCOS) is a common condition that consists of a group of symptoms due to hormonal imbalance, affecting females during their reproductive age. If left untreated, PCOS may lead to serious long-term complications, such as infertility. The symptoms of PCOS can range from mild to severe, including: (1)
- Irregular menstrual cycle or no menses at all.
- Elevation in androgen (male hormone) levels that causes hirsutism (excessive hair growth).
- Weight gain.
- Production of acne and oily skin.
- Hair loss or thinning.
- Small cysts can be found on the ovaries.
- In severe cases, PCOS can cause infertility due to ovulation problems.
Causes of Polycystic Ovary Syndrome (2)
The exact cause of PCOS is not yet well-known; however, various risk factors can promote its occurrence, including the following:
1. Insulin Resistance
Insulin is a hormone produced in the pancreas to regulate blood sugar concentration by transferring sugar into cells for energy. However, when insulin resistance happens, the body compensates by producing excess amounts of insulin. Elevated levels of insulin can increase androgen production by the ovaries, which can lead to impaired menstrual cycle and ovulation.
2. Genetic Factors
A positive family history of PCOS can increase the chance of developing it due to the presence of certain genetic mutations related to this syndrome.
3. Obesity
Studies have shown a direct link between being overweight or obese and the risk of developing PCOS; as increased body fat stimulates insulin resistance that may promote hormonal imbalance.
4. Inflammation
Recent studies suggest that females with PCOS might have higher concentrations of inflammatory markers, such as C-reactive protein (CRP), white blood cells (WBCs), and other markers, indicating that PCOS is associated with low-grade inflammation. This can promote increased production of androgens in the ovaries.
5. Hormonal Imbalance
PCOS patients have been found to have several hormonal imbalances, including:
- Increased androgen production- which affects ovulation.
- Elevated levels of luteinizing hormone (LH)– which stimulate ovulation.
- Higher levels of prolactin– a hormone that stimulates milk production in the mammary glands.
- Reduced levels of sex hormone-binding globulin (SHBG)– a protein that binds to androgens and reduces their effects.
Treatment Options for Polycystic Ovary Syndrome (3)
Treatment options for PCOS depend on the symptoms, their severity, and the goal of treatment. These methods include the following:
1. Lifestyle Changes
Weight loss is essential for controlling PCOS symptoms through lifestyle modifications, including regular exercise and a balanced diet rich in essential nutrients. Weight loss can help reduce insulin resistance and androgen levels, promote a normal, regular menstrual cycle, and enhance ovulation.
2. Medications
Prescribed medications to control symptoms of PCOS can include:
- Oral birth control pills, such as Diane pills, reduce androgen levels, regulate the menstrual cycle, and eventually prevent serious complications like uterine cancer.
- Clomiphene citrate and letrozole, fertility medications, can be prescribed to patients trying to conceive, as they promote ovulation.
- Metformin, an antidiabetic medication, can also be prescribed to control insulin resistance by enhancing insulin sensitivity, reducing insulin levels, and helping with weight loss.
- Spironolactone, an anti-androgen medication, can be prescribed to reduce hirsutism and acne.
3. Surgical Intervenions
In severe cases of PCOS that do not respond to other treatment approaches, surgery can be the right option. A laparoscopic procedure can create small holes in the ovaries to reduce androgen production and enhance ovulation.
References
- https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/
- https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos
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