Polycystic Ovarian Syndrome

What is Polycystic Ovarian Syndrome?

Polycystic Ovarian Syndrome (PCOS) is a condition that has both hormonal and metabolic causes, with a wide and variable
range of symptoms. PCOS can occur at any age after puberty and before menopause.

Are my symptoms caused by PCOS?

Having cysts on the ovaries does not mean you have PCOS. Ovarian cysts are actually fluid- or solid-filled sacs that do not
contain eggs. In PCOS, on the other hand, there are small multiple follicles (small round fluid-filled sacs containing an immature
egg) which ovulate irregularly.
PCOS can cause symptoms starting from the very first periods, or can appear later on due to weight gain.
Symptoms can be very different from one patient to another, and there is no single test that can diagnose PCOS.
Having at least two of the following signs is often enough to confirm PCOS.
1. A pelvic ultrasound scan shows specific ultrasound characteristics;
2. Menstrual cycles are irregular (there are over 35 days between each period);
3. Excess facial and body hair, severe acne and partial/complete loss of hair in the top part of the head (androgenetic
alopecia).
All of these symptoms become more severe in overweight or obese women.

What causes PCOS?

The exact cause of PCOS is unknown, although insulin resistance has a key role in causing this condition. Chronic stress and
overweightedness can both cause insulin resistance. Insulin resistance then stimulates the ovaries to produce male hormones
(androgens) which can block ovulation and cause additional PCOS symptoms such as irregular cycles, acne, excess facial and
body hair. Having PCOS and leaving it untreated increases the chances of developing Diabetes.

Are there any tests that can diagnose PCOS?

There is actually no single test that can diagnose PCOS. Your Doctor will accurately collect your history and examine you in
order to understand if there are signs of insulin resistance, androgen excess and acne. A pelvic ultrasound scan will assess
whether there are typical ultrasound signs that are unique to PCOS. Specific blood tests will rule out other hormonal issues
and assess your glucose and lipid metabolism.

Does PCOS cause infertility?

Having PCOS does not mean you cannot get pregnant, as PCOS is a treatable cause of infertility. PCOS can make it difficult to
conceive a pregnancy due to ovulatory dysfunction. When there is overweightedness causing PCOS, the resulting hormonal
imbalances can block ovulation. Reaching a normal weight in these cases of PCOS is necessary to improve fertility. Hormonal
treatments used to induce ovulation only work effectively when the body weight is within normal ranges (with a BMI between 20
and 25).

Which are effective treatments for PCOS?

Treatment for PCOS varies depending on the symptoms involved and may include a combination of the following:
● Nutrient intake and Body weight: Reaching your healthy weight is always effective in treating PCOS symptoms such
as irregular cycles, acne, unwanted hair and ovulation dysfunction, and will improve the effectiveness of drug
treatments used for PCOS. Along with cutting sugars in your diet, it is extremely important to have daily portions of
vegetables, wholegrain carbs, berries, pulses, mixed nuts, fish and seafood and lean meats.
● Inositol: A specific combination of Myoinositol and Chiroinositol, two vitamin-like substances, is effective in improving
PCOS symptoms, ovulation and fertility outcomes. Inositol can be found in fresh citrus fruits, fresh cantaloupe, beans,
brown rice and nuts.
● Regular and moderate physical exercise: This reduces your sugar levels and prevents insulin resistance.
● Mindfulness, Meditation and Counselling: These can support you by reducing stress and improving insulin resistance.
● Hormonal contraception: The pill, mini-pill, contraceptive patch or vaginal ring can all reduce androgen production
and can therefore improve acne as well as excess facial and body hair.
● Hormonal treatments that promote ovulation such as Clomiphene, Gonadotropins and Metformin can be used in
some cases, the latter of which is also effective to aid weight reduction.
● Spironolactone: This medication blocks the effects that androgens have on the body, improving acne and excess hair.
It is not recommended for women who are looking to become pregnant.
● Eflornitine: This cream slows down hair growth.
● Electrolysis and Laser treatments permanently reduce thick and dark facial and body hairs.