Polycystic ovarian syndrome (PCOS) is common condition seen in 4-18 percent of the reproductive age group (12-45 year). It is a complex, disorder of uncertain etiology. Main cause of PCOS is the imbalance of female sex hormones i.e. estrogen, progesterone and testosterone (in small amount) which is produced in the ovary. Main symptoms are menstrual disorders, over weight, hirsuitisum, anovulation and reduced fertility. The functions of above mentioned hormones in correct levels help to regularise menstruation, development of eggs in the ovary and other reproductive functions.
In PCOS cases instead of regular ovulation and egg formation follicles forms small cysts in the ovary. In ultrasonography this findings reported as ‘string of pearl appearance’. PCOS usually diagnose in 20-30 years of age even if these condition starts in the adolescent period itself.
Changes in the menstrual cycle may be prolonged absence of period or frequent, with a history of one or more normal period after menarche (onset of period). Obesity and weight gain seen even if not in habit of increase food consumption. Hersutism means ACNE increase in hair growth in face, chest wall, abdominal wall, around nipple and dark skin over the back of the neck and axila. If not treated properly, decrease in size of the breasts , male pattern baldness and voice changes may occur as late findings.
The other principle features are insulin resistance resulting in Type- II diabetes, anovulation reduced fertility, high blood pressure and cholesterol levels.
Ovaries and Ovulation
Ovaries are a pair of glands that lie on either side of the uterus, which produce eggs and various hormones mentioned. Hormones are chemicals which is produced in one part of the body, transferred to the blood stream and utilised by different organs for various functions of the body. Ovulation occurs once in a month, release the eggs which transfer to the womb through the fallopian tube.
PCOS is diagnosed if atleast any of the two conditions out of the three signs are present.
• Irregular cycles with scandy or heavy flow
• Imbalance in hormones
• Atleast twelve follicles seen in ovaries confirmed by USG (String of pear appearance)
Insulin resistance: Main role of insulin in body is control of blood sugar and produce smaller amount of testosterone in the ovary. But in insulin resistance, body will produce extra amount of insulin for glucose metabolism. And this exes insulin produce more and more testosterone. This is the main reason for increasing weight and immature development of follicle and anovulation.
Treatment of PCOS
1. Lifestyle changes
A healthy lifestyle consists of healthy diet, regular and exercise, and maintaining a healthy weight.
Avoid too much sweets, chips, chocolates and fast food.
2. Awareness of PCOS
Metformin is the ideal drug of choice which will help to activated insulin, metabolise glucose, induce ovulation and regularises the periods, help to reduce over weight (obesity) help to prevent Type- II diabetes.
Electrolysis and laser treatment help permanent hair removal.
Infertility associated with PCOS needs regular follow up and evaluation.
