Polycystic Ovarian Syndrome:PCOS Part 2

Last week, we started the topic on Polycystic Ovarian Syndrome, discussing some of its causes. This week, we shall continue on the causes and then proceed to symptoms, diagnosis and effect on the body. Causes include:

Inflammation: Women with PCOS often have increased levels of inflammation in their body. Being overweight can also contribute to inflammation. Studies have linked excess inflammation to higher androgen levels.

Hormone imbalance: Many women with PCOS are found to have an imbalance in certain hormones. The exact reason why these hormonal changes occur is not known. It’s been suggested that the problem may start in the ovary itself, in other glands that produce these hormones, or in the part of the brain that controls their production. The changes may also be caused by the resistance to insulin. These changes include:

• Increased levels of testosterone: a hormone often thought of as a male hormone, although all women usually produce small amounts of it.

• Low levels of sex hormone-binding globulin (SHBG): a protein in the blood that binds to testosterone and reduces its effect.

• High levels of luteinizing hormone (LH): this stimulates ovulation, but may have an abnormal effect on the ovaries if levels are too high.

• Increased levels of prolactin: this can be found only in some women with PCOS. Prolactin is a hormone that stimulates the breast glands to produce milk only in pregnancy. High levels in some women may indicate the presence of polycystic ovaries.

Symptoms of PCOS
Symptoms tend to be mild at first. You may have only a few symptoms or a lot of them. The most common symptoms are:

• Acne

• Weight gain and trouble losing weight.

• Extra hair on the face and body. Often women get thicker and darker facial hair and more hair on the chest, belly, and back.

• Thinning hair on the scalp.

• Darkening of skin, particularly along neck creases, in the groin, and underneath breasts.

• Skin tags, which are small excess flaps of skin in the armpits or neck area.

• Irregular periods. Often women with PCOS have fewer than nine periods a year. Some women have no periods. Others have very heavy bleeding.

• Many women who have PCOS have trouble getting pregnant (infertility).

• Depression.

What Are The Effects Of PCOS On The Body?

Having higher-than-normal androgen levels can affect fertility and other aspect of health
Infertility: To get pregnant, you have to ovulate. Women who don’t ovulate regularly don’t release as many eggs to be fertilized. PCOS is one of the leading causes of infertility in women.

Metabolic syndrome: Up to 80 percent of women with PCOS are overweight or obese. Both obesity and PCOS increase your risk for high blood sugar, high blood pressure, low HDL (“good”) cholesterol, and high LDL (“bad”) cholesterol. Together, these factors are called metabolic syndrome, and they increase the risk for heart disease, diabetes, and stroke.

Sleep Apnea: This condition causes repeated pauses in breathing during the night, which interrupt sleep. It is more common in women who are overweight especially if they also have PCOS. The risk for sleep apnea is 5 to 10 times higher in obese women with PCOS than in those without.

Endometrial cancer: During ovulation, the uterine lining sheds. If you don’t ovulate every month, the lining can build up. A thickened uterine lining can increase your risk for endometrial cancer.

Depression: Both hormonal changes and symptoms like unwanted hair growth can negatively affect emotions. Many people with PCOS end up experiencing depression and anxiety.

How is PCOS diagnosed?

PCOS in women is typically diagnosed when symptoms like high androgen levels, irregular menstrual cycles and cysts in the ovaries are observed. To further diagnose PCOS and rule out other causes of your symptoms, the doctor may review your medical history and also conduct a physical examination.

• Physical exam: Blood pressure, body mass index (BMI), and waist size will be measured. The doctor may examine your skin for extra hair on your face, chest or back, acne, skin discoloration, hair loss or signs of other health conditions (such as an enlarged thyroid gland).

• Pelvic exam: A pelvic examination will be used to check for signs of extra male hormones (for example, an enlarged clitoris) and check to see if your ovaries are enlarged or swollen.

• Pelvic ultrasound (sonogram). This test uses sound waves to examine your ovaries for cysts and check the endometrium (lining of the uterus or womb).

• Blood tests. Blood tests check your androgen hormone levels, sometimes called the male hormones. Other hormones related to other common health problems that can be mistaken for PCOS, such as thyroid disease will be evaluated. Your doctor may also test your cholesterol levels and test you for diabetes…………………………………………..TO BE CONTINUED