Follow Us on Google
Polycystic Ovary Syndrome (PCOS) is a doctor’s nightmare and young girl’s dilemma. It is very difficult to pinpoint and diagnose. Doctor’s arrive on the diagnosis, through elimination by substation. Symptoms and signs are usually very bizarre.
Polycystic Ovary syndrome (PCOS) is a condition in which a woman’s levels of sex hormones oestrogen and progesterone are out of balance. This leads to the growth of ovarian cysts (benign masses on the ovaries). PCOS can affect a woman’s menstrual cycle, fertility, cardiac function and appearance.
The condition was first described in 1935 by American Gynaecologist Prof. Irving F. Stein SR, and Prof. Michael L Leventhal, from whom its original name of Stein – Leventhal Syndrome is taken. The earliest published description of a person with what is now recognised as PCOS was in 1721 in Italy. Cyst – related changes in the ovaries were described in 1844.
PCOS affects pre-menopausal women, and the age of onset is most often before bone age reaches 16 years, that is peri-menarchal.
However, clinical recognition of the syndrome may be delayed by failure of the patient to become concerned if her irregular menses, hirsutism (excessive hair growth everywhere) or other symptoms or by the overlap of PCOS findings with normal physiologic maturation during the 2 years after attaining puberty (menarche).
In lean or skinny women with a genetic predisposition to PCOS, the syndrome may be unmasked when they subsequently gain weight.
The insulin resistant PCOS is by far the most common. High insulin and leptin impede ovulation and stimulate the ovaries to make testosterone. Insulin resistance is caused by sugar, smoking, fat and environmental toxins.
We have pill induced or post pill PCOS or otherwise called hormonal birth control suppressing ovulation. For most women, it is a temporary effect and ovulation will usually resume fairly soon after the pill is stopped. But for some women, ovulation- suppression can persist for months or even years. During that time, it is not unusual to be given the diagnosis of PCOS. Some experts deny the existence of the pill – induced PCOS, but it is very real. It is the second most common type of PCOS.
We also have inflammatory PCOS or chronic immune activation, which results from stress, environmental toxins, intestinal permeability and inflammatory foods like gluten or Al casein. Inflammation is a problem for PCOS because it impedes ovulation, disrupts hormone receptors and stimulates adrenal androgens such as DHEA and androstenedione.
We also have “Hidden – Cause – PCOS, and this is the “simpler – than – you – think” type of PCOS. There is one simple thing that is blocking ovulation. Once that single thing is addressed this type of PCOS resolves very quickly, usually within 3 – 4 months.
Having PCOS can increase your chances of developing other health problems later in life. For example women with PCOS are at increased risk of developing type 2 diabetes, depression, mood swings, high blood pressure, high cholesterol and sleep apnea.
Women who have had absent or very irregular periods, fewer than 3 or 4 periods a year, for many years have a higher – than – average risk of developing cancer of the womb lining – endometrial cancer.
The exact cause of PCOS is not known. Most experts think several factors, including genetics, play a role.
Some of the symptoms of PCOS include irregular menstrual cycle, too much hair on the face, chin or parts of the body where men usually have hair. This is called “hirsutism”. Hirsutism affects 70 percent of women with PCOS. Acne on the face, chest and upper back. Thinning hair or hair loss on the scalp – male pattern baldness. Weight gain or difficulty losing weight. Darkening of skin particularly, and underneath breast, skin tags, which are small flaps of excess skin in the armpits or neck area.
Some potential complications of PCOS include infertility, hypertension, high cholesterol, anxiety, depression, sleep apnea, endometrial cancer, heart attack, diabetes, and breast cancer.
If you become pregnant, your doctor may refer you to a doctor who specialises in high risk pregnancies. Women with PCOS have a higher rate of miscarriage, gestational diabetes, and premature delivery. They may need extra monitoring during pregnancy.
The earlier your PCOS is diagnosed and treated, the lower your risk of developing these complications. Avoiding tobacco products and participating in regular exercise can also reduce your risk of some of these complications. Consult your doctor on what PCOS means for your overall health and how you can prevent serious complications.
Over the years in Gregory University Uturu, I had diagnosed a lot of students, we call them scholars here, with PCOS. My usual leading sign is when a girl complains of excessive facial hair. One even told me outright that she shaves every other day, like a boy. That her boyfriend buys double shaving sticks because of her. Her complaints triggered in my medical mind the possibility of PCOS. Lo and behold she was diagnosed with PCOS when I referred her to a Gynaecologist.
There is no test to definitely diagnose PCOS. Your gynaecologist is likely to start a discussion of your medical history, including your menstrual periods and weight changes. A physical exam will include checking for signs of excess hair growth, insulin resistance and acne.
Your doctor might then recommend a pelvic exam, blood test, and ultrasound especially abdominal scan.
If you have a diagnosis of PCOS, your doctor might recommend additional tests for complications. These tests can include – periodic checks of blood pressure, glucose tolerance, cholesterol and triglyceride levels. Also screening for depression and anxiety. Screening for obstructive sleep apnea.
PCOS can be treated, but there is no cure. Treatment focuses on controlling symptoms and managing the condition to prevent complications.
The treatment will vary from woman to woman, depending on specific symptoms.
Tips for controlling symptoms may include – eat a healthy diet, take regular exercise, take birth control pills if you are not planning to become pregnant.
Ask your doctor about medications that may help you. Anti-androgens are drugs that reduce male hormone levels. These can help stop excess hair growth and reduce acne. Diabetes medications may also be prescribed to lower blood glucose and testosterone levels.
Surgery may be recommended for some women with PCOS. Ovarian drilling is a procedure in which your doctor punctures your ovary with a small needle that carries an electric current. This is done in order to destroy part of the ovary. It is a short – term solution that can promote ovulation and reduce male hormone levels.
Polycystic ovary syndrome (PCOS) cannot be prevented. But early diagnosis and treatment helps prevent long- term complications, such as infertility, metabolic syndrome, obesity, diabetes and heart disease.
Always be medically guided.
Please follow me on twitter @DRSUN
