Sometimes women may also face trouble in getting pregnant even in their childbearing years(15-44 years). There is a medical condition that affects a women’s pregnancy and is known as Polycystic Ovary Syndrome(PCOS). It is one of the most common causes of female infertility and affects 6% to 12%(almost 5 million) of U.S women. Such health conditions continue to lasts far beyond the childbearing years. This article is based on female health covering the topic, Polycystic Ovary Syndrome(PCOS).
What Is PCOS?
Polycystic Ovary Syndrome(PCOS) is a hormonal disorder that affects their fertility during their childbearing phase. Many women suffer from such complications unknowingly. According to a study, Almost 70% of women with PCOS hadn’t been diagnosed.
Polycystic Ovary Syndrome(PCOS) affects women’s reproductive organ, ovaries that produce estrogen, androgen and progesterone, a hormone that is responsible for the menstrual cycle. It is a syndrome or a group of symptoms that affect the ovaries and ovulation, consequently, affects the fertility of women. This group of symptom is categorised into three main categories, such as:-
- Cysts in the ovaries
- High level of male hormones
- Irregular or skipped periods
In Polycystic Ovary Syndrome(PCOS), fluid-filled sacs are grown inside the ovaries in the form of follicles. Each one of them contains an immature egg and this egg is unable to attain enough maturity ìn order to trigger ovulation.
The lack of ovulation now alters the level of FSH, LH, estrogen, and progesterone. Due to the lack of ovulation and growth of fluid-filled sacs the level of estrogen and progesterone level decreases than usual and androgen level increases than the normal. Due to the extra amount of androgen, the menstrual cycle gets disrupted.
What Causes Polycystic Ovary Syndrome?
The specific cause behind the polycystic ovary syndrome is not yet known. But most of the doctors believe that because of the high level of androgen the ovaries are unable to produce hormones and make eggs with normal rate.
Excess insulin, low-grade inflammation, genes are associated with the cause of polycystic ovary syndrome.
Genes: According to some studies PCOS is hereditary. It has also been estimated that some genes have the tendency to inherit this condition with from the parent gene.
Excess insulin: According to a case study, about 70% of women suffering from PCOS have insulin resistance which means the cells of these women are unable to use insulin properly. Insulin is a hormone that is produced by the pancreas for the body cells to absorb sugar.
When the body cells are unable to use insulin, its level tends to increase as insulin secretion continues to remain at the same pace by the pancreas. The extra insulin triggers the ovaries to produce more androgen that further lead to the production of fluid-filled sacs inside the ovaries leading to an alteration in the level of the hormones.
Inflammation: Women with PCOS has been found to have low-grade inflammation that stimulates polycystic ovaries to produce male hormone, androgen. This again alters the level of hormones in the females and may also lead to heart and blood vessel problems.
In some cases, the inflammation is found to be high that leads to overweight and contributes to higher androgen level.
So, these are the possibilities behind the occurrence of Polycystic Ovary Syndrome(PCOS).
Some Complications With PCOS
Complications of Polycystic Ovary Syndrome(PCOS) are as follows:-
- Miscarriage or premature birth
- Gestational diabetes or pregnancy-induced high blood pressure
- Nonalcoholic steatohepatitis- severe liver inflammation that occurs because of fat accumulation in the liver
- Metabolic syndrome- hypertension, diabetes, abnormal cholesterol or triglyceride level that is linked with cardiovascular disease.
- Sleep apnea
- Depression, anxiety, and eating disorders
- Abnormal uterine bleeding
- Endometrial cancer
What Are The Symptoms Of PCOS?
Antonio Vallisneri was the first Italian physician who described the Polycystic Ovarian Syndrome symptoms, such as:-
- Irregular periods: Due to the lack of ovulation the process of shedding of the uterine lining gets prevented every month. As a result, some women with PCOS get few than eight periods in a year.
- Heavy Bleeding: Due to the building up of uterine lining for a longer period of time, you may feel heavy bleeding than your normal periods.
- Hair growth, acne: In PCOS, the hormones are altered resulting in an increase in an androgen. This increased in the level of androgen results in some physical changes, such as hirsutism(excessive growth of hair on face and body), occasionally severe acne and male-pattern baldness.
- Weight gain: According to the case studies, almost 80% of women with PCOS are overweight or obese.
- Darkening of the skin: Dark patches on the skin especially on the neck, in the groin, and under the breasts.
- Headaches: In some women suffering from PCOS may also experience headaches.
How Polycystic Ovary Syndrome Is Diagnosed?
When it comes to PCOS diagnosis, the doctor would like to know about your medical history including your menstrual periods, your weight changes, and signs of excess hair growth. The doctor may recommend you to undergo certain tests, such as:-
- Pelvic exam: During a pelvic exam the doctor would visually and manually check for masses, growth and other abnormalities in your reproductives organs.
- Blood Tests: The doctor may also recommend you for blood tests in order to measure hormone levels and also includes possible causes of menstrual abnormalities or androgen excess that imitates PCOS. Your doctor would also like to know the glucose tolerance, fasting cholesterol, triglyceride level, and insulin level with the help of blood tests.
- Ultrasound: With the help of ultrasound, the doctor would like to know about the appearance of your ovaries and the thickness of the lining of your uterus. In this procedure, a transducer(wandlike device) is placed inside your vagina which emits sound waves that are displayed into images on a computer screen.
Additionally, your doctor may also screen you through tests, such as:-
- Screening for depression and anxiety
- Screening for obstructive sleep apnea
- Monitoring of blood pressure
What Is The Treatment For Polycystic Ovary Syndrome?
PCOS treatment begins with lifestyle changes, such as weight loss, diet and exercise. Losing only (5-10)% of your body weight will help you to regulate your menstrual cycle and reduces PCOS symptoms. Losing weight will also help you to control your cholesterol, insulin, and reduces heart disease and diabetes risks.
- Maintaining a healthy weight: Having an ideal weight will help you to reduce the insulin and androgen level that may restore ovulation. If you face any difficulty ask your doctor to help you with a weight control program.
- Limit carbohydrate intake: Foods with low fat and high carbohydrate may increase your insulin levels. Hence ask your doctor to recommend you a diet plan with low carbohydrates or complex carbohydrates that raise your sugar level very slowly.
- Be active: Practising regular exercise will lower your blood sugar level. Regular exercise will improve your circulatory system improving the capacity of the blood cells to absorb insulin and lowers the sugar level. This healthy habit also helps you to maintain an ideal weight preventing your body from altering your hormones.
These were the home remedies that will help you to change your lifestyle and improve your PCOS condition. Here are some medications that will also help you to fight against PCOS.
Medications: PCOS mainly affects your menstrual cycle, ovulate, and hair growth. The doctor may provide you with medications that will help you to control these basic symptoms, such as:-
In order to control your menstrual cycle, your doctor may recommend you with medicines, like:-
- Combination of birth pills: During PCOS the level of hormones, such as estrogen and progesterone decrease as compared to androgen. Your doctor will provide you with pills containing estrogen and progesterone with a decreased level of androgen. This pills again alters the hormone back to their normal level and reducing your risk of PCOS. You can also use a skin patch or vaginal ring to alter your hormone back to its normal level as they contain a combination of estrogen and progesterone.
- Progestin therapy: Your doctor may also ask you to go for progestin therapy for 10 to 14 days every one or two months in order to regulate your periods and to protect against endometrial cancer. This therapy won’t affect your androgen level and won’t prevent pregnancy. In case you also wish to avoid pregnancy, you can go for the progestin-only minipill or progestin-containing intrauterine device.
In order to help you ovulate, your doctor may also recommend you:-
- Clomiphene(Clomid): It is a fertility medicine that helps women suffering from PCOS to get pregnant. Although this medicine increases the risk for twins and other multiple births.
- Metformin(Glucophage, Fortamet): It is a drug used to treat type-2 diabetes and also treats PCOS by improving insulin level. One study also found that consuming metformin during the change in your diet plan and exercise will help you to improve your weight loss, lowering your blood sugar, and restores a normal menstrual cycle better than changes to diet and physical activity.
- Gonadotropins: These are also hormone medicines that balance your hormone level are usually injected into the body.
Now comes the third symptom, hair growth. To reduce excessive hair growth, your doctor might recommend:-
- Birth control pills: Consuming the birth control pill will help you to decrease the production of androgen that is responsible for excessive hair growth.
- Spironolactone(Aldactone): Aldactone blocks the effects of androgen on the skin. It can also cause birth defects, hence effective contraception is required while taking this medication. Do consult with the doctor before consuming the drug. The medicine is not recommended in case of a pregnant woman or planning for pregnancy.
- Eflornithine(Vaniqa): It is a medicational cream that helps to slow down the facial hair growth in women.