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A common hormonal disorder among women of reproductive age is Polycystic Ovary Syndrome or PCOS. The condition can cause small fluid follicles to develop on the ovary and cause prolonged menstrual cycles.

There isn’t a definitive test for polycystic ovary syndrome. Instead, your medical practitioner will rely on your medical history and your current menstrual cycle and weight changes. A physical examination will check for excessive hair growth, acne and insulin resistance.

Source: Medical News Today

A physical exam may also include:

  • A pelvic exam where your doctor will inspect your reproductive organs for abnormalities and growths and masses.
  • Blood samples to be analysed for hormone levels. The testing will attempt to exclude possible menstrual cycle changes and androgen excess that can mimic polycystic ovary syndrome. You may also have your cholesterol and triglyceride levels checked.
  • An ultrasound exam for your doctor to visualise the appearance of your ovaries and the lining of your uterus. A wandlike transducer is used in a transvaginal ultrasound to relay audio signals for conversion into images on a screen.

Once you have a diagnosis of PCOS, your medical practitioner will conrinue to monitor your health with:

  • Routine tests of your blood pressure, glucose tolerance and triglyceride and cholesterol levels
  • Keep a close eye on anxiety and possible depression.
  • Look out for obstructive sleep apnea.

It is probable that your doctor will recommend a light exercise program and a low carb diet to control your weight.

Polycystic Ovary Syndrome (PCOS)

Women with polycystic ovary syndrome have an unusually high level of the male hormone androgen. This hormone imbalance disrupts the normal menstrual cycle.

PCOS causes undue hair growth on the face and body and, ironically, baldness, or hair loss from the head.

What is PCOS?

PCOS is a hormone problem that can affect women of child-bearing age. According to PubMed, between 2.2 and 26.7 per cent of women in this age group have PCOS.

Estrogen and progesterone are the hormones responsible for regulating the menstrual cycle. The ovaries also produce small quantities of androgem the male hormone.

The function of the ovaries is to release eggs monthly to be fertilised by the male sperm.

Furthermore, the monthly egg release is a process called ovulation.

The ovulation process is controlled by the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH). FSH stimulates the ovary to release a sac containing an egg. LF then stimulates the ovary to release a mature egg.

The condition of POS is “a syndrome” which means it is a group of symptoms that affect the ovaries and the ovulation process. The main features are:

  • Cysts in the ovaries
  • High level of male hormone
  • Irregular or missed periods

A lot of fluid-filled sacs grow in the ovaries.

These sacs are follicles, each containing an immature egg. These eggs never mature sufficiently to trigger ovulation.

This omitted ovulation alters hormone levels. Estrogen, progesterone, FSH, LH levels all fall while androgen levels rise.

Women with the additional male hormone fewer periods. PCOS is not a new condition. It was originally described by the Italian physician Antonio Vallisneri in 1721.

Genetic factors, brain inflammation and insulin resistance have all been linked to the production of excess androgen.

Female hormone Imbalance

Women with PCOS produce more male hormone than is normal. This hormone imbalance causes menstrual cycles to be skipped and lowers the probability of becoming pregnant.

The condition can also cause the growth of facial hair and, ironically, baldness. It will also have implications regarding the development of diabetes or heart disease.

Birth control pills and diabetic medication can help with the hormone imbalance, thereby reducing the PCOS symptoms.

PCOS can interfere with the normal ovulation cycle. The ovaries produce the hormones estrogen and progesterone which regulate the menstrual cycle. Additionally, the ovaries produce small amounts of the male hormones calle

d androgens.

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are produced in the pituitary gland, control ovulation.

FSH stimulates the ovary to produce a follicle. A follicle is a sac that contains an egg. And then LH triggers the ovary to release a mature egg.

PCOS affects the ovaries and ovulation. The three main indicators are:

  • cysts in the ovaries
  • high levels of male hormones
  • irregular or missed periods
Polycystic Ovary Syndrome Pelvic Examination
Pelvic Examination Source: Mayo Clinic

With PCOS the ovaries develop many cysts, hence the name polycystic. These cysts are fluid-filled sacs containing an immature egg. The eggs never mature sufficiently to trigger ovulation.

This lack of ovulation changes the levels of estrogen, progesterone, FSH, and LH. The levels of progesterone fall more than normal while the levels of male androgens rise more than normal.

Who can get Polycystic Ovary Syndrome

Roughly 5% to 10% of women of childbearing age, regardless of race or ethnicity will have PCOS. The risk of developing polycystic ovary syndrome may be higher if you are obese or you have a familial connection to PCOS.

Is PCOS linked to any other health conditions?

Yes, scientific studies have found a number of links to other health problems:

  • Diabetes or glucose intolerance will be found in more than half of the women with PCOS.
  • High blood pressure is likely to be a symptom of women with polycystic ovary syndrome
  • Bad Cholesterol is often seen in women with PCOS. They will have higher levels of LDL (bad) cholesterol and lower levels of HDL (good) cholesterol. This accounts for the greater risk of heart disease or stroke.
  • Sleep apnea is when momentary and repeated halts in breathing interrupt sleep. This sleep problem is also strongly linked to being obese.
  • Depression and anxiety are both common among women with PCOS.
  • Endometrial cancer. Problems with ovulation, obesity, insulin resistance, and diabetes all increase the risk of developing cancer of the endometrium. The endometrium is the lining of the uterus or womb.

Will PCOS symptoms disappear after menopause?

Possibly not because PCOS affects many systems in the body. The hormonal imbalance does not change with age, so they may continue to have symptoms of PCOS.

Furthermore, the risks of PCOS-related health problems, such as diabetes, stroke, and heart attack, increase with age. These risks may be higher in women with PCOS than those without.

How is Polycystic Ovary Syndrome diagnosed?

There is no single test and your doctor is likely to perform tests to rule out other conditions

  • Physical Examination will allow your doctor to assess your general health and weight. He will be able to make an inspection for unusual hair growth or skin discolouration.
  • Pelvic exam could show evidence of extra male hormones, a possible enlarged clitoris.
  • Pelvic ultrasound (sonogram) will allow examination of the ovaries for cysts
  • Blood tests. Will allow the measurement of your hormone levels
PCOS Transvaginal Ultrasound
Transvaginal Ultrasound Source: Mayo Clinic

The development of cysts

In keeping with the name polycystic, Women with PCOS grow many small cysts in their ovaries. Although not all women with PCOS grow these cysts, women without PCOS can grow cysts.

Ovulation, the process of releasing eggs in expectation of fertilisation by the male sperm, occurs when hormone levels reach a level needed to trigger the ovulation.

The PCOS cysts develop when ovulation doesn’t get triggered. The cysts that have formed in the ovaries produce androgens (male hormones). The presence of these androgens can interfere with the normal menstrual cycle.

PCOS Treatment

Treatment for PCOS varies depending upon a number of factors. In particular, different treatment will be used for, women who hope to become pregnant, and for those with no expectation of motherhood.

For women who are planning a pregnancy:

  • Diet and exercise can help you lose weight and reduce symptoms. This should help the body to use insulin more efficiently.
  • Medication to help ovulation will help the ovaries release eggs normally. This can increase the chance of multiple births (twins or triplets). May trigger abdominal bloating and pelvic pain.

For women not wishing for a pregnancy:

  • Birth Control Pills help to control the menstrual cycle.
  • Diabetes medication is often used to reduce insulin resistance. Should also reduce androgen level, slow hair growth and help more regular ovulation.
  • Diet and exercise will help you lose weight and help your body use insulin more efficiently.

How does diet affect PCOS

Two of the primary ways that diet affects PCOS are weight management and insulin production and resistance.

There is general agreement about the beneficial foods for PCOS. Three diet types can help manage  the symptoms:

  • A low glycemic index (GI) diet suggests foods with a low GI are digested more slowly. This helps to slow the rise of insulin levels.
  • An anti-inflammatory diet of berries, fatty fish and leafy greens may rteduce inflammation-related symptoms.
  • The DASH Diet is often recommended by doctors because the Dietary Approaches to Stop Hypertension diet helps reduce the risk of heart disease.

A healthful PCOS diet may look like:

  • natural, unprocessed foods
  • high-fibre foods
  • fatty fish, including salmon, tuna, sardines, and mackerel
  • kale, spinach, and other dark, leafy greens
  • dark red fruits, such as red grapes, blueberries, blackberries, and cherries
  • broccoli and cauliflower
  • dried beans, lentils, and other legumes
  • healthful fats, such as olive oil, as well as avocados and coconuts
  • nuts, including pine nuts, walnuts, almonds, and pistachios
  • dark chocolate in moderation
  • spices, such as turmeric and cinnamon

Foods to avoid

Foods widely seen as being unhealthful should also be avoided on a PCOS diet.

  • Refined carbohydrates, such as mass-produced pastries and white bread.
  • Fried foods, such as fast food.
  • Sugary beverages, such as sodas and energy drinks.
  • Processed meats, such as hot dogs, sausages, and luncheon meats.
  • Solid fats, including margarine, shortening, and lard.
  • Excess red meat, such as steaks, hamburgers, and pork.
References
PCOS Symptoms and Causes Mayo Clinic
PCOS Diagnosis and Treatment Mayo Clinic
PCOS Symptoms Causes and Treatments Healthline
Polycystic Ovary Syndrome Women’s Health
Polycystic Ovary Syndrome John Hopkins Medicine
What to eat if you have PCOS Medical News Today
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Polycystic Ovary Syndrome or PCOS Explained