Polycystic Ovary Syndrome:
Everything You Need to Know about PCOS

Polycystic ovary syndrome or PCOS is a common, complex hormonal disorder found in about 10% of women of reproductive age all over the world. There is no surefire cure for PCOS; the symptoms can be controlled with varying degrees of success. The treatable features of PCOS include the clinical symptoms, hormonal irregularities, and metabolic problems. But left untreated it can lead to various critical conditions like hypertension, renal problems, type II diabetes mellitus, cardiovascular disease, and cardiac problems. Endometrial cancer due to anovulatory menstrual cycles is also a distinct possibility.

Symptoms of polycystic ovary syndrome include abnormal bleeding, extreme weight gain, depression, tiredness, thyroid problems, headaches, sleeping disorders, high cholesterol, poor memory, panic attacks, constant thirst, dizzy spells, insulin resistance, extreme cravings, cystic ovaries, cystic acne, anovulatory menstrual cycles, irregular periods, mood swings, high levels of testosterone, infertility, extreme hair growth on face and body. All these symptoms are not constantly present in all women with PCOS and different manifestations often occur. About one in four women have polycystic ovaries; but having polycystic ovaries does automatically imply PCOS.

PCOS affects hormone cycles. The follicle is a fluid filled sac within the ovaries that contain the egg, and each month the normal growth of the follicle leads to a rise in estrogen production until the follicle releases the egg.  This is called ovulation. Once the dominant follicle takes over, the extra ones disappear. In polycystic ovaries, the mechanisms regulating this are disturbed and the extra follicles do not fade but persist and look like small cysts on the ovaries. The immature follicles and the inability to ovulate are most likely caused by low levels of follicle stimulating hormone (FSH), and high levels of male hormones (androgens) produced in the ovary.

Conventional management of PCOS includes hormonal therapy consisting of birth control pills, anti-androgen medications, and other special hormone-regulating drugs.  As PCOS has an insulin resistance component, a drug called metformin is also added routinely. Ovarian drilling has been found to benefit some women. It is a process where between 4 and 30 tiny holes are made in a cystic ovary. Newer surgical techniques minimize previous problems but they still remain a risk. In extreme cases, if the cysts are very large, surgical excision may be recommended. But the first line of treatment remains losing weight. Along with weight loss there is a remarkable improvement in ovarian function.