What You Should Know About Polycystic Ovarian Syndrome (PCOS)

POLYCYSTIC OVARY SYNDROME

WHAT YOU SHOULD KNOW ABOUT POLYCYSTIC OVARIAN SYNDROME (PCOS) AND PREGNANCY?

Polycystic ovary syndrome (PCOS) is a health problem that affects one in ten women of childbearing age. Women with PCOS has a problem with hormonal imbalances and metabolism that can affect their overall health and appearance. If you find out you have PCOS, it can be very difficult to get pregnant. And if you are able to get pregnant, you are at risk of many complications during pregnancy, and delivery. PCOS is also a common and treatable cause of infertility.

Women with PCOS are three times more likely to have miscarriages, compared to women without PCOS. They are more likely to develop preeclampsia, gestational diabetes, and to have a large baby and premature delivery. This can lead to complications during childbirth or cesarean delivery.

WHAT IS POLYCYSTIC OVARY SYNDROME (PCOS)?

Polycystic ovary syndrome (PCOS), also known as a polycystic ovarian syndrome, is a common health problem caused by hormonal imbalances. Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age (ie. 15 to 45 years), causing enlarged ovaries with small cysts on the outer edges.

Polycystic ovary syndrome (PCOS) is an excess androgen hormone in women and the development of insulin resistance. Hormonal imbalances cause problems in the ovaries. The ovaries are one of the reproductive organs in the female body. Every woman has two ovaries. The main function of the ovaries is to store and produce eggs.

Ovaries make eggs that are released each month as part of a healthy menstrual cycle. The word “polycystic” itself means “many cysts”. This term describes the condition of the cyst in the ovary. Cysts are small, fluid-filled lumps. Each lump contains eggs that are not fully matured or be released during ovulation as it should be.

PCOS can cause a missed period or irregular menstruation. An irregular period can lead to:

· Infertility (inability to conceive). In fact, PCOS is one of the most common causes of female infertility.

· Development of cysts (small fluid-filled sacs) in the ovaries.

WHO GETS PCOS?

Between 5% and 10% of women between the ages of 15 and 44, or between the ages you may have children, have PCOS. Most women find that they have PCOS in their 20s and 30s when they have a problem with pregnancy and visit their doctor. However, PCOS can occur at any time after puberty.

Women of all races and ethnicities are at risk of PCOS. Your risk of PCOS can be high if you are overweight or if you have a mother, sister, or aunt with PCOS.

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WHAT ARE THE SYMPTOMS OF PCOS?

The symptoms of PCOS exist in many different ways. Some women will have some symptoms, or minor ones, while others will have severe symptoms. Symptoms can also change at different stages of a woman’s life. Symptoms of PCOS may begin after puberty, but they can also develop into later teen and adulthood. PCOS may go unnoticed for some time; because symptoms may also be caused by other health problems or are overlooked. Women with PCOS often have irregular or missed periods as a result of not ovulating.

Some of the symptoms of PCOS include:

1. Irregular Menstrual Cycle

The most common symptom experienced by women with PCOS or polycystic ovary syndrome is an irregular menstrual cycle. Their periods can come every 21 days or more. Menstruation can be very rare, too long, or even not occur at all for several years (amenorrhoea). A number of women with cases of this syndrome experience menstruation less than 8 times a year. This condition is related to decrease ovulation activity in the reproductive system so that the uterine wall cannot shed.

2. Heavy Bleeding

On the other hand, heavy bleeding is another symptom of PCOS that you should watch out for. This is because the uterine wall takes longer to accumulate and shed. So when PCOS sufferers have menstruation, more blood will be released than women in general.

3. Excess Hair Growth

Another symptom is having excess hair on the face and body. In fact, more than 70% of people who have PCOS will experience this condition. In some cases, sufferers have thicker and darker facial hair. In addition, excess hair can also be found on the chest, abdomen, and back. This condition is called hirsutism.

4. Acne Appear

The next characteristic of PCOS is the excessive production of androgens or male hormones. The reason is, this condition can cause the skin to become oilier than usual. This condition causes acne on the face, chest, and upper back.

5. Mood Changes

In PCOS sufferers, the body produces irregular hormone levels, so that the women’s mood can change continuously. This condition has the potential to cause stress, even depression. This is one of the signs or features of polycystic ovary syndrome or PCOS.

6. Weight Gain Drastically

As many as 80% of women who suffer from polycystic ovary syndrome experience significant weight gain. In addition, sufferers also generally have difficulty losing weight.

7. Appears Baldness

Did you know that baldness is a characteristic or symptom of PCOS? Yes, with age, sufferers may experience baldness or what is also called male-pattern baldness. Symptoms of PCOS are a condition caused by excess production of male hormones in the women’s body.

8. Dark Skin Color

Other symptoms of PCOS that you may need to pay more attention to are darker skin tones. The skin will have patches or darker color in the folds, such as the neck, groin, and under the breasts.

9. Headache

Headaches are another feature of PCOS. Hormonal changes that are too extreme can cause headaches in some women.

10. Fertility Disorders

If the body does not ovulate properly, there can be fertility problems. This condition causes the body not to produce enough eggs to be fertilized. If the sufferer has difficulty trying to have children, this could be a symptom or characteristic of a woman with PCOS.

11. Difficulty Sleeping (Sleep Apnea)

PCOS or polycystic ovary syndrome, especially in obese people is a condition that can disrupt the sleep cycle due to irregular breathing, even stopping. This condition is called sleep apnea. The risk of people with polycystic ovary syndrome to experience this is 5 to 10 times higher than that of normal people.

WHAT CAUSES PCOS?

The exact cause of PCOS is unknown. Most experts feel that a number of factors, including genetics, play a role:

1. High Levels of Androgens.

Androgens are sometimes called “male hormones”. However, this hormone is not only found in the male body. This hormone controls physical characteristics that men tend to have, such as excess hair growth and male-pattern baldness. Although all women make small amounts of androgens, women with PCOS have more androgens than usual. Higher levels of normal androgens in women can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle and can cause further hair growth and acne, two symptoms of PCOS.

2. Luteinising Hormone (LH).

In addition, there is also luteinizing hormone (LH), which is a hormone that stimulates ovulation. Changes in the amount of this hormone are one of the causes of PCOS. This is because when these hormone levels exceed normal limits, it can interfere with the function of the ovaries in producing eggs.

3. High Insulin Levels.

Insulin is a hormone that controls how your body converts glucose in the blood into energy. When the insulin hormone increases in the blood, the body will experience insulin resistance. This condition is one of the causes of PCOS. Insulin resistance is a condition that occurs when cells in muscle, fat, and liver do not respond well to insulin.

At that time, the pancreas will continue to produce even more insulin and over time, your blood sugar levels will continue to rise. Insulin resistance can occur in people who have several health conditions such as obesity, high blood pressure, high cholesterol levels, and type 2-diabetes.

A study published in the journal Fertility and Sterility also states that PCOS is a disease experienced by 70% of women due to insulin resistance. Many women with PCOS are insulin resistant; especially those who are overweight or obese, have unhealthy eating habits, are not getting enough physical activity, and have a family history of diabetes (typically type 2 diabetes). Over time, insulin resistance can lead to type 2 diabetes.

4. Low-Grade Inflammation.

The term is used to describe the production of certain substances by white blood cells to fight disease. Studies have shown that women with PCOS have a low-grade type of inflammation that stimulates the polycystic ovaries to produce androgens, which can lead to cardiovascular problems.

5. Family Lineage.

Studies suggest that certain genes may be linked to PCOS. This means that if your mother or sister has PCOS, your chances of developing it are much higher. However, there is no single gene that causes PCOS, so it is likely that this condition is caused by a combination of different types of genes.

6. Sex Hormone-Binding Globulin

Sex hormone-binding globulin or SHBG is a protein that also has the potential to cause PCOS. SHBG is a protein in the blood that is bound to testosterone and can reduce the effects of this hormone.

7. Hormone Prolactin

In addition, the hormone prolactin is a hormone that can also trigger PCOS if the amount is excessive. Prolactin is a hormone that stimulates the breast glands to produce breast milk during pregnancy. However, this hormone can also trigger PCOS if the amount is excessive.

8. Weight Gain

Obesity or being overweight is another cause of PCOS. When the body has a bodyweight that exceeds the ideal limit, insulin resistance will get worse. Actually, women who suffer from PCOS may also experience insulin resistance, but the symptoms do not arise if you have an ideal body weight. Meanwhile, increasing body weight actually triggers insulin resistance to show various symptoms. Such as irregular menstrual cycles or excessive hair growth.

HOW IS PCOS DIAGNOSED?

There is not a single PCOS diagnostic test. To help diagnose PCOS and control other causes of your symptoms, your doctor may talk to you about your medical history and perform various physical examinations and tests:

· Physical Examination. Your doctor will measure your blood pressure, body mass index (BMI), and waist size. They will also look at your skin to access excess hair on your face, chest, or back, acne, or skin discoloration. Your doctor may look for any hair loss or symptoms of other health conditions (such as an enlarged thyroid gland).

· Pelvic Examination. Your doctor may perform a pelvic exam to detect signs of extra male hormones (for example, an enlarged clitoris) and test to see if your ovaries are enlarged or swollen. The doctor looks at your genitals for mass, growth, or other abnormalities.

· Pelvic Ultrasound (Sonogram).This test uses sound waves to examine your ovarian cysts and look at the endometrium (uterine lining). Your doctor checks the shape of your eggs and the size of your cervix. A transducer is inserted into the vagina (transvaginal ultrasound). The transducer emits sound waves that are translated into images on a computer screen.

· Blood Test. A blood test looks at your levels of androgen hormones, sometimes called “male hormones.” Your doctor will also check for other hormones related to other common health problems that can be mistaken for PCOS, such as thyroid disease. Your doctor can also check your cholesterol levels and test you for diabetes.

If you have PCOS, your doctor may recommend additional tests for complications. Such tests may include:

· Periodic testing of blood pressure, glucose tolerance, and cholesterol and triglyceride levels

· Assessing stress and anxiety

· Screening for obstructive sleep apnea

If other conditions are excluded, you maybe diagnosed with PCOS if you have at least two of the following symptoms:

· Irregular menstruation, including the period that comes often, not often enough, or not at all

· Symptoms with high levels of androgens:

vExtra hair growth on your face, chin, and body (hirsutism)

vAcne

vHair loss in the scalp

· Higher than normal blood levels of androgens

· Numerous cysts on one or both ovaries.

CAN I GET PREGNANT IF I HAVE PCOS?

Yes. Having PCOS does not mean that you cannot get pregnant. PCOS is one of the most common, but treatable, causes of infertility causes in women. In women with PCOS, hormonal imbalances interfere with the growth and release of eggs from the ovaries (ovulation). If you do not ovulate, you cannot get pregnant.

Your doctor can talk to you about ways to help you open up and increase your chances of getting pregnant. You can also use our Ovulation Calculator to see which dates in your menstrual cycle are most likely to be fertile.

HOW DOES PCOS AFFECT PREGNANCY?

Some women may not notice that they have PCOS until they try to conceive. PCOS is often undetectable. But if you have been trying to conceive naturally for more than a year, you should talk to your doctor about the test.

PCOS can cause problems during your pregnancy and for your baby. Women with PCOS have higher rates of:

· Abdominal cramps

· Pregnancy diabetes

· Preeclampsia

· Cesarean section (C-section )

· Your baby also has a higher risk of being overweight (macrosomia) and spending more time in the Neonatal Intensive Care Unit (NICU).

HOW DOES PCOS POSE RISKS FOR BABY?

Unfortunately, having PCOS during pregnancy makes things very difficult. It will require extra care for you and your baby.

Potential risks for a baby with PCOS in the mother includes:

· Premature birth

· Large gestational period

· Miscarriage

· Lower Apgar score

· If your child is a girl, some studies have shown that there is a 50 percent chance that she will also have PCOS.

Women with PCOS are also more likely to have a cesarean section because they often have larger-sized babies. Other complications may also occur during childbirth and delivery.

PCOS AND BREASTFEEDING

If you find out you have PCOS, you may need to continue managing the symptoms even after your pregnancy. But the symptoms and the severity may vary. Sometimes hormonal fluctuations after pregnancy and breastfeeding can change the symptoms, so it can take a while before you get into normal.

It is safe to breastfeed with PCOS, even if you have insulin medications to help control your blood sugar. Women with gestational diabetes are at risk of developing type 2 diabetes later in life, but breastfeeding can help reduce that risk.

Breastfeeding has many benefits for you and your baby, so if it suits your family, be sure to check out the options and resources available to have a successful breastfeeding experience.

WHAT ARE THE PCOS TREATMENT OPTIONS TO GET PREGNANT?

There is no cure for PCOS, but you can manage PCOS symptoms. You and your doctor will work on a treatment plan based on your symptoms, your plans to become pregnant, and your risk of long-term health problems such as diabetes and heart disease. The goals of PCOS treatment are to control symptoms and prevent the growth of more severe cysts inside the ovaries.

Depending on the symptoms, the treatment can vary, such as:

1. Improve the Menstrual Cycle

To regulate your menstrual cycle, your doctor may recommend the following treatments:

· Birth Control Pills

Birth control pills that contain both estrogen and progestin can reduce androgen production and regulate estrogen in the body. Hormone control can reduce the risk of endometrial cancer, have acne, and experience excess hair growth.

· Progestin therapy

Progestin therapy for 10-14 days to 2 months can regulate the menstrual cycle and protect you from the risk of endometrial cancer. This drug is suitable for those of you who want to undergo a pregnancy program.

2. Giving Drugs to Help the Ovulation Process

To help the body ovulate normally, the doctor will give drugs such as:

Clomiphene (Clomid)

Letrozole (Femara)

Metformin (Glucophage, Fortamet)

Gonadotropin

Metmorphine as a diabetes drug can also be prescribed for PCOS drugs.

This drug specifically works to reduce insulin resistance and fertility problems due to PCOS.

3. In vitro fertilization (IVF).

IVF can be an option to get pregnant if medicines do not work. In IVF, your egg is fertilized by your partner’s sperm in a laboratory and then implanted in your uterus for growth and development. Compared with medication alone, IVF has higher pregnancy rates and better control of the risk of having twins and triplets (by allowing your doctor to transfer one fertilized egg to your uterus).

4. Ovarian Surgery

This surgery called ovarian drilling may also be done to make the ovaries work better. Surgery is also a method, usually only if other options do not work. The outer shell (called the cortex) of the ovaries gets thickened in women with PCOS and is thought to play a role in preventing spontaneous egg production. Ovarian drilling surgery is a surgery where a doctor makes a few holes in the surface of your ovary using lasers or a nice electrically heated needle. Surgery usually restores ovulation, but only 6 to 8 months.

5. Weight loss.

If you are overweight or obese, losing weight with a healthy diet and regular exercise can help to improve your menstrual cycle and improve your fertility. Get a healthy personal diet plan.

Your doctor can help you create a pregnancy plan. Other strategies, such as weight loss, healthy eating, and in some cases, medications, can increase your chances of getting pregnant.

WHAT ARE SOME LIFESTYLE CHANGES OR HOME REMEDIES THAT CAN IMPROVE MY PCOS SYMPTOMS?

Here are lifestyles and home remedies that can help you deal with PCOS or polycystic ovary syndrome:

1. Weight loss.

Healthy eating habits and regular physical activity can help reduce the symptoms associated with PCOS. Losing weight can help lower blood glucose levels, improve your body’s ability to use insulin, and help your hormones reach normal levels. Even a 10% weight loss (for example, a 150-pound woman who loses 15 pounds) can help improve your menstrual cycle and improve your chances of getting pregnant.

2. Reducing Carbohydrate Intake

Obesity is a common symptom in women who have PCOS. Reducing carbohydrate intake is the best way to treat these symptoms. In addition, intake of protein and healthy fats can lower blood sugar levels, so that blood insulin levels remain stable.

3. Eat Foods with A Low Glycemic Index

Foods with a glycemic index low are food that does not raise blood sugar levels quickly. It can also trigger insulin resistance. The main food sources with a low glycemic index include vegetables and fruit, whole grains, protein, and healthy fats.

4. Avoid Refined Carbohydrates And High Sugar

Refined carbohydrates in general can trigger an inflammatory process that leads to insulin resistance. You need to stop or reduce the amount of intake in large quantities, to control the symptoms of PCOS. Refined carbohydrates that should be reduced are rice, pasta, and noodles which are made from flour. However, consuming pasta made from whole grains is the right alternative. In addition, the intake of liquid sugar such as sucrose, corn fructose syrup, and dextrose in various packaged drinks should also be reduced.

5. Removing Hair.

You can try facial hair removal creams, laser hair removal, or electrolysis to remove excess hair. You can find creams and products in drug stores. Procedures such as laser hair removal or electrolysis should be performed by a physician and may not be covered by health insurance.

6. Slowing Hair Growth.

Prescription drugs (eflornithine HCl cream) can help reduce the rate of new hair growth in unwanted areas.

HOW CAN I PREVENT COMPLICATIONS FROM PCOS DURING PREGNANCY?

You can reduce your risk of complications during pregnancy by:

1. Achieving a Healthy Weight Before Pregnancy.

Ask your doctor about the healthy weight during pregnancy and what you can gain during the different stages of pregnancy.

2. Reaching Healthy Blood Sugar Levels before Pregnancy.

You can do this with a combination of healthy eating habits, regular exercise, weight loss, and medications such as metformin.

3. Taking Folic Acid.

Talk to your doctor about how much folic acid you need.

IS PCOS LINKED TO OTHER HEALTH PROBLEMS?

Yes, studies have found links between PCOS and other health problems, including:

1. Diabetes.

More than half of women with PCOS will develop diabetes or prediabetes (glucose intolerance) before the age of 40. Read more about diabetes on our diabetes page.

2. High Blood Pressure.

Women with PCOS are at a higher risk of developing high blood pressure compared to women of the same age without PCOS. High blood pressure is a leading cause of heart disease and stroke. Learn more about heart disease and stroke.

3. Unhealthy Cholesterol.

Women with PCOS tend to have higher levels of LDL (bad) cholesterol and lower levels of HDL (good) cholesterol. High cholesterol raises the risk of heart disease and stroke.

4. Sleep Apnea.

This is when a temporary and repeated pause in breathing disrupts sleep. Many women with PCOS have obesity or overweight, which can cause sleep apnea. Sleep deprivation raises the risk of heart disease and diabetes.

5. Depression and Anxiety.

Depression and anxiety are common among women with PCOS.

6. Endometrial Cancer.

Problems with ovulation, obesity, insulin resistance, and diabetes (all common in women with PCOS) increase the risk of developing endometrial cancer (lining of the womb or uterus).

Researchers do not know if PCOS causes some of these problems, if these problems cause PCOS, or if there are other conditions that cause PCOS and other health problems.

WILL MY PCOS SYMPTOMS GO AWAY AT MENOPAUSE?

Yes and no. PCOS affects many systems in the body. Many women with PCOS find that their menstrual cycles become regular as they approach menopause. However, their PCOS hormonal imbalances do not change with age, so they may continue to have PCOS symptoms.

Also, the risks of PCOS-related health problems, such as diabetes, stroke, and heart attack, keep increasing with age. These risks may be higher for women with PCOS than those without.

WHAT TYPES OF MEDICATIONS TREAT PCOS?

The types of drugs that treat PCOS and its symptoms include:

· Hormonal Contraceptives, Including a Pill, Patch, Shot, a Vaginal Ring, and an Intrauterine Hormone (IUD) Device.

For women who do not want to get pregnant, hormonal birth control can be:

Make your menstrual cycle more common

Reduces the risk of endometrial cancer

Help to improve acne and reduce excess hair on the face and body (Ask your doctor about birth control with estrogen and progesterone.)

· Anti-Androgen Drugs.

These drugs block the effect of androgens and can help reduce scalp hair loss, growth of facial and body hair, and acne. They are not approved by the Food and Drug Administration (FDA) to treat PCOS symptoms. These medicines can also cause problems during pregnancy.

· Metformin.

Metformin is commonly used to treat type 2-diabetes and may help some women with PCOS symptoms. It is also not approved by the FDA to treat PCOS symptoms. Metformin improves insulin’s ability to lower blood sugar and can lower both insulin and androgen levels. After a few months of use, metformin can help resume ovulation, but it usually has little effect on acne and extra hair on the face or body. Recent research suggests that metformin may have other beneficial effects, including weight loss and lowering cholesterol levels.

The most important thing to know about PCOS and pregnancy are that the complications are real. That is why it is more important than ever to take steps to have a healthy pregnancy. Talk to your doctor, follow a safe exercise program during pregnancy and a diet plan, and take the medication as prescribed. These are all recommended ways to control PCOS during pregnancy.

Disclaimer: Only generic information is provided in this content and this is in no way a substitute for a qualified medical opinion. Always consult your own doctor or a specialist for more information. HEALTHY and FITNESS do not claim responsibility for this information.