Understanding Polycystic Ovary Syndrome (PCOS)

Imagine having unusual body hair, irregular periods, or constantly having difficulty losing weight or conceiving; women who suffer from Polycystic Ovary Syndrome (PCOS) deal with just a few of these symptoms and more. PCOS is an endocrine disorder comprised of a set of symptoms due to heightened androgens, which are male hormones in women. PCOS is the most common endocrine disease, which affects different endocrine glands in the body, and affects approximately two to twenty percent of women between eighteen to forty-four. The condition is also one of the leading causes of reduced fertility in women.

How Does PCOS Form Within The Body?

PCOS stems from a disorder occurring within the endocrine system, which is comprised of numerous glands, such as the pineal, pituitary, thyroid, thymus, adrenal, pancreas, ovary, or testes glands, which affects the hormones or other functions within the body. The condition occurs in most women due to a combination of genetic and environmental elements, as women who are obese, do not get enough exercise, and have a family history of the condition are prone to developing PCOS. PCOS is a heterogeneous disorder of an uncertain cause, and there is some evidence indicating it is a genetic disease. Therefore, a child has a fifty percent chance of inheriting the condition from either their mother or father, as men can be asymptomatic carriers, or display some symptoms such as early baldness or excessive hair.

Causes Of PCOS Continued

As a complex multigenic condition, the exact affected gene has not yet been discovered. However, it is known the phenotype - the genetic code that creates the condition - appears to manifest itself partially due to the high levels of the (male) androgen present in the ovarian follicle theca cells. As the ovaries are the primary organ affected, recent research has indicated PCOS is a multisystem disorder, with the predominate issue being in the hormonal regulation in the hypothalamus, that includes many organs. Polycystic ovaries develop when a woman's ovaries are stimulated to produce more hormones, specifically testosterone, by either one or a combination of the release of excessive luteinizing hormone (LH) through high levels of insulin in the blood or by the anterior pituitary gland.

The Hormones Affected By PCOS

The main hormone PCOS affects is the androgen. All females produce androgens, commonly known as ‘male hormones.' However, women suffering from PCOS have higher levels of this hormone coursing throughout their bodies. The ovaries produce this excessive amount, but the adrenal glands can also produce an excessive amount of the hormone. Excessive androgens are responsible for many of the condition’s symptoms including unwanted hair, thinning hair, acne, and irregular periods.

Insulin is another bodily hormone that affects PCOS, as it what permits the body to absorb glucose (blood sugar) into the cells for energy. However, when a patient is suffering from PCOS, the body does not respond the same way to insulin, which can lead to elevated blood glucose levels, resulting in the production of more insulin. It is a vicious cycle, as when the body produces too much insulin, the body responds by producing more androgens, which worsens the symptoms and condition for the patient. Progesterone is the final hormone that affects PCOS, as a lack of this hormone is what contributes to irregular periods for a patient.

What Are The Symptoms?

There are numerous and often physically and emotionally devastating symptoms a woman can suffer from when it comes to dealing with PCOS. Symptoms can begin after puberty, but can also develop during the later teen years and into early adulthood. Symptoms and signs of the disease include irregular or no menstrual periods, heavy periods, acne, excessive and unwanted body and facial hair known as hirsutism, pelvic pain, difficulty conceiving, and patches of thick, darker, and velvety skin.

Other symptoms include weight gain, difficulty losing weight, fatigue and low energy, mood changes, headaches, and sleep problems. The severity of these symptoms is primarily determined and can dramatically increase if a patient is obese. One of the most challenging symptoms for a female to deal with if they are suffering from PCOS is infertility, as the disorder is the leading cause of female infertility. Although some women may need assistance in conceiving, such as through in vitro fertilization (IVF), other women can conceive naturally, as the condition affects every woman and body differently.

Diagnosis Of PCOS

There is not one specific or standard test available to determine if a patient is dealing with PCOS. The first step to diagnosing PCOS is for a doctor to inquire about the patient's medical history of symptoms, such as irregular or missed periods, weight and hair changes, and acne. A doctor may also check into a patient’s family medical history to indicate if the symptoms are related to PCOS rather than another disease, as well as check the patient’s weight, vitals, and do a complete physical exam. Lab tests can be conducted to check blood sugar and androgen levels, as well as a sonogram, to evaluate the ovaries.

The best way to diagnose a woman with PCOS is through an ultrasound, as cysts on the ovaries are often indicators that a patient may be suffering from this condition, and can only be viewed through an ultrasound. These types of tests can help diagnose a woman with PCOS. However, a doctor can refer the patient to a specialist for hormones, or an endocrinologist, to determine one-hundred percent if the patient has PCOS and is not being misdiagnosed with a different hormone-related condition.

How To Treat PCOS

There is no cure for PCOS. However, there are a variety of treatments available to women who suffer from this disorder to make life easier. Treatment can be simple, such as making suitable lifestyle changes such as losing weight and exercising more frequently. Birth control pills are the most common treatment used to control some of the symptoms of PCOS, as it can help improve the regularity of menstrual cycles, excess hair growth, and acne, and lowers the overall levels of androgen and protects the inner lining of the uterus.

Although not approved by the FDA, doctors will often prescribe metformin as the medicine helps the body become more sensitive to insulin, which helps lower blood glucose, insulin, and androgen levels. Typical acne treatments and hair removal techniques can also help, and women who want to become pregnant are encouraged to improve their fertility chances by losing weight and using clomiphene, which induces ovulation, or metformin. As mentioned, women trying to conceive may also use IVF when other fertility treatments are not as effective.

Lasting Consequences Of PCOS

Once a patient is diagnosed with PCOS, they are at an increased risk of developing a shocking amount of other health problems. However, this diagnosis does not mean they are inevitably going to develop more health issues; they just have an increased risk of doing so. These associated conditions and other health problems include Type II diabetes, obesity, heart disease, endometrial hyperplasia and cancer, obstructive sleep apnea, mood disorders, high blood pressure, depression and anxiety, dyslipidemia, strokes, miscarriages, acanthosis nigricans, and autoimmune thyroiditis. The risk of developing ovarian or breast cancer does not significantly increase, however, both are still diseases associated with the disorder. Early diagnosis and treatment can reduce the risk of some of these critical health issues, such as Type II diabetes and heart disease.