Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects 1 in every 5 women. Despite this, there are lot of questions that arise in people’s minds regarding PCOS to which we don’t yet have answers. Experts are not sure of its cause, and there is currently no ‘cure’ for the condition. 50% of women who have PCOS are not aware that they have the condition, yet it is the most common cause of female infertility and it can lead to type 2 diabetes, high blood pressure, high cholesterol, mood swings and depression.
Symptoms of PCOS vary between every individual and sometimes go unnoticed. Common symptoms are:
- Irregular periods or absent periods
- Excessive body hair and facial growth
- Weight gain
- Thinning of hair
- Acne or oily skin
- Some women also have a higher chance of getting skin tags around the neck, and get more dandruff frequently.
Insulin Resistance and PCOS
The pancreas produces a hormone known as insulin to control the amount of sugar present in the blood. Women with PCOS are resistant to insulin, so the body produces extra insulin to compensate.
This becomes a issue because excess levels of the male hormone known as testosterone are produced by the ovaries when high levels of insulin are present. The elevated testosterone levels result in the excess androgen-related symptoms such as thickening and darkening of facial and body hair, and it interferes with the development of the egg follicles in the ovaries.
In every menstrual cycle the follicle should break, and the matured egg should be released, but, for women with the PCOS, this process doesn’t always happen correctly. Instead, the follicle remains as a cyst. Women looking to become pregnant face difficulties due to the irregular ovulation and also the risk of miscarriage is high.
Resistance to insulin can also lead to weight gain which makes the PCOS symptoms worse as excess fat causes the body to produce even more insulin.
Women with PCOS are found to have an imbalance in certain hormones that includes:
- Testosterone – This hormone will be present in excess. Testosterone is often thought of as a male hormone but all women produce a small amount of it.
- Luteinising hormone (LH) – This hormone is also present in excess. LH simulates ovulation but when present in high levels, it causes an abnormal effect on the ovaries.
- Sex hormone-binding globulin (SHBG) – This would be present in low levels. SHBG is present in the blood and binds to testosterone to reduce the effect of it.
- Prolactin – The problem with this hormone arises only in some women with PCOS, in which case it will be present in excess. Prolactin simulates the breast glands to produce milk in pregnancy.
Sometimes PCOS runs in the family: if a woman’s mother, sister or aunt have PCOS then the risk of her developing PCOS is often increased. There may be a genetic link to PCOS, but the specific gene responsible for it has not yet been identified.
The initial diagnosis starts with blood tests to determine the relevant hormone levels which may be followed by the ultrasound scan that can show if there are a number of follicles in the ovaries. When someone is diagnosed with PCOS, they are either treated by the GP or referred to a specialist.
PCOS cannot be completely cured, but it can be managed. There are different treatment options. The commonly available treatment options are:
- Changes in the lifestyle
Women who are overweight have an especially high risk of developing the long-term health problems. By losing excess weight the condition can also be improved. The NHS suggest that even a weight loss of 5% can greatly improve the condition. Regular exercise and eating a healthy balanced diet can enable women to achieve weight loss goals.
The contraceptive pill may be recommended to induce regular periods.
For women trying to get pregnant, a medication known as Clomifene is usually recommended first. This medication helps in the release of an egg from the ovaries.
Another commonly prescribed medication is Metformin. This medication, which is often used to treat type-2 diabetes, lowers the amount of glucose released by the liver into the blood and improves the body’s response to insulin. The resulting improvement in testosterone levels helps to reduce PCOS symptoms.
- Nutritional therapy
Glycaemic index (GI) represents the rise in blood glucose levels after eating specific carbohydrates. Foods with a low GI cause the blood glucose to rise less sharply, so they are thought to be helpful to women with PCOS. Low GI foods include many fruits such as avocado, non-starchy vegetables, healthy fats that includes oily fish like salmon, and whole-grains. Magnesium rich foods like dark leafy greens, nuts and seeds are important to be included in a regular diet; magnesium deficiency appears to be linked with insulin resistance.