Know About Polycystic Ovarian Syndrome Symptoms And Treatment

Globally, Polycystic ovarian syndrome affects 5% to 15% of women. It is one of the major causes of infertility in females, and by age 40, more than 50% of the women with PCOS develop type-2-diabetes.

Polycystic ovarian syndrome (PCOS) is a disorder caused by an imbalance in reproductive hormones. It can cause irregular menstrual periods, infertility and other health problems. In this disorder, women develop multiple cysts in their ovaries, leading to the name “polycystic”. However, some women with this disorder don’t have cysts formation. 

In this topic, we will discuss what polycystic ovarian syndrome symptoms are, why they occur, and PCOS treatment in detail. Before diving into pcos symptoms and treatment, let’s understand some basics about polycystic ovarian syndrome to get clarity.

How Does PCOS Happen?

The release of a mature egg each month is called ovulation. When the mature egg is released from the ovary, it can be fertilized by male sperm.When the egg is not fertilized, it is removed from the body during periods. 

Estrogens, progesterone, follicle-stimulating hormone and luteinizing hormone are the hormones involved in regulating the menstrual cycle and ovulation. Insufficiency of these hormones interferes with ovulation, and ovaries tend to produce cysts (fluid-filled sacs) containing immature eggs that may never mature enough to be released from the ovary.

Androgens are male reproductive hormones, but androgens are present in little quantities in women also. In women with polycystic ovarian syndrome, androgens present in higher amounts that disrupts the menstrual cycle, prevent ovulation, and causes some other polycystic ovarian syndrome symptoms. 

Why Does PCOS Happen?

Researchers still don’t know why exactly polycystic ovarian syndrome occurs in some women. Few studies show genetics may play a role. Around seventy percent of women with PCOS have insulin resistance. Insulin resistance is the inability of our body to properly use the hormone insulin. Insulin controls how our body uses sugar for energy. 

When the body can’t use insulin correctly, the demand for this hormone increases resulting in higher levels of insulin in our body. It can induce the ovaries to produce more androgens. Obesity is the primary cause of insulin resistance. Together with obesity, PCOS can raise your risk of diabetes, and symptoms will get worse. Women with this disorder also tend to have inflammation in their bodies. 

Polycystic Ovarian Syndrome Symptoms

• Irregular periods: Lack of ovulation in PCOS may cause the women to miss periods or have fewer than eight periods a year. Some of them may stop having menstrual periods. The menstrual periods may be very light periods or abnormally heavy periods.
• Excess bodily hair: Elevated levels of male hormones cause too much hair in the body parts such as the face, chin, chest, stomach, and back. This condition is called hirsutism and affects more than seventy percent of women with PCOS.
• Weight gain: Around 80% of the women gain weight, particularly around the belly and have trouble losing weight. It may occur due to high androgen levels. Abdominal fat is linked with the increased risk of heart disorders and other health problems.
• Darkening of the skin: People may notice thick or dark skin patches, especially along neck creases, under the breasts and arms and in the groin region. If women with PCOS have insulin resistance, they develop this symptom. Women will be evaluated for diabetes as this symptom is early evidence of diabetes.
• Acne or oily skin: Androgens play a lead role in the development of oily skin and pimples in PCOS. These polycystic ovarian syndrome symptoms may occur in the face, neck, chest or upper back.
• Thinning of hair: The excess androgens can also make the hair on your head start thinning, particularly near the front of the scalp. It can worsen in middle age.
• Headaches: Hormonal imbalances can cause frequent headaches in women suffering from  PCOS affecting their daily routines. Overweight and obese women with this disorder experience more frequent headaches than with normal weight.
• Inability to conceive: Less frequent or absence of ovulation makes PCOS one of the leading causes of female infertility.
• Skin tags: A little piece of extra skin may occur in the armpits or on the neck.

PCOS Treatment:

Your physician will suggest treatment options based on your symptoms, age, medical history. Treatment options vary based on your pregnancy plan.

PCOS Treatment Options If You Do Not Plan To Become Pregnant:

a.) Hormonal birth control: Birth control pills, patches, vaginal rings, shots, or IUD (intrauterine device) can be used to make the menstrual cycle normal and reduce acne and excess body hairs. Oral contraceptives are an effective and preferred option to manage menstrual irregularities and other symptoms. 

They are two types: Progestin-only pills and combination birth control pills. The combination pills contain progestin and estrogen. These are synthetic hormones similar to the ones made by the ovaries. Apart from managing the symptoms, these pills help reduce the risk of endometrial cancer (cancer of the womb lining), which may occur when not having regular periods for a long time.

b.) Metformin: Metformin is the diabetic medication used to control blood sugar levels in type 2 diabetes. Metformin helps the body to use insulin effectively and may help in reducing androgen levels and regulating ovulation. Metformin may also have other health benefits, such as lowering cholesterol levels and reducing the risk of heart disorders. 

PCSO Treatment Options If You Want To Become Pregnant:

Decreased or absence of ovulation caused by PCOS can cause difficulties in becoming pregnant. It can also cause problems during pregnancy. Thanks to the advancement in the medical field, women with PCOS can have a healthy pregnancy with a proper treatment plan.

Pregnant people with PCOS have a higher risk of complications during the pregnancy, such as premature delivery, heavier babies, gestational diabetes, high blood pressure, and preeclampsia. PCOS women are 3 times more likely to have a miscarriage when compared to a normal woman. So, they will be monitored closely throughout the pregnancy period by a medical team to prevent complications.

Your physician will prescribe one of the below treatments to help you to get pregnant.

a.) Ovulation inducing medications:        

Oral medications: Clomiphene and letrozole 

Given by injection: Gonadotropins 

Clomiphene is usually the 1st treatment recommended for PCOS women to get pregnant. It can help with the monthly release of an egg from the ovaries. Letrozole is another oral medication used to cause ovulation. This medication is also sometimes used to treat breast cancer. 

When these two oral medications fail to stimulate ovulation and the patient is unable to get pregnant, gonadotropins are recommended. These medicines may increase the risk of multiple births (twins or more). The risk is higher in the case of gonadotropins.

b.) Surgery: When fertility problems are not rectified after taking medicines, a minor surgery called LOD (laparoscopic ovarian drilling) may be recommended. A heat or laser is used to destroy the ovarian tissue that produces male hormones. Surgery usually restores ovulation but only for six to eight months. Physicians rarely suggest this treatment.

c.) In vitro fertilization: The egg of a PCOS woman is fertilized with her partner’s sperm in a laboratory and then transferred to the uterus. It is recommended when medications don’t work. IVF possesses higher pregnancy rates and little risk of having multiple births. 

d.) Lifestyle changes: A balanced diet and moderate physical activity is a safe option to manage symptoms in women trying to get pregnant. They help the body use insulin properly and assist in ovulation. Ask your physician to recommend a dietitian to find a personalized healthy eating plan.

After pregnancy, symptoms and severity of polycystic ovarian syndrome can vary. PCOS women need to pay close attention to lose weight after delivery as the weight gain can worsen the symptoms. Continuing the PCOS treatment after pregnancy is essential. 

When PCOS women reach menopause, they continue to experience some symptoms of PCOS along with menopausal symptoms. PCOS and menopause affect hormones in different ways. Seek medical help if you experience symptoms that affect your quality of life.

Herbs And Spices To Manage PCOS Symptoms:

There are many herbs and spices which can help relieve PCOS symptoms. Here are five common herbs and spices that can be useful in PCOS. Though they are common, you need to consult your physician before taking them regularly as they may interact with other medicines you take.

1. Tulsi (Holy basil) , known as a queen of herbs, is a wonderful herb for PCOS. It possesses antioxidant and anti-inflammatory properties. It controls male hormones that are involved in unwanted hair growth and acne with PCOS. It can help prevent weight gain and lower your blood sugar levels. Chew at least ten leaves on an empty stomach or drink boiled tulsi water daily.

2. Cinnamon is a common spice in our food. It can reduce insulin resistance and regulate blood sugar levels. Cinnamon can also enhance fertility and make PCOS women have more regular periods. Add cinnamon to your diet, or you can simply mix the cinnamon (half a teaspoon) in water and drink.

3. Fenugreek seeds can help in controlling insulin levels in the body. It may also help to lose weight and lower cholesterol levels in the body. Soak fenugreek seeds overnight. Have it thrice a day, one teaspoon on an empty stomach in the morning, one teaspoon five minutes before lunch and dinner.

4. Ginger contains antioxidant and antimicrobial properties. It helps to relieve period pain, balances blood sugar, fights inflammation and supports weight loss. Drink ginger tea two times each day or try adding to juices.

5. Flax seeds are a good source of omega fatty acids and fibres. The protein lignan present in the flax seeds helps reduce testosterone and insulin levels in the body. Add ground flax seeds to the breakfast, mix them with juices, or simply add them to your drinking water.

Treatment For Excessive Hair Growth Caused By PCOS: 

1. Birth control pills: It decreases the male hormones involved in excessive body hair growth.

2. Anti-androgen medications: Medications such as spironolactone, flutamide, cyproterone acetate, and finasteride block the effects of male hormones and help control hair growth and acne. These medicines can cause problems during pregnancy. Hence, it is not recommended for women who are pregnant or planning to get pregnant.

3. Eflornithine cream: This cream can be used to slow down the growth of hair in unwanted places. Improvement can be seen in four to eight weeks after treatment with this medication. It does not remove unwanted hair, so it may be used along with hair removal products. 

4. Electrolysis: In this treatment, electric current is used to damage and destroy the hair follicle. You may need multiple treatments.

Achieving Healthy Weight With PCOS:

Polycystic ovarian syndrome with obesity or being overweight may worsen the symptoms. Losing weight can be helpful in easing some symptoms by lowering insulin and androgen levels in the body. When lifestyle changes are not effective in losing weight, your physician may recommend weight loss medications such as orlistat. It may also help lower cholesterol levels.

Losing weight can be hard, but losing even 5% of weight may help in reducing the symptoms. Here are a few tips to reduce weight in PCOS. Limit carbohydrates, processed foods, and added sugars in your diet. Make sure your diet includes enough protein, plenty of fibres, and healthy fats. 

Some examples of high fiber foods are apples, raisins, dates, berries, spinach, peas, sweet potatoes, cabbage, broccoli, lettuce, kale, Brussel sprouts, corn, and apricots.

Some examples of healthy fats are almonds, peanuts, avocados, olives, hazelnuts, and vegetable oils. Fish such as sardines, salmon, mackerel, ground flax seeds, and walnuts also provide healthy fats. 

Try to have a moderate physical activity of 45 to 60 minutes three times a week and 7 to 8 hours of sound sleep each night.

PCOS Acne Treatment:

Birth control pills will help to manage acne in polycystic ovarian syndrome. The pills recommended for treating acne usually contain one or two of the following drugs, progestin norgestimate, drospirenone, or norethindrone acetate. Anti-androgen medications are also helpful in acne management. 

Vitamin D, A, and B vitamin supplements may also be helpful in the management of acne. Consult your doctor for suitable options and do not take more than recommended dosages. Make sure that you follow a good skincare routine to achieve the best results. 

It's Time To Visit A Doctor:

Have you missed periods or excessive body hair growth? 

Trying to get pregnant for more than one year but not yet successful and thinking you might have PCOS? 

PCOS may lower the chances of getting pregnant and is linked to many other health problems such as diabetes, depression, liver problems, etc. Be sure to visit your health care professional if you experience any polycystic ovarian syndrome symptoms and lower your risk of other health conditions.