Polycystic Ovarian Syndrome (PCOS)

What is Polycystic Ovarian Syndrome?

In a healthy menstrual cycle, the reproductive hormones induce the ovaries to make the egg and release it every month. In PCOS, due to the imbalance of the hormones, the egg may not be developed, and even if it is developed, it may not be released during ovulation each month.

PCOS is a common condition that affects 10% of women of childbearing age. PCOS causes missed or irregular menstrual periods. Irregular periods in women can lead to:

• Infertility
• Development of cysts in the ovaries

What causes PCOS?

Hormonal imbalance of the reproductive system

High levels of androgen. Androgen is a male hormone that is responsible for the development of male traits, such as being more masculine, having more hair, acne, male-pattern baldness. In the reproductive organs, when the level of androgen is high in females, this can prevent the ovaries from releasing the egg during the menstrual cycle.

PCOS is associated with diabetes and insulin resistance. Insulin is a hormone that controls the carbohydrate and sugar in your body and turns them into energy. In insulin resistance circumstances, the body is not able to respond to insulin, leading to a high level of sugar in the body, which is termed diabetes mellitus.

Symptoms of PCOS include:

Irregular or absence of menstrual cycle

• Acne
• Hairy- distribution of hair over where men usually have- facial, chin, body
• Hair loss and hair thinning
• Weight gain
• Skin pigmentation – typically over the skin creases over the neck, groin, armpit and under the breasts
• Skin tags

What are other health conditions associated with PCOS?

• Diabetes
• High blood pressure
• High cholesterol
• Obstructive sleep apnoea
• Depression and anxiety
• Endometrial cancer

What do I expect during my consultation with my doctor?

Your doctor will take a relevant, thorough medical history, and a physical examination of your face, hair, chest back, abdomen, and pelvis. Other physical examinations include measuring your blood pressure, body mass index (BMI), and waist size. You will be offered hormonal blood tests and ultrasound of the pelvis to evaluate further your reproductive organs.

How is PCOS treated?

Although there is no cure, there are treatment options to manage PCOS. The goal of management is to manage your symptoms, restore and increase the chance of fertility in childbearing ladies, and manage risks of long term health issues such as diabetes and heart disease.

Leading a healthy lifestyle and eating a normal healthy balanced diet is crucial in PCOS ladies. A reduction of 5% of body weight has been shown to increase fertility chance and to restore spontaneous ovulation in some women.

In ladies who are not planning pregnancy, hormonal birth controls in the form of pills, patches, shot, vaginal rings, or intrauterine hormonal devices are used to regulate the menstrual cycle, reduce the risk of endometrial cancer, improves acne and reduce excessive hair in the face and body.

A medication known as metformin may be recommended in those with insulin resistance and diabetes. Interestingly metformin also lowers the androgen levels in ladies with PCOS, and aid in restoring ovulation.

Speak to your doctor for further advice, as every lady has different needs and concerns, and your treatment is likely individualized to yourself.

Can I still become pregnant if I have PCOS?

Yes. Although PCOS is a common cause of infertility in women, thankfully often, it is treatable. Your doctor can discuss ways to help you to ovulate and increase your chance of becoming pregnant.