What is PCOS?
PCOS Polycystic Ovary Syndrome is a common hormonal condition affecting more than 10% of women who may have symptoms of high male hormone levels and irregular cycles.
The three clinical criteria of PCOS are:
- Evidence of excess male type hormones, noted either by having elevated blood hormones levels of androgens or excess growth of facial or body hair in areas where men usually have hair
- Irregular periods with menstrual cycles more than 35 days apart or eight or fewer menstrual cycles per year not due to hormonal birth control
- The presence of a high number of eggs on an ovarian ultrasound
What age does PCOS start?
PCOS any time after puberty
- PCOS any time after puberty
- How common is PCOS
- PCOS is very common – upto 1 – in – 5 every women has PCOS
- Symptoms and Causes
What are the signs of polycystic ovary syndrome (PCOS)?
- Irregular periods – A women’s periods are irregular if the gap between them is less than 21 days or more than 35 days. Irregular periods can affect anyone who has periods. It’s more likely for your periods to be irregular when they first start during puberty, and when you’re nearing menopause.
- Abnormal Hair Growth – You may grow excess facial hair or experience heavy hair growth on your arms, chest and abdomen. This affects up to 70% of people with PCOS.
- Acne - Acne is a type of hormonal acne caused by excess androgens, leading to increased oil production that clogs pores
- Obesity - Obesity can worsen Polycystic Ovary Syndrome (PCOS) symptoms by increasing insulin resistance and hyperandrogenism, which further disrupts ovulation and menstrual cycles.
- Darkening of the skin - PCOS can cause skin darkening due to acanthosis nigricans, a condition characterized by dark, velvety patches in skin folds like the neck, armpits, and groin. This is primarily caused by insulin resistance, a common feature of PCOS where high insulin levels stimulate the skin cells to overproduce pigment. Another type of darkening can be melasma or dark spots from post-acne marks, which are also linked to hormonal changes.
- Cysts - Many people with PCOS have ovaries that appear larger or with many follicles (egg sac cysts) on ultrasound.
- Skin tags - Skin tags are little flaps of extra skin. They’re often found in your armpits or on your neck.
- Thinning Hair – People with PCOS may loose patches on their head or start to bald.
- Infertility - PCOS is the most common cause of female infertility. Not ovulating regularly or frequently can result in not being able to conceive.
Can I have PCOS but not have any symptoms?
Yes, it is possible to have PCOS without noticeable symptoms, as many individuals may have mild or subtle signs they are unaware of, or they might discover the condition only when experiencing fertility issues. Over half of those with PCOS may not show any external symptoms, and some women might not even know they have it until they face difficulty getting pregnant also.
What is the main cause of PCOS?
The exact cause of PCOS is unknown. There’s evidence that genetics play a role. Several other factors, most importantly obesity, also play a role in causing PCOS:
Insulin Resistance – Insulin is a hormone that the pancreas makes. It allows cells to use sugar, your body’s primary energy supply. If cells become resistant to the action of insulin, then blood sugar levels can go up. This can cause your body to make more insulin to try to bring down the blood sugar level.
Too much insulin might cause your body to make too much of the male hormone androgen. You could have trouble with ovulation, the process where eggs are released from the ovary.
One sign of insulin resistance is dark, velvety patches of skin on the lower part of the neck, armpits, groin or under the breasts. A bigger appetite and weight gain may be other signs.
Higher level of male hormones called androgens – The ovaries may produce high levels of androgen. Having too much androgen interferes with ovulation. This means that eggs don’t develop on a regular basis and aren’t released from the follicles where they develop. Excess androgen also can result in hirsutism and acne.
Low grade inflammation – White blood cells make substances in response to infection or injury. This response is called low-grade inflammation. Research shows that people with PCOS have a type of long-term, low-grade inflammation that leads polycystic ovaries to produce androgens. This can lead to heart and blood vessel problems.
Diagnosis & Tests
How is polycystic ovary syndrome (PCOS) diagnosed?
A diagnosis of PCOS can usually be made if other rare causes of the same symptoms have been ruled out and you meet at least 2 of the following 3 criteria:
- You have irregular periods or infrequent periods – this indicates that your ovaries do not regularly release eggs (ovulate)
- Blood tests showing you have high levels of "male hormones", such as testosterone (or sometimes just the signs of excess male hormones, even if the blood test is normal)
- Scans showing you have polycystic ovaries As only 2 of this need to be present to diagnose PCOS, you will not necessarily need to have an ultrasound scan before the condition can be confirmed.
Can I get pregnant if I have PCOS?
Yes, you can get pregnant with PCOS, but it may be more challenging due to irregular or absent ovulation. Working with a doctor to manage hormonal imbalances, track your cycle, and consider treatments like medication or fertility procedures can significantly increase your chances of conceiving. Lifestyle changes such as healthy eating and exercise are also crucial first steps.
