Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that affects approximately one in nine women. Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes irregular periods and may make it harder to get pregnant. It can also cause unwanted changes in the way you look. If left untreated, it can increase the risk of developing diabetes and heart disease later in life.
Global Stats of PCOS
Polycystic Ovary Syndrome (PCOS) is a prevalent condition. It affects as many as 10-15% of women worldwide. However, as much as 75% of patients with the condition are left undiagnosed. This is likely due to patient presentation variability and lacks public awareness about the condition.
PCOS Risk Factors
PCOS affects women of all ages, but it is most commonly diagnosed in women between 18 and 44. Women of all body types, races, and ethnicities can also develop PCOS. It is also more common in women with a family history of diabetes or other metabolic conditions. Certain lifestyle factors such as being overweight or obese and not getting enough exercise can also contribute to developing the condition and exacerbates the symptoms of PCOS.
Signs and Symptoms of PCOS
It is a hormone disorder common among women of reproductive age. Since this condition may affect women as early as their teens, it is essential to understand the symptoms and its effects. Some common symptoms include:
Irregular periods: It’s common for people with this condition to have rough periods and even complete absence of their periods in severe cases
Increased facial and body hair: High androgens (male hormones) can cause excess hair growth in manly places, e.g., on the face, chest, stomach, thumbs, or toes.
Difficulty Getting Pregnant: It can become difficult to get pregnant because it might stop you from ovulating regularly. You may have trouble getting pregnant if you have irregular periods or no periods.
Weight Gain: People with this condition often gain weight around their abdomen and waist that is hard to lose. This condition may also be linked with insulin resistance, where the body does not respond appropriately to insulin, increasing the risk of type 2 diabetes.
Acne: This is due to an increase in testosterone production, making skin more greasy
Hair Loss on the Scalp: Especially around the sides and the top of the head, similar to male pattern baldness. High levels of male hormones also cause this in the blood binding to hair follicles.
Patches of Darkened and Thickened Skin: These patches generally appear on the neck, armpits, elbows, or groin area.
Diagnosis of PCOS
Most women don’t know that they have PCOS until they have problems getting pregnant. This is because most causes are mild, without apparent symptoms. If you are concerned that you might have PCOS, your Gynecologist will want to rule out other conditions that cause similar symptoms. The Gynecologist will use several methods to diagnose and rule out other conditions, including:
- History and examination; A history of irregular or infrequent and even absent periods and examination showing acne, excess hair growth, and dark patches on your skin
- Blood Tests. These can measure hormone levels and check for abnormal male hormones (androgens). Blood tests also can check your risk of diabetes and heart disease. Tell your doctor if you or any family members have diabetes or heart disease.
- Ultrasound scan of your pelvis revealing polycystic ovaries
Based on the results of these tests, The doctor will let you know if you have PCOS and devices a treatment plan moving forward.
The Rotterdam Criteria is a set of guidelines that doctors follow when diagnosing patients with PCOS. According to these guidelines, a patient must have 2 out of 3 of the following conditions to be diagnosed:
- Irregular periods due to lack of ovulation
- Higher than normal levels of androgens (male sex hormones)
- Polycystic ovaries on ultrasound scan
In the absence of any other cause of the above symptoms and findings
Long-Term Effects of PCOS
Polycystic Ovary Syndrome (PCOS) can cause many serious, long-term health problems. While some women may experience only mild symptoms, PCOS can be severe for others. Some of the potential long-term effects of PCOS include:
Type 2 Diabetes or Prediabetes: Insulin resistance is common in women with PCOS. They are more likely to develop diabetes in pregnancy. PCOS can lead to type 2 diabetes. The risk of developing diabetes increases if you are obese have a family history of diabetes, are over 40 years old, or have had gestational diabetes in pregnancy.
Uterine Cancer: Women with PCOS are slightly more likely to develop uterine cancer, especially if they have less than three periods in a year and don’t regularly shed the lining of their uterus (endometrium). To protect the lining of your womb from developing precancerous or cancerous changes in the cells, you should have a period once every three months to shed and renew the lining of your womb. See your doctor help you achieve this.
PCOS does not increase your risk of developing ovarian or breast cancer
High Blood Pressure (Hypertension). A woman’s risk of developing hypertension increases if she has PCOS and obesity or insulin resistance.
Sleep Apnea. This sleep disorder causes you to stop breathing during sleep temporarily. It can cause disturbed sleep and snoring and cause you to feel tired and sleepy during the day. It is associated with obesity.
The first step in treating PCOS is to visit your Gynecologist or doctor to determine that you have this condition and there is no one-size-fits-all solution. Treatment will depend on what symptoms are present.
It is essential to start with lifestyle modifications for all patients in managing PCOS. A healthy lifestyle with a balanced diet and regular 30 minutes of exercise at least three times a week are fundamental to reducing the risk of developing the long-term complications of PCOS. While the cause of PCOS isn’t known, doctors think extra weight may contribute to PCOS symptoms by increasing insulin production in your body.
For patients who are overweight or obese, reducing their weight by as little as 5-10% can dramatically improve their insulin resistance, androgen levels, menstrual pattern, acne, and excess hair growth.
If your menstrual cycle is affected by PCOS, you may use medicine such as birth control pills to help regulate it. Other medicines include metformin (Glucophage), which helps control blood sugar levels, and spironolactone (Aldactone), which blocks the action of male hormones in women.
PCOS is a disorder that impacts millions of women worldwide every day. This article was an opportunity for us to share our learnings about this chronic condition with you and shed light on the potential treatments. If you are concerned about PCOS, the best thing you can do is visit your Gynecologist. Managing your PCOS effectively means individualized treatment and attention from your physician. It’s critical to take charge by seeking answers to all of your questions, paying close attention to any symptoms you experience, and making sure that you’re addressing your PCOS with the most effective treatments currently available.
Our Expert Gynecologist
Dr. Mayada Thamir Younis
Consultant Obstetrics and Gynecology
Burjeel Hospital, Abu Dhabi