What is PCOS?
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder found commonly among women of reproductive age. Individuals with PCOS have infrequent, irregular, or prolonged menstrual periods. They also have higher-than-normal levels of the male hormone androgens. Excess of androgens disrupt the normal menstrual cycle and cause irregular periods.
Some individuals also have multiple cysts on their ovaries, leading to the name polycystic syndrome. Although, it is misleading because not every individual diagnosed with PCOS has cysts in their ovaries.
Overview
PCOS affects around 2% to 25% of women of reproductive age. Often women are unaware and live with undiagnosed PCOS. It is a hormonal disorder and affects the ovaries. The ovaries secrete the female reproductive hormones, namely, estrogen and progesterone. These hormones are responsible for the normal menstrual cycle. The ovaries also secrete a small amount of male hormone called androgens.
Ovaries are responsible for ovulation each month. They release eggs to be fertilized by the sperm. Ovulation is also controlled by the Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH), produced by the pituitary gland. FSH stimulates the ovary to produce a follicle(a fluid-filled sac that contains an egg), and LH stimulates the ovary to release the matured egg from the follicle.
In PCOS, many follicles grow inside the ovaries but fail to mature and are not released by ovulation. The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Progesterone levels are lower than usual, while androgen levels are higher than usual. Extra male hormones disrupt the menstrual cycle, so women with PCOS get fewer periods than usual.
Symptoms of PCOS
PCOS is a syndrome with a group of symptoms. The three main features are:-
Irregular periods
Higher-than-normal levels of male hormones
Multiple cysts (small, fluid-filled sacs) in the ovaries
An individual should have at least two out of the above three symptoms to be diagnosed with PCOS. Most women develop PCOS-related symptoms around puberty when they start menstruating, while others develop these symptoms after considerable weight gain or when they are unable to get pregnant.
Some of the most common symptoms of PCOS are :
- Irregular periods – Due to lack of ovulation, the uterine lining fails to shed every month and this leads to irregular periods. Individuals with PCOS generally get fewer than eight menstrual periods per year or none at all.
- Heavy bleeding – Due to irregular periods, the uterine lining builds up over time, and hence when they finally get their periods, there is heavy bleeding.
- Hair growth/Hirsutism – There is excess hair growth on areas such as the back, chest, belly, face, etc. This is due to an excess amount of androgens in the blood.
- Acne – The presence of excess male hormones makes the skin oilier than usual and causes breakouts on the face, chest, or upper back.
- Obesity – Almost 80% of women with PCOS have obesity or are overweight.
- Male pattern baldness – Hair on the scalp gets thinner and falls out.
- Darkening of the skin – Excessive pigmentation of the skin in certain areas like body creases, e.g. on the neck, groin area, or under the breast, is seen.
Headaches – Hormone imbalance triggers headaches in some individuals with PCOS.
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