PCOS – Symptoms, Diagnosis, Challenges & Treatment | Dr. Kanchan Murarka | IHR Guwahati

Dr. Kanchan Murarka
IVF SPECIALIST

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PCOS is also commonly known as PCOD or polycystic ovarian disease. The term; PCOD is a misnomer and should not be used.

With an incidence of 5 to 10% worldwide, PCOS is a common endocrine disorder where there is an imbalance of hormones in the body.

It causes a wide range of problems ranging from acne to obesity to infertility and can affect all age groups of females. Due to our modern lifestyle and environmental pollutants, the incidence of PCOS is on the rise and is becoming a major cause of concern due to its obesity and fertility-related issues.

It has an unknown etiology and is recognized as a heterogeneous disorder that is also genetically predisposed. Women are more likely to develop PCOS if their mother or sister also has the same condition. It is associated with insulin resistance in the body and the overproduction of androgens, primarily from the ovary. The ovaries fail to ovulate on time and the women can develop cysts in the ovaries which on sonography appear like a “string of pearls”.

PCOS in adolescence

Young adolescent girls present with irregular periods or amenorrhea, and heavy or scanty bleeding during menses, weight gain, fatigue, unwanted and excessive hair growth, increased hair loss leading to frontal baldness, oily skin, acne, sleep problems, and mood changes. Most symptoms begin shortly after puberty but can also develop during late teens or early adulthood.

PCOS in married women

In addition to the above problems after marriage, women may also suffer from infertility. Many women have the myth that PCOS patients cannot conceive by themselves, but the fact is that women with PCOS do conceive spontaneously especially if they follow a healthy lifestyle and maintains a normal weight. Due to PCOS during pregnancy, there is a higher rate of miscarriage, gestational diabetes, and premature delivery.

PCOS in elderly women

In addition to the irregular menses and excessive bleeding during menses older women with PCOS have a high risk of developing other health complications such as hypertension, high cholesterol, anxiety and depression, sleep apnea, heart attack, diabetes, and endometrial, ovarian, and breast cancer.

Recommended treatment

The symptoms of PCOS can be managed to a large extent by various means. Early diagnosis is very important so that we can implement measures to prevent long-term health sequelae.

Weight loss and maintaining a normal BMI (Body mass index) is the mainstay of treatment. It lowers blood glucose levels, maintains the normal hormonal profile, and helps to regulate the menstrual cycle.

Weight loss can be achieved by following a healthy diet and regular physical activity regime. In married women, who are trying to conceive, 5 -10% of weight loss can regulate the menstrual cycle, bring back the ovulation, and help the women to conceive. Along with weight loss, fertility drugs can be administered to aid ovulation. In unmarried girls and in women who do not want to get pregnant oral contraceptive pills may be prescribed. In order to stop excess hair growth and help reduce acne, using anti-androgens is the recommended course of action.

PCOS among women, especially adolescents, is an urgent public health problem that needs careful assessment, timely intervention and appropriate treatment. Promotion of healthy lifestyles, regular exercise and increased awareness programs is necessary to control the problem.