Polycystic Ovarian Syndrome or PCOS is the most common hormonal disorder of women in the reproductive-aged group. 15 to 20% of women worldwide will have it in their lifetime. Although it usually presents with a variety of symptoms, some patients are diagnosed incidentally after seeing their physician for entirely different reasons.

The exact cause of PCOS is unknown. It is a complex interplay of hormones, but genetics is believed to play a role in its development.

Here, we discuss five facts about PCOS that every woman should know:

Signs and symptoms of PCOS

The common signs and symptoms include:

• Menstrual irregularities: Oligomenorrhea or cycles over 35 days, infrequent menstrual periods, or no periods at all
• Hirsutism or excess hair growth in body in areas where we don’t usually have much hair, like the face, the chest, or the back
• Thinning of the hair or hair loss
• Acne and oily skin
• Difficulty in getting pregnant 
• Weight gain

Hormones play an important role in PCOS

Women normally produce small amounts of male hormones, called androgens, in the body. In PCOS, there is an increase in the level of circulating androgens that can prevent ovulation and also cause the male- pattern of symptoms such as hirsutism.

Estrogens, or female hormones, are also produced in excess. Follicles grow but the egg does not get released. Instead, small cysts with fluid are formed within the ovary. Estrogen excess can cause future complications if consistently unopposed with progesterone, another hormone necessary to make you menstruate.

Insulin is a hormone that is necessary for the regulation of sugar or glucose. Cells convert glucose primarily as a source of energy in the body. Women with PCOS have insulin resistance in which the body isn’t able to use insulin correctly – blood sugar then rises triggering a further increase in insulin production. Excess insulin then increases androgen production, making ovulation more difficult.

Now we know why PCOS is commonly called “hormonal imbalance.”

Women can still get pregnant even with PCOS

This is a huge relief for women who are struggling with PCOS. Although more difficult compared to women in the general population, PCOS patients may ovulate intermittently. There are a lot of ovulation-inducing drugs that can help improve one’s fertility with PCOS.

However, a common misconception in couples trying to conceive is that only the woman needs medical attention. Remember, male factor is believed to cause up to 40% of infertility in couples. While PCOS remains a common reason for anovulation, managing infertility appropriately will increase the chances of pregnancy.

There are significant long-term complications from PCOS.

Although primarily a reproductive disease, PCOS predisposes patients to a lot of future complications if PCOS remains unmanaged.

Weight gain and obesity are major predictors of cardiovascular risks. Women with PCOS often have lipid abnormalities that increase their risk for cardiovascular inflammation and hypertension. Diabetes may develop with age. The unopposed estrogen can thicken the lining of the uterus (endometrium) making one more susceptible to endometrial cancer. Skin concerns such as acne and hirsutism and the burden of being overweight also affect the quality of life and mental health. These complications are curbed significantly when PCOS is addressed early.

PCOS management is multifactorial

Since PCOS centers on hormonal imbalance, it is also commonly treated with hormones. Oral contraceptive pills (OCP) regulate the hormones in the body, making you menstruate regularly. Your doctor will ask whether you are desirous of pregnancy at that point in your life. If you aren’t, OCPs are a good option for you. However, contraceptive pills are contraindicated in patients with uncontrolled hypertension and diabetes, smokers over the age of 35, those with a history of thrombosis or blood clots, stroke, breast cancer or undiagnosed vaginal bleeding, among many others.

Medications such as metformin improve insulin sensitivity in your cells, thereby decreasing androgen production in the body. Vitamins and minerals such as B-vitamins, vitamin D3, magnesium, and Omega-3 have been found in studies to have a beneficial effect on PCOS patients.

The importance of exercise and a healthy diet cannot be overemphasized. The cycle of a sedentary lifestyle, unhealthy eating habits, weight gain, and reproductive issues is way too common today. Exercising at least 30 minutes a day for five days a week, making conscious diet choices, reducing stress and quitting vices improve your overall cardiovascular health and well-being.

Understanding the disease empowers you to live with it. Talk to your doctor today regarding PCOS and its risks. Your body will thank you later for it.

^{1 Deswal, R., Narwal, V., Dang, A., & Pundir, C. S. (2020, December 28). The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. Journal of Human Reproductive Sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879843/.}