TL;DR:
- PCOS Overview: Chronic hormonal disorder affecting women aged 12–44; common symptoms include irregular periods, infertility, obesity, and skin issues. Cannot be cured but can be managed.
- Causes: Multifactorial (genetic, endocrine, environmental, lifestyle factors); insulin resistance and hyperinsulinemia are key contributors.
- Symptoms: Irregular/absent periods, heavy bleeding, acne, hair loss, excess hair growth, abdominal obesity, infertility, PMS symptoms (bloating, mood swings, pain).
- Diagnosis: Based on AES or Rotterdam criteria—requires multiple symptoms confirmed through blood tests and ultrasounds.
- Treatment: Hormonal therapies (birth control, anti-androgens), ovulation stimulation (clomiphene, FSH, IVF), ovarian cauterization, weight loss (5–10%), low-carb diet, exercise, and regular medical monitoring.
- Significance: Untreated PCOS increases risks for infertility, heart disease, diabetes, and cancer; regular endocrinologist/gynecologist care is essential.
Polycystic ovary syndrome (PCOS) is a disorder of normal hormone secretion. Depending on diagnostic criteria, it usually affects premenopausal women (between 12 – 44 years of age). Most patients learn of the presence of PCOS in their 20s – 30s, when they have trouble getting pregnant and decide to see a doctor. Up to 15% of women who present for such a reason have PCOS. The risk of the disease is higher if a woman is obese or has a family history of polycystic ovary syndrome. Hormonal disorders associated with the condition can cause irregular periods and difficulty getting pregnant.
polycystic ovary syndrome
PCOS was first described in 1935 by two American doctors. It is a chronic disease that cannot be cured. With the use of certain measures and therapies, it is possible to mitigate its effects and solve the problems it causes. Women struggling with PCOS have ovarian hyperandrogenism, which leads to the development of abdominal obesity, adverse metabolic consequences, fertility problems, excessive body hair, androgenetic alopecia and acne lesions. Patients with PCOS also have congenital insulin resistance and associated hyperinsulinemia, which can lead to the development of arteriosclerosis, hypertension, and type 2 diabetes. These conditions have a very negative impact on cardiovascular disease. Hormonal disorders cause the egg cells to fail to mature or be released into the fallopian tube during ovulation. The egg follicles die and become small cysts.
What are the causes of PCOS?
Polycystic ovary syndrome has a multifactorial origin – **genetic, metabolic, endocrine and environmental. Some of the syndrome's features are inherited, while others are due to hypothalamic-pituitary disorder, excessive male sex steroid production and insulin resistance with hyperinsulinemia. Less researched causes also include consumption of soy products, thyroid disease with iodine and fT3 deficiency, among others. Some also believe that zinc deficiency, excess exercise, strict reduction diets and too little starch in the food can have a big impact.
What are the symptoms of PCOS?
Women with PCOS struggle with a variety of symptoms. The most common is infrequent, irregular menstruation or lack of it. The condition also occurs if menstruation is normal. Cycles that do occur may also have massive bleeding – it's worth checking with a gynecologist, since heavy bleeding is an early sign of endometrial cancer, to which women with polycystic ovarian syndrome are much more likely to suffer. Patients also face long periods of premenstrual syndrome. **Symptoms include bloating, mood changes, pelvic pain, back pain, among others **Symptoms of PCOS also include difficulty getting pregnant** (resulting from very infrequent or absent ovulation – it occurs in women between the ages of 25 and 45), skin problems associated with high levels of androgens – acne, seborrhea, baldness, facial hair, androgenetic alopecia. In half of the cases, there is also an excessive tendency to gain weight, with fat tissue concentrated mainly in the lower torso.
What is the diagnosis of PCOS based on?
PCOS is diagnosed according to criteria developed by the AES (The Androgen Excess and PCOS Society) or the Rotterdam criteria. According to the AES, an adult woman with PCOS has each of the following symptoms: ovarian dysfunction, hyperandrogenism. However, other endocrine diseases that produce similar symptoms (adrenal hyperplasia: androgen secreting tumors, thyroid dysfunction, insulin resistance syndrome, etc.) must be excluded. According to the Rotterdam criteria, on the other hand, in order to correctly diagnose PCOS in women, two of three symptoms must be present, which include: the presence of polycystic ovaries on ultrasound, biochemical and/or clinical signs of hyperandrogenism, complete absence or rare ovulation. Other criteria doctors follow when diagnosing PCOS in teenage girls. They are found to have menstrual disorders and hyperandrogenism. The diagnostic criterion for this disease in young people is no longer the image of polycystic ovaries. To correctly diagnose PCOS, the symptoms of the condition alone are not enough. An ultrasound of the reproductive tract and blood tests are important. It is also very important to determine free testosterone, DHEA-S, SHBG and androstendione. PCOS is also diagnosed if there are 20 follicles in the ovary. Their average is 2 – 9 mm. An ovarian volume of 10m3 is also a symptom.
How does the treatment of PCOS proceed?
The treatment of PCOS is based on knowing and eliminating the cause of the disease, i.e. hormonal disorders. Bi-component birth control pills, as well as anti-androgen agents should be used. Therapy takes a long time, but brings many benefits related to the reduction of ovarian volume and even the return of ovulatory cycles. For many patients, this means the possibility of getting pregnant after stopping the pill. However, it is important to know that PCOS is a disease that cannot be completely cured, and the treatment chosen should be tailored to the patient's needs. Women need to think about whether they are thinking about getting pregnant in the near future. This is what determines the method of treatment. Before the doctor decides to prescribe pills, he takes into account whether the woman is struggling with acne, whether there is a need to regulate the cycle, reduce weight and insulin resistance. For this purpose, it is important to choose professional and experienced doctors who will take a medical history and indicate the necessary tests to be performed. Treatment methods are based on several ways. The most popular relates to ovulation of ovulation, which is used when a woman wants to get pregnant but is having trouble doing so. However, it is important to keep in mind that not every PCOS patient has trouble getting pregnant. Ovulation stimulation is the administration of clomiphene between the 5th and 9th day of the cycle. If this method is not enough, the doctor suggests FSH stimulation or in vitro method. Another technique is ** ovarian cauterization, which is used for infertility. The cysts are then punctured. This facilitates the occurrence of regular ovulation in subsequent cycles. The effects of this method are noticed one year after the procedure. Oral estrogen-gestogen contraception is another method that is used when a woman does not want to be pregnant, but wants to normalize her cycle and enjoy regularity of her periods. This technique protects the endometrium just as gestagen-based drugs do. It is used every few weeks to induce menstruation. An important aspect of treatment is also **proper nutrition**. Weight reduction is important, as it has been proven that 5 – 10% weight loss can restore ovulation and increase the possibility of pregnancy by 50%. The greatest importance is then to reduce carbohydrate intake, and a diet based on a low glycemic index, high fiber intake, regular and frequent meals. Adequate exercise, sleep and water should also not be overlooked.
Why is it necessary to treat PCOS?
**Even in 40% of affected women, polycystic ovary syndrome causes infertility, but this is not the only problem that women with PCOS and obesity often face. At a much higher rate than healthy people, these women are also at risk for hypertension, heart disease, stroke and type II diabetes. It is therefore very important for **PCOS sufferers to be under the constant supervision of an endocrinologist and gynecologist** even when they are not planning to become pregnant. Untreated PCOS can lead to complications such as: obstructive sleep apnea, atherosclerosis, heart attack, and endometrial cancer.
Conclusion
PCOS is a complex, lifelong condition requiring proper diagnosis and care. Left untreated, it can increase risks for infertility, heart disease, diabetes, and more. While it cannot be cured, treatments like hormone therapy, lifestyle changes, and medical interventions can manage symptoms. Early detection and personalized care improve outcomes significantly. If you suspect PCOS, consult a specialist to address your needs and prevent long-term complications. Staying proactive about your health and treatment can lead to better quality of life and reduced health risks. Managing PCOS starts with understanding its intricacies and acting effectively.
