September 1 denotes the beginning of the PCOS (Polycystic ovary condition) mindfulness month and this year, it additionally denotes the beginning of the ‘World PCOS Day of Unity’ occasion, coordinated by the PCOS Challenge: The National Polycystic Ovary Syndrome Association. PCOS Awareness Month is a governmentally assigned occasion and its point is to bring issues to light and help work on the existences of those influenced by PCOS through defeating side effects and changing the way of life that prompts PCOS.
The term “polycystic” literally means “which contains many cysts”. Cysts are small pockets of air, gas, or fluid that can form in many parts of the body. There is a talk of PCOS when the ovaries increase in size due to the presence of multiple small cysts. This chronic endocrine gynecological disease of imprecise origin, but probably with a genetic and environmental component, mainly concerns young women.
The symptoms of PCOS are expressed to different degrees in different women.
Among the most marked, we observe-
• An absence or disorders of menstrual cycles (metrorrhagia)
• Weight gain or even obesity
• Hirsutism, that is to say, the presence of excessive hair (on the chest, stomach, and face)
• It appears in some cases of fertility disorders, going as far as sterility, linked in particular to anovulation
• Consequences of the interruption of follicular maturation
• Hair loss at the top of the head
• Signs of virilization are also possible but rarer.
• In some cases, dark spots on the skin of the neck, under the arms, and in the groin area (inside the thighs) may appear.
No single factor can be held responsible for the development of PCOS. However, the two major reasons for this are considered to be hormonal imbalance and resistance to insulin.
1. In around 80% of PCOS-affected women, the reason is insulin resistance. In this condition, the body needs to use itself in order to produce some extra insulin so that the sugar can be broken down. As a result, testosterone can be produced in excess which will further interrupt the growth of the follicles. This can also lead to an irregularity in ovulation.
2. Another very common factor of PCOS is attributed to the kind of lifestyle that a person is leading. If a person is overweight and has a body mass index out of range, then it can lead to insulin resistance.
3. If the testosterone levels are high, the levels of luteinizing hormones are also high or if high levels of prolactin get produced, then, this can lead to PCOS.
If you are facing symptoms like acne, menstrual cycle disorders, excessive hairiness, or difficulty in conceiving, a consultation with the attending physician or gynecologist is necessary, as well as certain additional examinations (abdominal ultrasound, blood test, etc.) to seek the diagnosis of PCOS .
The diagnosis of PCOS is usually achieved by combining the results of the questioning and those of additional tests. In particular, a blood test is carried out, which makes it possible to observe the levels of hormones, in particular luteinizing hormone, or LH, which increases in a variable manner.
Androgens are also dosable and may be above normal. In addition to this blood test, tests are added, such as an ultrasound which shows the presence of cysts in both ovaries and the resulting increase in the volume of these organs.
“Faced with a diagnosis of PCOS, you may feel frustrated or sad. You may also feel relief that there is a reason and treatment for your possible problems (difficulty keeping a normal weight, excess body hair, acne, or irregular periods) Remember that regular follow-up with a health professional, a positive attitude, and a healthy lifestyle are essential”, advises Dr. Parth Joshi, leading Fertility specialist at Indira IVF.
To date, there is no cure for PCOS. However, drug therapy may be prescribed to regulate the menstrual cycles and decrease hair growth and acne. The different options are discussed with the gynecologist :
• Contraceptive hormone therapy may be prescribed to correct the PCOS hormonal levels/ imbalance by lowering testosterone levels (which will reduce acne and hair growth) and regulating the menstrual cycle. It also helps reduce the risk of endometrial cancer (which is slightly higher in young women who do not ovulate regularly).
• Metformin © is used to lower the level of insulin in the blood, especially in patients with high insulin levels with pre-diabetes or diabetes. The two treatments- Metformin © and the contraceptive pill can be combined.
• Treatment of acne in the form of creams, oral antibiotics, and other drugs.
Solutions exist for excess hair, which can quickly become complex. To avoid this, it is recommended to discuss with your gynecologist and dermatologist the possibility of whitening the hairs or to use waxing, depilatory creams, electrolysis, or laser treatment for example.
The most important part of treatment is a healthy lifestyle and a balanced diet combined with daily physical activity. Balancing insulin levels, PCOS hormonal levels and losing weight can reduce the risk of diabetes and some of the symptoms of PCOS. Support from a nutritionist doctor may be necessary for a better guidance on balancing PCOS hormonal levels.
Due to ovulation problems, PCOS can be a cause of subfertility or infertility. Some women can get pregnant normally, while others ovulate only 2 or 3 times a year, or not at all.
The advice of a gynecologist is necessary in case of difficulty in conceiving. Ovarian stimulation, ovarian drilling (surgery to restore spontaneous ovulation), or assisted reproductive technology (ART) can help in fulfilling your parenthood dream.
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