Know about PCOS and ways to prevent it

Genetics, lifestyle, and environment may all play a role in pathogenesis of PCOS.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorder affecting one in 10 women of reproductive age well beyond the ovaries. When the disease and symptoms are limited to ovaries and reproductive system it’s called PCOD and when it has started involving other systems in body it’s called PCOS. Genetics, lifestyle, and environment may all play a role in pathogenesis of PCOS.

In PCOS certain hormones in body like oestrogen, progesterone and its derivatives, testosterone and insulin (sometimes thyroid and prolactin as well) are out of balance. These imbalances typically show up as small cysts in the ovaries, irregular menstrual cycles, a higher level of androgens in the body causing excess facial/body hair, acne, and mood changes with increase in insulin levels to overcome the insulin resistance leading to obesity.

Other common symptoms include breathing problems while sleeping, depression, oily skin, infertility, skin discolorations, high cholesterol levels, elevated blood pressure, pain in the lower abdomen and pelvis, multiple ovarian cysts, and skin tags. Some women have only a few symptoms while others have several.

The diagnosis of PCOS is based on a careful evaluation of many factors, because there is no specific test to definitely diagnose PCOS. In addition to assessing common PCOS symptoms, taking a detailed medical surgical and family history, blood tests are required to test the hormone levels for irregularities and an ultrasound for closer look at the ovaries to see if they meet PCOS criteria. Not everyone with PCOS has ovarian cysts, and and polycystic ovaries on their own don’t meet the criteria for diagnosis.

Unmanaged PCOS is associated with type 2 diabetes, infertility, stroke, obesity, sleep apnoea, raised triglycerides, hypertension and cardiovascular disease, fatty liver and depression. Early diagnosis and treatment can help reduce the occurrence of these.

People with PCOS are more likely to seek out and require fertility treatments than people who don’t have it. In people without PCOS, ovulation (the release of an egg from the ovary) typically happens about once a month. People with PCOS may ovulate less frequently or predictably, and may be more prone to miscarriages, which is why PCOS is a common cause of infertility. But good news is that not all women with PCOS have difficulty becoming pregnant and in those who do about 80% will conceive with little aid and experience a smooth pregnancy. The optimal Body Mass Index for fertility is 20-25. If your BMI is above 30, even 5-10% weight loss significantly improved the pregnancy rate.

Diet, exercise and lifestyle modification can make a huge difference in decreasing symptoms, spurring ovulation, losing weight and making you feel better than you’ve ever felt. Getting active for 30 minutes at least three times a week is a great start. Nutrition tips include drinking lots of water and avoiding high glycaemic foods in the form of refined carbohydrates and sugars, opting for 100% whole grain, eating more unsaturated vegetable oils such as walnuts and avocado, choosing berries with antioxidants instead of sweets, eating plenty of green. Diet should include high fibre, lean protein, adequate fats and vitamins and minerals.

Not smoking is also important, as nicotine may increase androgenic activity and smokers tend to have more testosterone in their body .Smoking is associated with increased free testosterone and fasting insulin levels in women with polycystic ovary syndrome, resulting in aggravated insulin resistance.

Several medications may be prescribed for PCOS, but they don’t cure but offer only control of the disease. Birth control is often prescribed as a first-line treatment after or with lifestyle changes. Other medications which may be prescribed for PCOS include insulin sensitizers and anti-androgens to help in balancing hormones. Metformin is a drug commonly prescribed to help regulate blood sugar in some forms of PCOS. People who are trying to get pregnant might be prescribed a drug to help them ovulate and also help in weight management.

Maintaining good health is essential to prevent as well as treat hormonal disturbances and conditions. The best treatment for PCOD and PCOS will include timely diagnosis and the appropriate steps that can help overcome the syndrome and make the journey towards conception a success.

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PCOS Dr. Renu Raina Sehgal


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