Christmas Eve Dinner

 Decoding PCOS: Insights into the Silent Hormonal Disruptor

BY Dr. S.N. Sailaja Consultant Obstetrician & Gynaecologist,

Ankura Hospital for women and children, LB Naga

Polycystic Ovary Syndrome (PCOS) is a multifactorial endocrine disorder primarily characterized by chronic anovulation, affecting women of reproductive age. The hallmark symptoms of PCOS include irregular menstrual cycles, hirsutism (excessive hair growth), and weight gain. It is recognized as the most prevalent female endocrine disorder and a leading cause of infertility, with a global prevalence ranging from 6% to 26%. In India, the prevalence is reported to be between 3.7% and 22.5%, affecting approximately 20% of young women.

PCOS is influenced by several risk factors, including genetic predisposition, neuroendocrine abnormalities, sedentary lifestyles, poor dietary habits, and obesity. Although synthetic drugs such as metformin and oral contraceptive pills are commonly prescribed for treatment, concerns about their side effects have led to an increasing interest in traditional and herbal remedies.

The condition can be classified into four main types:

1.     Insulin-resistant PCOS: The most common form, associated with high insulin levels leading to excessive androgen production and ovulatory dysfunction.

2.     Inflammatory PCOS: Characterized by chronic low-grade inflammation, which stimulates androgen production.

3.     Hidden-cause PCOS: Often linked to underlying conditions such as thyroid disorders or deficiencies in certain nutrients.

4.     Pill-induced PCOS: Triggered by the use of hormonal birth control, which can disrupt normal hormonal balance upon discontinuation.

Women with PCOS may experience a range of symptoms, including Missed or irregular menstrual cycles, Enlarged ovaries with multiple cysts, Excessive body hair growth (hirsutism), Weight gain, particularly around the abdomen, Acne or oily skin, Male-pattern baldness or hair thinning, Difficulty with fertility

PCOS can also lead to serious medical conditions such as Type 2 Diabetes, Hypertension, Hyperlipidaemia, Endometrial or Breast Cancer, and Depression. The psychological impact of PCOS is significant, with many women experiencing anxiety, depression, and a reduced quality of life. Research indicates that women with PCOS have higher rates of these mental health issues compared to the general female population, which can adversely affect their self-esteem and social relationships.

PCOS is diagnosed through a combination of physical examinations, blood tests, and imaging studies. A pelvic examination assesses the health of reproductive organs, while blood tests measure hormone levels. An abdominal ultrasound is often used to evaluate the size of the ovaries and the thickness of the endometrium. Additional tests, such as glucose tolerance and lipid profiles, may be recommended to monitor overall health.

 

PCOS cannot be cured, but it can be effectively managed. It is a chronic condition that requires long-term management rather than a one-time cure. However, with appropriate treatment and lifestyle changes, many of the symptoms and complications associated with PCOS can be controlled, allowing women to lead healthy, fulfilling lives.

1.     Lifestyle Modifications:

o    Diet and Exercise: A balanced diet and regular physical activity can help manage weight, improve insulin sensitivity, and regulate menstrual cycles. Even modest weight loss can significantly reduce symptoms.

o    Stress Management: Techniques such as mindfulness, yoga, and counselling can help manage the stress and anxiety that often accompany PCOS.

2.     Medications:

o    Hormonal Birth Control: Oral contraceptives are commonly prescribed to regulate menstrual cycles, reduce androgen levels, and manage symptoms like acne and hirsutism.

o    Insulin Sensitizers: Medications like metformin can help improve insulin sensitivity, which is beneficial for managing symptoms and reducing the risk of developing Type 2 Diabetes.

o    Anti-Androgens: These medications can reduce excessive hair growth and acne by blocking the effects of androgens.

3.     Fertility Treatments:

o    For women with PCOS who are trying to conceive, fertility treatments such as ovulation- inducing medications (e.g., clomiphene citrate) or assisted reproductive technologies (e.g., IVF) may be necessary.

4.     Surgical Options:

o    In some cases, laparoscopic ovarian drilling may be considered to stimulate ovulation in women who do not respond to other treatments. However, this is typically a last resort option.

While PCOS itself cannot be cured, the symptoms can be managed to the point where they have minimal impact on daily life. With ongoing management, many women with PCOS can conceive, reduce the risk of associated conditions like diabetes and heart disease, and maintain a good quality of life. Regular monitoring and adjustments to treatment plans are crucial, as PCOS symptoms and their severity can change over time.

For comprehensive guidance and support in managing PCOS, the gynaecologists at Ankura Hospital offer expert, individualized care tailored to each patient's unique needs. Ankura Hospital is dedicated to addressing the multifaceted challenges of PCOS, providing a holistic approach to treatment and empowering women to take control of their health.

Raising awareness about PCOS and encouraging women to adopt the right knowledge, attitudes, and practices are crucial steps in effectively managing this disorder. Through education and support, we can improve the quality of life for women with PCOS and help them navigate the challenges they face.