Causes, treatments and symptoms of PCOS

The symptoms of PCOS (polycystic ovary syndrome) can vary depending on several genetic and hormonal factors.

Polycystic ovary syndrome is a highly prevalent disorder accounting for anovulatory infertility in 6-20% of women of the reproductive age group. Symptoms arise during early puberty and are broadly characterized by irregular menstrual cycles, anovulation and acne.

The symptoms of PCOS show a cycle of neuroendocrine, metabolic and ovarian dysfunction. Studies have linked obesity with occurrence of PCOS, but BMI data may not always significantly correlate with the patients.

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Signs of PCOS: Diagnostic criteria

Fatigue is associated with the symptoms of PCOS. (Image via Unsplash/Elisa Venture)

Several diagnostic criteria have been proposed and have been used over the past two decades. Three of those criteria have been interchangeably used since then.

Presently, the Rotterdam criteria are the most widely used for PCOS classification; it proposes that if at least two of the three following characteristics:

• Oligo- and/or anovulation
• Clinical and/or biochemical signs of hyperandrogenism
• Polycystic ovaries in the candidate, excluding congenital adrenal hyperplasias, androgen-secreting tumors and Cushing's syndrome

The disorder is polygenic in nature, and multiple factors contribute to PCOS etiology. Family and twin studies performed to identify genes that contribute to PCOS susceptibility found the condition to be clustered within families.

First-degree relatives of both sexes of PCOS-affected women were found to be predisposed to conditions like gonadal or adrenal hyperandrogenism, type 2 diabetes mellitus and cardiovascular diseases compared to relatives of unaffected women.

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Common and unusual symptoms of PCOS

Symptoms of PCOS start around the time of the first menstrual period but can also be delayed if the periods are irregular. Signs and symptoms of PCOS include:

1) Irregular periods

Less frequent or irregular periods are common signs of PCOS. Periods that last for many days can be something of concern. Trouble getting pregnant is one of the concerns for many, as regular and good menstrual health is essential for reproductive health. Amenorrhea is quite common in PCOS.

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2) Excess androgen production

High levels of androgen hormones, including testosterone, may trigger growth of excess body and facial hair. This is called hirsutism and is also associated with severe acne and male-pattern baldness.

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3) Polycystic ovaries

Ovaries might be bigger in size. Small follicles containing immature ovum may be deposited around the edge of the ovary. These can be observed via ultrasound scan.

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Possible causes of PCOS

Genetics is considered to be the root cause of PCOS. (Image via Unsplash/Sangharsh Lohakare)

The exact cause of PCOS isn't known. Genetic and epigenetic research is striving to understand the root cause of this highly prevalent syndrome. Possible causes that might be associated with the symptoms of PCOS are:

1) Insulin resistance

Insulin is a hormone synthesized in the pancreas. It helps with glucose utilization in the body. When cells become resistant to the action of insulin, blood sugar spikes take place.

Long-term insulin resistance is nothing but type 2 diabetes mellitus. Too much insulin is found to be associated with excess production of androgen hormones. An insulin resistance diet might come in handy.

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2) Inflammation

White blood cells produce inflammatory response molecules. Research shows that people who show symptoms of PCOS have chronic inflammation.

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3) Genetics

Research suggests that certain genes might be linked to PCOS. Having a family history of PCOS may play a role in developing the condition.

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4) Excess androgen

Elevated levels of androgen interfere with ovulation, which is the most common among symptoms of PCOS. The cause of the excess production of testosterone is not known, and there might be genetic reasons behind it.

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Treatment of polycystic ovary syndrome

Currently, there are no PCOS treatments, and doctors usually treat the symptoms of PCOS using existing drugs, including hormonal steroids, diabetic drugs, vitamin D supplements, myoinositol and other formulations. Extensive research is being conducted to develop a cure. A diet for PCOS can help women with this condition in a natural way.

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Indranil Biswas is a nutritionist and personal trainer with a diploma in dietetics and personal training with a specialization in sports nutrition and strength training.

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