UNDERSTANDING PCOS: PCOS SYMPTOMS AND TREATMENT, DIET TIPS

PCOS means Polycystic Ovarian Syndrome. It is a collection of symptoms that affects the overall health of an individual due to disturbance in the endocrine hormones of the body.  It can mainly cause irregular menstrual periods, excess hair growth, acne, and infertility. 

Defining PCOS 

Polycystic ovary syndrome (PCOS) is a heterogeneous condition which is defined by the presence of two out of the following three criteria 

1. Oligo- and/or anovulation (ovaries release less or no eggs) 
2. Hyperandrogenism (clinical and/or biochemical evidence of the presence of more male sex hormones) 
3. Polycystic ovaries  

PCOS, therefore, encompasses symptoms of menstrual cycle disturbance and, as such, is the commonest cause of secondary amenorrhea. 

Polycystic ovary syndrome (PCOS) is an endocrine disorder which significantly influences women throughout their reproductive age 1 in 10 women globally are diagnosed with this disorder. In order to reduce the health risks of this potentially growing public health concern, it is vital to understand the causes, symptoms, and treatments that work. 

Causes of PCOS: 

The exact cause of PCOS is still unknown, but several factors are believed to contribute to it: 

• Hormonal Imbalance: Women with PCOS often have higher levels of androgens (male hormones), which disrupt normal ovulation and menstrual cycles. 
• Insulin Resistance: Many women with PCOS have insulin resistance, causing the body to produce more insulin. This can increase androgen production and worsen symptoms. 
• Genetics: PCOS often runs in families, suggesting a genetic component. 
• Lifestyle Factors: Obesity and sedentary habits can exacerbate hormonal imbalances and insulin resistance. 

PCOS SIGNS AND SYMPTOMS:  

The first signs of PCOS are Hyperandrogenism (acne, hirsutism, alopecia) and  Menstrual disturbance 

Common Symptoms: 

• Irregular or missed periods (oligomenorrhea or amenorrhea) 
• Acne and oily skin 
• Excess hair growth (hirsutism) on the face, chest, or abdomen 
• Thinning hair or scalp hair loss 
• Weight gain or difficulty losing weight 
• Dark patches of skin (acanthosis nigricans) 
• Mood swings, depression, or anxiety 

Not all women will experience every symptom, and the severity can vary widely. 

Women with PCOS have a greater truncal abdominal fat distribution, as demonstrated by a higher waist-to-hip ratio. 

Women with polycystic ovary syndrome are also at increased risk of developing ovarian hyperstimulation syndrome (OHSS). This occurs if too many follicles (>10 mm) are stimulated and results in abdominal distension, discomfort, nausea, vomiting and sometimes difficulty breathing.

Possible late sequelae OR Complications of PCOS: 

• Diabetes mellitus 
• Dyslipidaemia 
• Hypertension 
• Cardiovascular disease 
• Endometrial carcinoma  
• Breast cancer 

Difference between PCOS and PCOD: 

Diagnosing PCOS: 

Examination and investigation of patients with PCOS : 

A thorough history and a careful examination should always be carried out before investigations are instigated – looking particularly at stature and body form, signs of endocrine disease. 

EXAMINATION 

Measurement of height and weight should be done in order to calculate a patient’s body mass index (BMI). The normal range is 20–25 kg/m2, and a value above or below this range may suggest overweight. Signs of hyperandrogenism (acne, hirsutism, balding (alopecia)) are suggestive of PCOS, although biochemical screening helps to differentiate other causes of androgen excess. 

Acanthosis nigricans is a sign of profound insulin resistance and is usually visible as hyperpigmented thickening of the skin folds of the axilla and neck; it is associated with PCOS and obesity 

Lab diagnosis: 

• High levels of Fasting Insulin 

Hormonal assay:  

• Increased levels of Androgens (testosterone and androstenedione)  
• Increased Luteinizing hormone (LH), usually normal follicle stimulating hormone (FSH)  
• Increase in Sex hormone binding globulin (SHBG), results in elevated ‘free androgen index’ 
• High levels of Oestradiol, oestrone (neither measured routinely as very wide range of values) 
• Increase in Prolactin 

Treatment Options: 

• Lifestyle Modifications: Weight loss, regular exercise, and a balanced diet can significantly improve symptoms and reduce long-term risks6. 
• Medications: Birth control pills to regulate periods, anti-androgens for hair and skin symptoms, and metformin for insulin resistance. 
• Fertility Treatments: If pregnancy is desired, medications to induce ovulation may be prescribed. 
• Mental Health Support: Addressing anxiety and depression is an important part of comprehensive care 

A healthy diet is a cornerstone of PCOS management. The Mediterranean and DASH diets are often recommended for their anti-inflammatory and heart-healthy benefits17. 

PCOS diet : 

• Whole grains (brown rice, barley, whole grain bread and pastas) 
• Non-starchy vegetables (leafy greens, tomatoes, mushrooms, peppers, broccoli, cauliflower) 
• Omega-3 rich fish (salmon, tuna, sardines) 
• Beans, lentils, and other legumes 
• Healthy fats (olive oil, avocados, nuts) 
• Whole fruits (berries, cherries, apples) 
• Low-fat dairy products 
• Plenty of water and unsweetened beverages17 

Foods to Avoid: 

• Fried foods (French fries, chips, fried chicken) 
• Saturated fats (butter, margarine) 
• Red and processed meats 
• Sugary snacks and beverages (cakes, cookies, sodas) 
• Refined flour products (white bread, pizza crust, white rice) 
• Alcoholic beverages 

Tip: Focus on whole, unprocessed foods and limit foods that trigger inflammation or blood sugar spikes. 

PCOS Key points: 

PCOS is the commonest endocrine disorder in women (prevalence 15–20%). 

Key features include menstrual cycle disturbance, hyperandrogenism and obesity. 

PCOS runs in families and affects approximately 50% of first-degree relatives. 

Management is symptom orientated and lifestyle modification which should include weight management and healthy diet intake. 

Lack of conversation and hesitation to talk about menstruation leads to lot of women suffering from menstrual disturbances silently. But we can always make an effort to educate ourselves, and if you’re still here reading till the end of this article, you’re one of those people - and we thank you for it. For more such health awareness blogs, visit Docthub 

FAQs: 

1. What is PCOS? 

The full form of PCOS is Polycystic Ovarian Syndrome, and it is an endocrine disorder in the reproductive age group of females, which represents irregular menses, male-like patterns of hair growth or hair growth on unusual places like the chin, beard area, chest and abdomen. Genetic factor plays a role and is commonly associated with weight gain. 

2. How is PCOS diagnosed? 

PCOS is diagnosed clinically by its signs and symptoms like overweight, hirsutism and irregular periods. However, certain lab investigations and ultrasonography are done to confirm it  

3. Can women with PCOS get pregnant? 

Yes, women with PCOS can get pregnant, but they would require a gynaecologist’s guidance as there are chances of difficult pregnancies due to anovulatory cycles and disturbed hormones. 

4. What are the long-term health risks associated with PCOS? 

Following are the long-term complications associated with PCOS 

• Diabetes mellitus 
• Dyslipidaemia 
•  Hypertension 
• Cardiovascular disease 
• Endometrial carcinoma  
• Breast cancer 

5. Can PCOS cause cancer? 

PCOS by itself doesnot cause cancer, however the chances of cancer increases as there is increase in the level of estrogen hormone which increases the chances of endometrial cancer.