Polycystic Ovary (PCO) And Polycystic Ovarian Syndrome (PCOS) have been used interchangeably. However, it is important to note that the first (PCO) is sign seen on ultrasound not necessarily associated with any complaints. It is patients with PCOS who have complaints.
As per WHO, global prevalence of PCOS is highly variable ranging from 2.2% to 26%. In India some estimates suggest a prevalence of 1 in 5 women.
PCOS is a hormonal disorder of women of reproductive age group. These women have enlarged ovaries on ultrasound with multiple follicles which are peripherally arranged looking like pearls on a string which look like cysts, hence the name. In a regular menstrual cycle, a woman develops an egg which ovulates when matured. However, in most patients of PCOS this basic physiology of development and maturation of egg does not happen resulting in irregular cycle and difficulty in conception.
PCOS is considered as a multifactorial disorder causes include genetics, hereditary, lifestyle and stress.
Symptoms
- Irregular Periods – Most frequent complaint of patients are irregular periods which means periods occurring at frequency of more than 35 days and at times not occurring till medications are taken.
- Inability to conceive – This is another frequent complaint. The reason being that these patients have either anovulation ( do not form eggs) or oligo-ovulation ( form eggs in some months)
- Dysfunctional uterine bleeding -These patients can sometime experience abnormal menstrual bleeding such as bleeding for prolonged periods, irregular bleeding, heavy bleeding etc.
- Excess weight gain – PCOS is associated with metabolic disorders and most of these patients gain weight abnormally which in turn aggravates the symptoms of PCOS.
- Excess facial hair and / or acne – Elevated androgen levels found in these patients predispose them to acne and hirsutism.
A diagnosis of PCOS is made on the basis of at least two of the following:
- Irregular Periods : Infrequent, irregular or prolonged menstrual cycles are the most common sign of PCOS.
- Excess Androgen : Elevated levels of male hormones may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness
- Polycystic Ovaries: This is ultrasound finding where the ovaries are found to be enlarged in volume and have more than 12 follicles in each ovary.
Complications
- Difficulty in conception (due to failure to ovulate).
- Gestational diabetes or Pregnancy-induced high blood pressure.
- Miscarriage or Premature birth.
- Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increases your risk of cardiovascular disease.
- Type 2 diabetes.
- Sleep apnea
- Depression, anxiety and eating disorders
- Abnormal uterine bleeding
Treatment
There is no definite treatment for PCOS but directed to the major complaint. We definitely advice a lifestyle change which includes avoiding junk food, maintain regular sleep cycles , weight reduction and staying stress free.