Hello, I am Doctor Srisailesh Vitthala, one of the fertility specialist in the city. Today I am going to talk about polycystic ovary syndrome. What is polycystic ovary syndrome? Polycystic ovary syndrome, in short called as PCOS is very common. Here, I must insist PCOS is not a disease but it is a condition where women can have irregular periods, women can have facial hair, oily skin, acne and women in reproductive age group find difficult to get pregnant. Like I said, PCOS is very common. What I mean by this is one in four women in a reproductive age group can have PCOS. It is manifested with irregular menstruation period, obesity, facial hair, sometimes insulin resistance and also infertile.
What causes PCOS? In women usually every month they release one egg. The release of egg in women every month is called ovulation. In women with PCOS, unfortunately many of them do not release an egg. They form very small follicles but does not lead to ovulation, due to hormonal imbalance. This is called as anovulation and this is the main cause of PCOS.
Diagnosis of PCOS is based on three parameters, not on single parameter. The three parameters are – 1. Clinical features, which may rear irregular menstruation period. 2. Biochemical, where hormonal imbalance can be checked. 3. Ultrasound, where polycystic ovaries can be visualized. Now, 2 out of these 3 criteria, which I have mentioned are there then, we label our diagnosed women with PCOS. I must emphasis here that PCOS is a dynamic condition, which means in some months there could be PCOS and some months there cannot be PCOS based on the criteria which I have mentioned. Again I repeat, 2 out of the 3 criteria, which I have mentioned above is needed to diagnose women with PCOS.
What are the symptoms of PCOS? Women with the following symptoms can be labelled as PCOS. Women who has a less number of periods, I mean less than 8 in a year. They gain weight or they can go into obese. They can have some facial hair in the upper lips, chin, side burns, chest, thighs, which might mimic similar to the man. Women finding it difficult to get pregnant. All these above symptoms can be leading towards the PCOS.
What are the tests done to diagnose PCOS? Common tests done to diagnose PCOS are 1. Blood test and 2. Ultrasound. In blood test doctors evaluate or measure the hormonal imbalance. They are FSH, LH, E2, testosterone, cholesterol and blood sugars. 2. Ultrasound, in the ultrasound, they try to look small numbers of follicles, usually more than 15, 12-15 I would say in both the ovaries are indicate you of PCOS.
What are the treatment of PCOS? The treatment of PCOS depends upon what exactly the woman wants? For example, if a woman wants her period to be regularized, the common thing that regularize woman’s period is by using the birth control pills. The birth control pill not necessarily treat the cause but however, it could definitely make her periods regular. Other part is taking progesterone tablets, maybe 5-10 days every month, so that she will have a regular periods. If the woman wants her facial hair to be treated, then the facial hair can be treated in 2 ways: 1. Non-medical that means using laser, ablations or using the lotions on face to prevent further hair growth. Or 2. Taking medications, which we called as anti-androgens like spyro lactone etc. To prevent any facial hair to grow. If woman wants to conceive, then it is totally a different treatment. The medications which they take for getting pregnant is called ovulation induction drugs and it has to be followed by scanning to see if they are making eggs. Irrespective of the any treatment, if the women are obese, they have to change their lifestyle. I mean change in their diet, lose weight by doing exercise or yoga or anything, which helps to bring her weight down. Many doctors can also use anti-diabetic or diabetic medications called Metformin to help through any of the above features.
What are the long term problems of PCOS? PCOS women have a long term risk of developing: 1.diabetes, 2. High cholesterol, 3. Cardiovascular disease and if they don’t have a regular periods or if they don’t conceive, they might have a small risk of developing uterine cancer. Of course, getting pregnant is also difficult. So, it is very important for women with PCOS to seek doctor’s advice to address all the issues.
Ovum Hospital Team