Polycystic Ovary Syndrome (PCOS) Or Polycystic Ovary Disease (PCOD)

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Polycystic ovary syndrome (PCOS) or polycystic ovary disease (PCOD) is a problem in which a woman’s hormones are out of balance. It can cause problems with your periods and make it difficult to get pregnant. PCOS also may cause unwanted changes in the way you look. If it isn’t treated, over time it can lead to other health problems, such as diabetes and heart disease. Most women with PCOS grow many small cysts on their ovaries. That is why it is called PCOS. The cysts are not harmful but lead to hormone imbalances. Early diagnosis and treatment can help control the symptoms and prevent long-term problems.

What Causes Polycystic Ovary Syndrome (PCOS)?

The exact cause of polycystic ovarian syndrome is not clear, although a number of abnormalities have been documented in women with PCOS. There is some evidence for an inherited (genetic) cause for PCOS, although no specific genetic mutation has been identified as the cause. It has been shown that the ovaries of women with PCOS may produce excessive amounts of male hormones, or androgens, which lead to disruptions in the menstrual cycle and impaired fertility.
PCOS is also associated with insulin resistance, or an impaired ability to utilize insulin, and this abnormality is also likely related to the cause of PCOS.
The presence of small cysts in the ovaries is not specific for PCOS, since women who do not have PCOS may have ovarian cysts. Therefore the presence of cysts is not likely to be the cause of the symptoms of PCOS.

Symptoms

Symptoms of Polycystic ovary syndrome (PCOS)
The symptoms frequently begin at puberty although in many women the syndrome is not fully expressed until later in their reproductive years.
  • Menstrual disturbances:- Women with PCOS usually presents with oligomenorrhoea (reduced menstrual bleeding), amenorrhoea (absence of menstrual bleeding), prolonged erratic menstrual bleeding. Nearly 90% women with oligomenorrhoea have features of PCOS on Ultrasound. However, the features of PCOS are present only in 30% of women who presents with amenorrhoea.
  • Hirsutism, acne and alopecia:- Increased facial and body hair (hirsutism) is one of the most common presenting symptoms. About three-quarters of women who present with acne have PCO on ultrasound. Alopecia and more specifically crown pattern baldness have been less commonly reported in women with PCOS.
  • Recurrent miscarriage:- polycystic ovaries have been identified as being associated with recurrent miscarriage.
  • Metabolic:- The metabolic aspect of PCOS is obesity and insulin resistance. The distribution of fat in women with PCOS results in an increased waist: hip ratio and is frequently associated with greater insulin resistance than if fat is distributed predominantly in the lower body segment. Some patients may also present with acanthosis nigricans (a feathering pigmented area of tissue in the neck and axillary regions); this is now recognized as a non-specific marker of moderate to severe insulin resistance. Hypersecretion of insulin results in ovarian secretions of androgen leading to hirsutism and menstrual disturbance.
The other most common symptoms are as follows:
  1. Weight and difficulty in weight loss.
  2. Acne breakout.
  3. Development of excess hair on the face and body, which is not a feminine feature. Thicker and darker facial hair and unusually excessive hair on the belly, chest and back are also indicated in some women.
  4. Thinning of hair on the scalp.
  5. Irregularity with menstrual periods. Commonly, women with PCOD experience less than 9 periods during a year. Some women may have no periods at all, while others experience heavy, abnormal bleeding.
  6. Fertility problems are likely in women with PCOD.
  7. Depression.

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