According to the World Health Organization, approximately 116 million women worldwide are affected by Polycystic Ovary Syndrome (PCOS). But what does PCOS mean for you if you’re diagnosed with it? To understand more, let’s first dive into the basics of the female reproductive system.
How Does the Female Reproductive System Work?
The female reproductive system performs a number of vital activities. The egg cells, known as ova or oocytes, are made by the ovaries. The oocytes are subsequently moved to the fallopian tube, where they may be fertilised by a sperm. The fertilised egg is then transferred to the uterus, where the uterine lining has thickened in reaction to the usual reproductive hormones. The fertilised egg can then implant into the thicker uterine lining and continue to grow once inside the uterus. If implantation fails, the uterine lining is lost as menstrual flow. In addition, the female reproductive system creates female sex hormones, which help to keep the reproductive cycle going.
What Is Ovulation?
The follicle-stimulating hormone causes follicles in one of your ovaries to develop each month, between days six and 14 of your menstrual cycle. However, only one of the maturing follicles becomes a completely developed egg between days 10 and 14. A rise in the luteinising hormone on day 14 of the menstrual cycle leads the ovary to release its egg. The egg then begins its five-day journey to the uterus via a small, hollow structure known as the fallopian tube. The level of progesterone (another hormone) rises as the egg travels through the fallopian tube, helping to prepare the uterine lining for pregnancy.
What Is PCOS?
PCOS is a common health issue caused by reproductive hormonal imbalances. Your ovaries (which create the egg that is released each month) suffer as a result of this imbalance. With PCOS, the egg may not mature or may not be released like it should during ovulation. PCOS is therefore one of the most prevalent reasons for female infertility. Below is a comparison of a healthy ovary (left) versus a PCOS ovary (right).
What Are the Symptoms of PCOS?
PCOS can cause several symptoms, some of which you may disregard as minor, but if they collectively persist, they need to be addressed by a doctor. Women with PCOS may miss their period, have fewer periods (fewer than eight in a year), or their periods may come more often (every 21 days). Some women with PCOS even cease having menstrual periods. PCOS can produce excessive hair development on the face, chin, or other areas of the body where males usually have hair. This is known as hirsutism and up to 70% of women with PCOS suffer from it.
PCOS may bring on acne on the face, chest, and upper back.
PCOS can lead to hair thinning or loss, akin to male-pattern baldness.
PCOS can trigger weight gain or make losing weight difficult.
PCOS can cause darkening of the skin in the neck creases, groin, and beneath the breasts. Skin tags, which are little extra flaps of skin, can also develop in the armpits or neck.
What Causes PCOS?
The exact cause of PCOS is not known. Most scientists believe that a variety of variables, including genetics, have a role. Other factors can include:
High Levels of Androgens
Androgens are commonly referred to as “male hormones”, despite the fact that all women produce modest levels of androgens. They regulate the development of masculine characteristics such as male-pattern baldness. Women with PCOS have higher levels of androgens than usual, which can hinder the ovaries from producing an egg (ovulation) throughout each menstrual cycle, as well as produce excessive hair growth and acne – all of which are symptoms of PCOS.
High Levels of Insulin
Insulin is a hormone that regulates how food is converted into energy. Insulin resistance arises when the body’s cells do not respond appropriately to insulin. This makes the insulin levels in your blood rise above normal. Many PCOS women have insulin resistance, particularly those who are overweight or obese, have poor eating habits, do not get enough physical activity, and have a family history of diabetes (usually Type 2 diabetes). Insulin resistance can progress to Type 2 diabetes over time.
Is PCOS Treatable?
There are several types of medicines that treat PCOS and its symptoms.
Hormonal birth control – including the pill, patch, injection, vaginal ring, and hormone intrauterine device (IUD) – is one method of birth control that can help manage PCOS symptoms. Hormonal birth control can help women who don’t wish to get pregnant by:
- Increasing the regularity of the menstrual cycle.
- Reducing the risk of endometrial cancer.
- Aiding in the treatment of acne and the reduction of excess hair on the face and body.
It’s essential to see your doctor before starting birth control that includes both estrogen and progesterone.
These medications inhibit the action of androgens, which can aid in the reduction of hair loss, facial and body hair growth, and acne. The Food and Drug Administration (FDA) has not authorised them to treat PCOS symptoms, although there have been patient cases where these medications have been beneficial. These drugs can also create complications during pregnancy; therefore, it is critical to consult with your doctor before using them.
Metformin is often used to treat Type 2 diabetes and may benefit some individuals suffering from PCOS symptoms. It is not authorised by the FDA to treat PCOS symptoms, so see your doctor first. Metformin enhances insulin’s capacity to decrease blood sugar levels, and has the potential to lower both insulin and androgen levels. Metformin may help restart ovulation after a few months of usage, although it typically has minimal effect on acne and excess hair on the face or body. According to new studies, metformin may offer additional benefits such as decreasing body mass and improving cholesterol levels.
Previous studies have demonstrated that Myo-inositol is capable of restoring spontaneous ovarian activity, and consequently fertility, in most patients with PCOS. Some studies have also investigated the role of folic acid contained in the inositol preparation. The use of Myo-inositol and folic acid per day was shown to be a safe and promising tool in the effective improvement of symptoms and infertility for patients with PCOS, including improving oocytes.
Taking folic acid may help manage infertility rooted in ovulation problems for both women with and without PCOS. A study of over 18,000 women over an eight-year period indicates that having a high-quality multivitamin supplement containing folic acid may be beneficial. According to the data, using a supplement at least six times each week may lessen ovulation issues by 40%. Interestingly, the experts who led the study identified folic acid as one of the most plausible explanations for the patients’ increased fertility.