PCOS by Dr. Nitika Sobti

WHAT IS PCOS?

Polycystic ovary syndrome is a set of symptoms related to a hormonal imbalance that can affect women and girls of reproductive age. It is estimated that approximately 10 million women worldwide suffer from PCOS.


WHAT ARE COMMON SYMPTOMS OF PCOS?

1. Irregular mensuration – absent menses, frequent periods, heavy or scanty periods unpredictable periods,

2. Skin changes - Excess hair growth on face chest, abdomen and upper thighs , this condition is called hirsutism and is present in 70% of women with PCOS ,Oily skin ,severe acne ,patches of thickened dark velvety skin around the neck

3. Multiple fluid filled sacs in the ovaries diagnosed on ultrasound

4. obesity/weight gain/inability to lose weight

5. Breathing problems while sleeping, depression

6. Medical conditions -high cholesterol levels, elevated blood pressure, abnormal sugar levels.

Some women have only a few symptoms while others have several.

How is PCOS diagnosed?

There is no specific test to definitely diagnose PCOS, which is why it is commonly misdiagnosed. In addition to assessing common PCOS symptoms, a doctor will do a blood test to measure male hormone levels for irregularities and an ultrasound offers a closer look at the ovaries to see if they meet PCOS criteria. Three characteristic features of PCOS:

1. Absence of ovulation with irregular menses,
2. High androgen levels
3. USG features suggestive of cysts in the ovaries.

WHAT IS THE TREATMENT OF PCOS?

The treatment your doctor suggests depends upon:

• Your symptoms
• Your other medical health problems
• Whether you want to get pregnant

Treatment Plan

Oral Contraceptives

These are hormonal contraceptives and can be used for the long-term treatment of women with PCOS who do not wish to become pregnant. Oral contraceptive pills contain a combination of the hormones estrogen and progestin. In women with PCOS, these hormones

• Make menstrual periods more regular
• Reduce the level of androgens produced by the ovaries, leading to reduction in androgen activity
• Help clear acne and reduce excess hair growth

We should always be cautious that oral contraceptives, like all medications, are associated with side effects, some of them are serious. All possible risks and side effects should be discussed with your treating doctor before deciding on a treatment.

Insulin-Sensitizing Agents and Anti – Androgens

These medications make the body more responsive to insulin and keep glucose levels in normal range. In women with PCOS, these medications can help:

• Make periods more regular
• Help in weight loss
• Stabilize cholesterol levels
• Clear acne and reduce hair growth
• Aid in treating infertility associated with PCOS12
• Talk to your health care provider about any concerns you may have about these medications.

Removing or hiding unwanted hair and acne treatment

There are many ways to remove excess or unwanted hair or to hide this hair without actually removing it. Women with PCOS can use the methods below after consultation with the dermatologist for best results. Daily application of an eflornithine cream slows hair growth, especially on the face.

• Shaving, bleaching, plucking, waxing,
• Electrolysis, laser hair removal,
• Retinoid antibacterial agents, and antibiotics may also be used to treat acne. These products may be available in pills, creams, or gels, but need to be prescribed by your dermatologist for proper clearance and results.

DO LIFESTYLE CHANGES IMPACT THE TREATMENT IN PCOS?

1. Reduce Your Sugars and Carbohydrates; women with PCOS have insulin resistance wherein insulin is not used efficiently in the body.

2. Manage Weight; Some but not all women with PCOS are overweight, so dietary changes with high protein diet and low sugar is a treatment of PCOS.

3. Exercise regularly; Regular exercise has many benefits in treating PCOS .The optimal exercise should be at least 30mins for 5 days a week.

  •   150 minutes/week for weight management
  •   250minutes/week moderate exercise for weight loss 4. Avoid oily and processed foods

5. Regular eating and sleeping patterns

6. Avoid crash diets

7. Add whole grain products, fibers, protein , green leafy vegetables and fruits under low glycemic under foods