PCOS stands for Polycystic Ovary Syndrome. It is used interchangeably with polycystic ovarian disease (PCOD) in most parts of the world. It is a hormonal disorder, affecting at least 1 in 10 women of reproductive age. The exact cause is not known, but factors like genetics and insulin resistance may play a role. Symptoms include irregular menstrual periods, excess hair growth, acne, and weight gain. Most PCOS symptoms are often influenced by lifestyle.
Understanding Polycystic ovarian syndrome-
According to the 2003 Rotterdam PCOS criteria: Any 2 out of 3 criteria must be me to diagnose adult PCOS.
- Ovulatory dysfunction (delayed or missed periods)
- Hyperandrogenism (clinical signs like- acne, excess hair growth, or lab tests indicating excess androgen hormones)
- Polycystic ovary morphology (appearance of cysts) in one or both ovaries on ultrasound.
PCOS often starts in adolescence when symptoms like acne and irregular periods can be mistaken for a normal issue at this age. Polycystic ovary syndrome (PCOS) can manifest in various symptoms, which can vary in severity among individuals. Common symptoms include:
- Irregular menstrual cycles: Women with PCOS may have irregular periods or may even experience missed periods.
- Excess androgen levels: Elevated levels of male hormones (androgens) can lead to symptoms such as excess facial and body hair (hirsutism), male-pattern baldness, and acne.
- Polycystic ovaries: The ovaries may develop multiple small follicles, which can be seen on an ultrasound. These follicles may fail to release eggs regularly.
- Weight gain or difficulty losing weight: Many women with PCOS struggle with weight management, and obesity is often associated with the condition.
- Insulin resistance: PCOS is frequently linked with insulin resistance, a condition where the body’s cells do not respond efficiently to insulin. This can lead to high levels of insulin in the blood, which may contribute to weight gain and increase the risk of type 2 diabetes.
- Infertility or difficulty conceiving: Irregular ovulation can make it challenging to become pregnant.
- Skin issues: In addition to acne, some women with PCOS may experience skin darkening, particularly along skin folds such as the neck creases, groin, and underneath breasts (acanthosis nigricans).
It is important to note that not all women with PCOS will experience every symptom, and the severity of symptoms can vary widely. Additionally, PCOS is associated with an increased risk of other health conditions, such as type 2 diabetes, high blood pressure, and cardiovascular disease. Early diagnosis and management can help alleviate symptoms and reduce the risk of complications. If you suspect you may have PCOS, it is important to consult with a healthcare provider for proper evaluation and treatment.
Blood works to diagnose PCOS:
Blood tests are often used to diagnose polycystic ovary syndrome (PCOS) and to assess hormone levels and other markers associated with the condition. Some common blood tests used in the diagnosis and management of PCOS include:
Hormone levels:
- Testosterone: Elevated levels of total testosterone, a male hormone, can contribute to symptoms such as hirsutism (excess hair growth) and acne.
- DHEA-S: Dehydroepiandrosterone sulfate (DHEA-S) is another androgen that may be measured to assess hormonal imbalances.
To rule out other causes of missed periods:
- Luteinizing hormone (LH): Elevated LH levels relative to follicle-stimulating hormone (FSH) levels may indicate disrupted ovulation.
- Follicle-stimulating hormone (FSH): FSH levels may be measured alongside LH levels to evaluate ovarian function.
- Prolactin: Elevated levels of prolactin, a hormone that stimulates milk production, may be checked to rule out other conditions that can mimic PCOS symptoms.
Insulin resistance markers:
- Glucose: Fasting glucose levels may be measured to assess insulin resistance and the risk of developing type 2 diabetes.
- Insulin: Elevated insulin levels are common in women with PCOS, especially those who are overweight or obese.
Other markers:
- Cholesterol/lipid profile
- Thyroid function tests
- Full blood count & ferritin (to investigate iron deficiency anemia)
It is important to note that while these blood tests can provide valuable information in the diagnosis and management of PCOS, they are typically used in conjunction with other diagnostic criteria, such as physical examination, medical history, and imaging studies (e.g., ultrasound of the ovaries).
Can PCOS be prevented?
While there is no guaranteed way to prevent polycystic ovary syndrome (PCOS) since its exact cause is not fully understood, there are lifestyle changes and strategies that may help reduce the risk of developing PCOS or manage its symptoms. Here are some recommendations:
- Maintain a healthy weight: Obesity and excess weight are strongly associated with PCOS. Losing weight, if overweight, or maintaining a healthy weight through a healthy diet and regular exercise may help prevent or alleviate symptoms of PCOS.
- Exercise regularly: Engage in regular physical activity, such as brisk walking, jogging, cycling, swimming, or strength training. Exercise can help improve insulin sensitivity, aid in weight management, and regulate menstrual cycles.
- Manage stress: Chronic stress can exacerbate hormonal imbalances associated with PCOS. Practice stress-reducing techniques such as yoga, meditation, deep breathing exercises, or hobbies that you enjoy.
- Get enough sleep: Aim for 7-9 hours of quality sleep per night. Poor sleep habits can disrupt hormone levels and contribute to insulin resistance and weight gain.
- Limit exposure to endocrine-disrupting chemicals (EDCs): Some environmental chemicals, such as bisphenol A (BPA) found in plastics, pesticides, and certain cosmetics, may disrupt hormone balance, and potentially contribute to PCOS. Minimize exposure to these chemicals by choosing BPA-free products, eating organic foods when possible, and using natural, non-toxic personal care products.
- Consult with a healthcare provider: If you have irregular periods, excess hair growth, acne, or other symptoms associated with PCOS, consult with a healthcare provider for proper evaluation and management. Early diagnosis and treatment can help prevent complications and improve quality of life.
While these lifestyle strategies may help reduce the risk of developing PCOS or manage its symptoms, it is essential to recognize that individual factors and genetics also play a role in the development of the condition. Therefore, working with a nutrition professional and a medical doctor are crucial.
PCOS and psychological issues:
Polycystic ovary syndrome (PCOS) not only affects physical health but can also have psychological impacts due to hormonal imbalances and the associated symptoms. Some of the psychological symptoms commonly reported by individuals with PCOS include:
- Depression: PCOS is associated with an increased risk of depression. The hormonal imbalances and the challenges of managing symptoms like irregular periods, weight gain, and infertility can contribute to feelings of sadness and hopelessness.
- Anxiety: Women with PCOS may experience heightened levels of anxiety, often related to concerns about fertility, body image, and the impact of the condition on their overall health and well-being.
- Body image issues: Symptoms such as weight gain, excess hair growth (hirsutism), and acne can affect self-esteem and body image. Women with PCOS may struggle with negative body image perceptions and feelings of self-consciousness.
- Eating disorders: Some women with PCOS may develop disordered eating patterns, such as binge eating or restrictive eating, to cope with symptoms or control weight. This can further exacerbate the challenges of managing PCOS and may lead to additional health complications.
- Low self-esteem: Dealing with the physical manifestations of PCOS, such as acne, hirsutism, and weight gain, can impact self-confidence and self-worth, leading to feelings of inadequacy and low self-esteem.
- Stress: Managing the symptoms of PCOS, along with concerns about fertility, relationships, and overall health, can lead to chronic stress. High levels of stress can further disrupt hormone balance and exacerbate symptoms.
- Social withdrawal: Some individuals with PCOS may withdraw from social activities or avoid situations where they feel self-conscious about their appearance or symptoms, leading to feelings of isolation and loneliness.
It is important to recognize the psychological impact of PCOS and address these concerns as part of comprehensive care. Seeking support from therapists, support groups, or loved ones can be beneficial in managing the psychological aspects of PCOS.
My struggle with PCOS was a tough battle and a combination of all the above physical, emotional, and psychological symptoms, After I delved deep into Nutritional studies and certification in menstrual cycle health and awareness, I learned to take back control of my life by nourishing my body, managing stress, eating mindfully, supplementing vital nutrients, and implementing lifestyle interventions, hence, the quality of my life improved dramatically ever since.
When clients come to me with all these issues, they are so overwhelmed, I have immense empathy towards them and I totally get it. I like to delve deep into your current health status and address all the dietary and lifestyle factors to create a bespoke health plan for them.
Afterall, PCOS is not just a gynecological issue!
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