PCOS Causes, Symptoms, Complications, Diagnosis, Treatment & Management!

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects 4-20% women of reproductive age¹. However, up to 70% of women with PCOS remain undiagnosed.²

What Is PCOS?

Polycystic ovarian syndrome (PCOS) is a disorder, wherein the ovaries have multiple cystic follicles that cause persistent anovulation (happens when an egg doesn’t release from the ovary during your menstrual cycle). The cystic follicle occurs because the eggs are not released after ovulation.³

Polycystic Ovarian Syndrome is also a hormonal imbalance disorder that affects women of reproductive age.^3,4 PCOS affects around 4 to 20% of women globally.¹ According to research, a woman who suffers from irregular periods or oligo-amenorrhoea has a 90% chance of developing PCOS.⁵

What Causes PCOS?

These are some of the most common causes of PCOS:

Insulin Resistance 

The pancreas generates insulin, a hormone that aids in the utilisation of glucose to generate energy. However, sometimes the body resists the effects of insulin. And to compensate, the pancreas overproduces insulin.⁶ Higher insulin levels trigger testosterone levels, causing irregular periods.⁶ 

Hormone Imbalance

Several women with PCOS go through an imbalance of certain hormones like Testosterone, LH (Luteinising Hormone), SHBG (Sex-Hormone Binding Globulin) and Prolactin.⁶ Fluctuations in the aforementioned hormones, such as high amounts of testosterone and LH, lowered SHBG, and increased levels of prolactin, can lead to PCOS.⁶

Furthermore, higher levels of AMH (Anti-Müllerian Hormone- a hormone generated by the ovaries in females that aids in the creation of reproductive organs) has been linked to PCOS. Thus indicating that women with high AMH levels are more likely to develop PCOS than women with low AMH levels.^7,8 

PCOS Symptoms

When someone has PCOS, the symptoms may not appear straight away. Women can still have PCOS without experiencing its most prevalent symptoms until much later in life. The symptoms may become apparent in late teens or early twenties.⁶

Some common symptoms of PCOS include⁶- 

• Acne or oily skin
• Excess facial hair; hair growth on chest, thighs, and stomach
• Difficulty in conceiving
• Irregular periods or no ovulation
• Scalp hair loss or thinning hair
• Unusual weight gain

In some cases, women may develop alopecia (hair loss from scalp⁹), skin tags, and acanthosis nigricans (dark discoloration/ hyperpigmentation) in the body’s folds and creases.^10,11 

So far, we’ve discussed PCOS, its symptoms and how it affects menstruation. Now let’s look into the health complications related to this condition.

Complications Related To PCOS

We know by now that PCOS is a condition that affects reproductive health. But did you know that it also has certain health complications  associated with it? Let’s learn about them:^12,13

• Endometrial cancer (cancer in uterus inner lining) 
• High blood pressure 
• High sugar levels in blood
• High risk of miscarriage 
• Increased risk of heart diseases
• Increased risk of anxiety, depression, and eating disorders 
• Infertility
• Type 2 diabetes 
• Premature birth

PCOS Diagnosis

If you or anyone close to you are experiencing above-mentioned symptoms, then see a doctor immediately. Your doctor may recommend a hormone test. You may also be referred to a gynaecologist who will be able to assist you better. The specialist may discuss your symptoms and family history, followed by a medical examination. 

There’s a diagnostic criterion known as Rotterdam criteria (if other causes for the same symptoms have been checked out). According to this criteria, if you meet at least 2 out of the following then you may be at potential risk of developing PCOS -¹⁴

• Oligo-anovulation or Irregular periods
• Hyperandrogenism - A condition which gives rise to high androgen levels (a male hormone), leading to symptoms like acne, increased body & facial hair, inflamed skin and scalp hair loss 
• Transvaginal ultrasound scans showing polycystic ovaries

PCOS Treatment Options & Management Of Symptoms

PCOS is a common condition that often affects hormones³. On being diagnosed with ovarian cysts, doctors often advise lifestyle changes or medications to address or lower the effects of their symptoms.

Listed below are some of the ways PCOS could be managed. Nonetheless, individuals are advised to take their doctor’s suggestions before practising any of the following. 

1. Changes In Lifestyle

The first thing a person diagnosed with PCOS will be asked to do is modify their approach to life. Since estrogen deficiency and obesity are linked- it has been proven that losing weight upto 5% can substantially improve PCOS symptoms.¹⁵ 

Furthermore, one study showed that women with polycystic ovarian syndrome who adopt a dairy-free and carbohydrate-free diet can lose weight to improve the symptoms of PCOS. Same set of women also experienced decreased levels of excessive testosterone (a cause of PCOS), and had an improved insulin sensitivity (the ability of your body to turn sugar/glucose into energy).¹⁵

Other benefits that women with PCOS have experienced after losing weight include-¹⁵

• Restored ovulation, regular menstruation with better reproductive health
• Lowered risks of developing diabetes and high cholesterol
• Decrease in acne and excessive hair growth 

Moreover, working out or engaging in any form of physical activity helps to cope with PCOS-led depression.¹⁵ If you’ve been diagnosed with PCOS, talk to your doctor about your symptoms. And, based on your symptoms, devise an appropriate treatment plan.

2. Oral Contraceptive Pills

Women with PCOS who do not wish to become pregnant can take oral contraception after taking the doctor’s advice, as a long-term solution. Because they contain a combination of female hormones estrogen and progestin; oral contraceptives are beneficial in managing and treating many PCOS symptoms.¹⁵

Women with PCOS who have used oral contraception to alleviate their symptoms have experienced-¹⁵

• Regular menstrual cycle
• Decrease in acne and excess hair growth 
• Decreased androgen levels

Before taking contraceptive pills as a solution to your symptoms, it is important for you to understand that every medicine comes with certain levels of risks and side-effects.

3. Insulin Sensitising Drugs

Sometimes doctors may recommend insulin sensitising drugs. These medicines help in decreasing your body’s blood sugar levels by making other parts of your body more sensitive to insulin. They target fat, liver and muscle and increase their sensitivity towards insulin.¹⁶ 

Insulin sensitising drugs help with-¹⁵

• Regularising menstruation
• Lowering cholesterol levels
• Improving the weight loss process, etc.

4. Anti- Androgen Drugs

As already discussed, androgens are male hormones that induce PCOS in women. To overcome this, doctors will advise anti-androgen drugs. There are drugs available now that either prevent the body from producing male hormones or aid to reduce their effects. These drugs are useful in-¹⁵

• Decreasing androgen levels
• Reducing the excess hair growth
• Getting rid of acne

PCOS Prevention

Unfortunately, there is no proven way to prevent PCOS. However, there are steps that you can take to reduce the health-related effects, such as the ones mentioned in the previous section.³

If you have been diagnosed with PCOS, it is important to take care of your health. This includes eating a nutritious diet, exercising regularly, and managing your weight. You should also reach out to your doctor for advice on how to manage your PCOS.³

Conclusion

Polycystic ovarian syndrome is a condition which could affect a person for prolonged periods. But by adhering to some lifestyle changes and medications, individuals can get relief from its symptoms. Moreover, if you're embarking on motherhood or experiencing hormonal imbalance symptoms, tracking your hormones can help you understand your body better.  You can simply get one at-home self-collection test kit for the same. 

LifeCell’s OvaScore is one such at-home self-collection test, which helps in analysing female reproductive health. This test checks for 9 significant hormones that are linked to reproductive conditions like Early Menopause or Primary ovarian insufficiency, Polycystic Ovarian Syndrome, Thyroid health and General wellness, etc. 

Understanding your reproductive health has never been this easier. So what are you waiting for? Get your OvaScore test today!

5 FAQs Related To PCOS

Q1. Is PCOS A Serious Problem?

As discussed earlier in this blog, women with PCOS are likely to develop various health-related complications and, in some cases, may even have difficulty in conceiving. However with early diagnosis, the symptoms of PCOS can be managed which can help women in avoiding severe health issues.

Q2. What Are The Warning Signs Of PCOS?

The warning signs of PCOS can be seen on various aspects of a woman’s body such as-6

• Fertility: Difficulty in conceiving
• Hair: Excess facial hair, hair growth on chest, thighs, and stomach, scalp hair loss or thinning hair
• Menstrual cycle: Irregular periods or no ovulation
• Skin: Acne, oily skin
• Weight: Unusual weight gain

Q3. Can PCOS Be Cured?

Unfortunately, PCOS cannot be cured. However, as mentioned above, its symptoms can be managed.

Q4. Is PCOS Painful?

PCOS can cause pelvic pains and severe period cramps.³ 

Q5. Is PCOD And PCOS Same?

While PCOD (Polycystic Ovarian Disease) may seem similar, it differs from PCOS (Polycystic Ovarian Syndrome). In PCOD, the ovaries release immature eggs, resulting in hormonal imbalances and swollen ovaries, among other symptoms. Conversely, PCOS is characterised by endocrine problems leading to excess androgen production, making eggs more likely to develop into cysts. However, unlike PCOD, these cysts do not get released; instead, they accumulate within the ovaries.¹⁷

Q6. Does PCOS Affect Baby?

Yes, PCOS can affect baby by causing premature birth.¹⁸

Q7. Can PCOS Cause Miscarriage?

Yes, women with PCOS are three times more likely to have a miscarriage than women without  PCOS.¹⁹