What is PCOS?

It is a problem in which a woman's hormones are out of balance. It can cause problems with your periods and make it difficult to get pregnant. PCOS also may cause unwanted changes in the way you look. If it isn't treated, over time it can lead to serious health problems, such as diabetes and heart disease.

1 in 20 women of childbearing age has PCOS. With PCOS women typically have High levels of androgens, Missed or irregular periods and Small cysts in ovaries.

What causes PCOS?

·         Exact cause is unknown.

·         Genetics could play a role

·         Dietary habits

·         Insulin resistance

Excess androgens can lead to:

·         Acne

·         Increased hair growth

·         Weight gain

·         Problems with ovulation.

Why do women with PCOS have trouble with menstrual cycle fertility?

The ovaries have tiny fluid-filled sacs called follicles or cysts. As the egg grows, the follicle builds up fluid. When the egg matures, the follicle breaks open and the egg is released. In women with PCOS, ovaries don’t make all of the hormones it needs for an egg to fully mature.

Some follicles remain as cysts. For those reasons, ovulation does not occur and Progesterone is not made. Plus, ovaries make male hormones which also prevent ovulation.

What are the associated health problems in PCOS? 

·         50% of women with PCOS will have diabetes/impaired glucose tolerance before 40 years of age.

·         Risk of heart attack is 4-7 times more in PCOS.

·         Higher risk of High BP

·         Women with PCOS have higher levels of LDL and low levels of HDL.

·         Sleep apnoea

·         Women with PCOS may develop depression and anxiety

·         Higher risk of endometrial cancer

How does PCOS affect a woman while pregnant?

Women with PCOS have higher ratios of:

·         Miscarriages

·         Gestational diabetes

·         Premature delivery

·         PIH

Will hysterectomy cure PCOS?

Hysterectomy will not cure PCOS. Once you have PCOS, you will always have it. There is no cure for PCOS. However, there are many treatment options that can help minimise symptoms.

Diagnosis of  P COS

2 of the 3 following criteria are diagnostive of the condition.

·         Polycystic ovaries (either 12 or more peripheral follicles or higher ovarian volumes greater than 10cm³)

·         Clinical or biochemical signs of hyperandrogenemia.

·         Oligoovulation

Treatment of PCOS:

Treatment goals are based on symptoms.

1.       Lifestyle modification: this includes regular exercise and healthy eating habits

2.       Diabetes medications: Metformin is used to treat type 2 diabetes and to reduce PCOS symptoms. Metforminafects glucose to reduce testosterone's production. It also slows the growth of abnormal hair and after a few months may help ovulation to return

3.       Surgery: Ovarian drilling that may increase chances of ovulation.

4.       Clomiphene: Can be used to stimulate ovulation.