What is Polycystic ovarian syndrome?

This article was contributed by Dr Gayaithiri Ramasandran, Consultant Obstetrics & Gynaecology (O&G) at Pantai Hospital Cheras.
To book an appointment or learn more about Dr Gayaithiri Ramasandran and her clinic, click here.

What is Polycystic ovarian syndrome?

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among females of reproductive age worldwide affecting between 5% and 26% of females. Up to 70% of affected women remain undiagnosed worldwide. PCOS can be as common as being present in 1 in 4 women between the ages of 18 to 35 years. PCOS is a condition in combination of various metabolic disorder and hormonal imbalance.

Common Sign and Symptoms

• Irregular menses or no menses at all
• Infertility - difficulty getting pregnant 
• Hirsutism - excessive hair growth
• Weight gain
• Thinning of hair or hair loss
• Acne

Contributing factors 

The exact cause of PCOS is unknown. It is a multifactorial condition which include insulin resistance, hormonal imbalance, excesssive male hormone exposure and genetic which can run in family.

Associated health risks

PCOS is associated with multiple comorbidities:

• Infertility - Difficult to get pregnant
• Obesity
• Diabetes
• High cholesterol
• Hypertension
• Cardiovascular risks 
• Depression 
• Obstructive sleep apnea
• uterine cancer and pre cancerous conditions- It is important to have a period every 3-4 months to reduce the risk of excessive thickening of the lining of the uterus which eventually can lead to cancer.

How PCOS is diagnosed ?

Diagnosis is made by thoroughly assessing symptoms, doing physical exams, performing laboratory tests, and imaging. No single test can confirm or exclude the diagnosis of PCOS.

Diagnosis of PCOS must be based on the presence of at least 2 of the following 3 criteria: 

• irregular menstruation or ovulation disorder
• excessive androgen(clinical or biological) - high levels of "male" hormones in your body, which may cause physical signs such as excess facial or body hair 
• polycystic ovaries.- ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not actually have cysts if you have PCOS)

Management and treatment

• Lifestyle modification is the first line management of PCOS: healthy balanced diet, exercise and weight loss as low as 5% has been noted to be helpful with the resolution of clinical symptoms.
• The benefits of losing weight include:
• lower risk of insulin resistance and developing diabetes
• lower risk of heart problems
• lower risk of cancer of the womb
• more regular periods
• increase chance of becoming pregnant
• reduction in acne and a decrease in excess hair growth over time
• improved mood and self-esteem.
• Ther is no cure for PCOS but treatments can improve symptoms.
• The treatment plan is tailored around your health goals and is individualized.
• Medications may be prescribed to regulate menses, imrpove insulin resistance and fertility.
• Surgery such as laparoscopic ovarian drilling may be required to treat fertility problems associated with PCOS that do not respond to medicine.

When to see a doctor 

Do visit a gynaecologist for accurate diagnosis and get personalized treatment plan if you have any of the symptoms such as irregular, heavy or no menses, difficult to get pregnant, weight gain, acne or any concern about your reproductive health. 

Conclusion

Early detection and treatment can improve long term health risk.You can reduce this risk with a healthy lifestyle, regular health checks (e.g. blood pressure ,blood glucose and ultraound) and medicine if required. If you have any of the above mentioned symptoms, please do not hesitate to get consultation with Gynaecologist as soon as possible.