Girls as young as 14 years of age are facing hormonal imbalance in their bodies. PCOS is a common term being bandied about every day. If you or someone you know is experiencing unpredictable weight gain, acne, or irregular periods, it may be time for you to ask ‘What is PCOS?’ Let’s understand its basics and how to effectively manage this condition.
What is Polycystic Ovary Syndrome (PCOS)?
Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. In individuals with PCOS, the ovaries produce more than the normal amount of male hormones called androgens, which are usually present in a smaller amount in females.
As a result of this hormonal imbalance, the ovaries are unable to release eggs (ovulation), which causes irregular menstrual cycles. Irregular ovulation can also cause numerous small, fluid-filled sacs to develop on the ovaries. These sacs are called cysts and give the condition PCOS its name.
PCOD vs PCOS: Is There a Difference Between the Two?
Now we know that “PCOS” stands for Polycystic Ovarian Syndrome. But what is PCOD? What is the difference between PCOD and PCOS?
“PCOD” stands for Polycystic Ovarian Disease. “PCOS” and “PCOD” are the same condition and there is no difference between the two. “PCOD” is an older terminology, which is now being replaced by “PCOS” in most instances.
PCOS: Causes
The exact cause of PCOS is not known. However, there are some significant factors that play a role in causing PCOS. These factors include
Insulin Resistance
Many individuals with PCOS have insulin resistance. When your body becomes resistant to insulin, your cells lose the ability to take up the glucose (sugar) required to produce energy, which causes increased blood sugar levels. This, in turn, triggers the pancreas to produce more insulin to stabilise the blood sugar levels.
The excess insulin now in your blood, in turn, may lead to excess production of male hormones (androgens) in the body, causing difficulties in ovulation.
Excess Androgen Levels
Your ovaries may produce excess amounts of androgens and cause the symptoms of PCOS. High androgen levels prevent the ovaries from releasing eggs, which causes small, fluid-filled sacs to develop on the ovaries and leads to irregular menstrual cycles and other symptoms of PCOS.
Low-Grade Inflammation
According to studies, women with PCOS have low-grade inflammation. If you are obese and have abdominal fat, the adipose tissue (fat tissue) shows an increased secretion and release of proinflammatory cytokines. This can cause low-grade inflammation in your body, which stimulates the ovaries (polycystic) to produce androgens and may lead to heart and blood vessel problems.
Genetics
Research shows that PCOS runs in families. Many women who have a family history of PCOS develop the condition.
PCOS: Symptoms
The signs and symptoms of PCOS vary from person to person. You may have PCOS and none of its associated symptoms and you may have several of the PCOS symptoms.
You may observe the first signs of PCOS around the time of your first menstrual cycle or only experience it in the later stages.
- Cysts: As one of the most telling symptoms of PCOS, your ovaries may develop cysts, sac-like pockets filled with fluid, which are visible on ultrasound.
- Irregular periods: Irregular, infrequent, prolonged or missed periods are the most common symptom of PCOS. You may have fewer than 9 periods a year, more than 35 days between periods, or not have periods at all.
- Heavy bleeding: Your uterine wall lining may keep building up for a long period of time due to the hormonal imbalance and cause heavy bleeding during your periods.
- Abnormal hair growth: This condition is also called hirsutism. Most women develop unwanted hair on their face, and excessive hair growth on their arms, back, abdomen, and chest.
- Acne: Excess androgens can cause acne, especially on the back, chest, and face. You may continue to develop them past your teenage years.
- Skin darkening: Dark patches may develop on your skin, especially on the neck, armpits, groin and under the breast. This condition is known as acanthosis nigricans.
- Skin tags: You may also develop little flaps of extra skin on your neck and armpits.
- Obesity: About 80% of women with PCOS gain weight and may experience difficulty in losing it. The weight gain is most prominently around the abdomen.
- Male pattern baldness: The hair on your scalp may get thinner and you may lose patches of hair.
- Headache: You may experience headaches due to the hormonal imbalance in PCOS.
- Infertility: PCOS is the most common cause of infertility due to the decreased frequency or complete lack of ovulation.
PCOS: Complications
If you have PCOS and it goes undiagnosed and untreated for long, you are prone to develop complications such as:
- Infertility
- Gestational diabetes
- Miscarriage
- Premature birth
- Metabolic syndrome (a group of serious health conditions that increase your risk of heart disease and include high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol or triglyceride levels).
- Prediabetes
- Type 2 Diabetes
- Nonalcoholic Steatohepatitis
- Abnormal uterine bleeding
- Endometrial cancer (cancer of the uterine lining)
- Anxiety
- Depression
- Obstructive sleep apnoea
PCOS: Diagnosis
If you think you are experiencing the symptoms of PCOS, consult your doctor without any further delay.
Your doctor may use the following steps for the diagnosis of PCOS:
- Discuss your symptoms, medical history, family history, menstrual cycle, and any changes in your weight.
- Perform a physical examination for hair growth, discolouration of the skin, skin tags, and acne.
- Undertake a pelvic exam to inspect for any masses, growth, swollen ovaries, or abnormalities in your reproductive organs.
- Order blood tests to check for higher than normal levels of male hormones in your body. Tests for glucose tolerance and cholesterol and triglyceride levels may also be prescribed. These tests will help to rule out other possible causes that mimic the symptoms of PCOS.
- Finally, the doctor may perform a pelvic ultrasound to check the size of the ovaries, cysts in your ovaries, and the thickness of the lining of your uterus (endometrium).
You need to meet at least 2 of these 3 criteria to be diagnosed with PCOS:
- Irregular or missed periods
- Signs of excess androgen such as acne or excessive hair growth or blood test results confirm high androgen levels.
- Cysts on one or both ovaries.
PCOS: Treatment
PCOS symptoms and treatment are related. Treatment options for PCOS may vary because some individuals with PCOS may experience a range of symptoms, and others may deal with just 1 symptom.
Since PCOS is the most common cause of infertility, the treatment for PCOS depends on whether or not the individual wants to get pregnant. The treatment for PCOS also varies based on the symptoms, medical history, and other health conditions of the individual.
Treatment if You Do Not Want to Get Pregnant
Hormonal Birth Control: It can be in the form of pills, patches, shots, vaginal rings, or intrauterine devices (IUDs). This treatment modality can help to regulate your menstrual cycle, and improve PCOS symptoms such as excess hair growth and acne. The modality uses a combination of oestrogen and progestin to decrease androgen production and regulate oestrogen levels in the body.
Insulin-Sensitising Medication: Metformin, a drug used to treat diabetes, is also used as a part of the treatment process for PCOS. It works by reducing insulin resistance in PCOS. Once insulin is controlled, some individuals with PCOS may see improvements in their menstrual cycles.
Lifestyle Changes: The treatment of PCOS starts with lifestyle changes. Eating a balanced diet, regular physical activity, and the resultant weight loss can result in the improvement of several PCOS symptoms.
Treatment if You Want to Get Pregnant Immediately or in The Future
Medications to Induce Ovulation: Your doctor may prescribe medications to induce ovulation. These medications can help the ovaries release eggs normally. Drugs such as metformin, clomiphene, and letrozole are taken orally, while gonadotropins are given by injection to induce ovulation.
In Vitro Fertilisation (IVF): When the medications do not help with ovulation, matured eggs are retrieved from your ovaries and fertilised with your partner’s sperm in a lab. The fertilised eggs are then transferred into your uterus where they may grow into a healthy pregnancy. This process is known as In Vitro Fertilisation or IVF.
Along with these modalities, lifestyle changes, including a balanced diet and regular physical activity are advised for those trying to get pregnant with PCOS. A healthy diet and increased physical activity can promote weight loss, help your body use insulin and lower blood glucose levels, and may help you ovulate.
Diet and Nutrition Plan for PCOS
Importance of Diet in PCOS Management
Your diet plays a central role in managing PCOS, as it directly impacts your hormones, weight, and overall well-being. A well-balanced diet can help regulate insulin resistance, a common issue in PCOS, while also reducing inflammation and promoting hormonal balance. Think of your meals as a way to nourish and support your body, empowering it to work better for you.
Here are some key dietary resources that can guide you in managing PCOS more effectively:
PCOS Diet Plan Indian: Learn how to structure a balanced and sustainable Indian diet specifically tailored for PCOS management.
List of Fruits Good for PCOS: Explore a variety of fruits that can support hormone balance and reduce inflammation.
Low GI Food for PCOS: Discover a detailed guide to low glycemic index foods and their role in stabilizing blood sugar levels.
PCOD Diet Chart for Weight Loss: Follow a structured diet plan designed to help you lose weight while managing PCOD symptoms effectively.
Foods to Include
The right foods can make a world of difference in how you feel and manage PCOS symptoms.
Here are some superstars to include in your diet:
- High-fiber foods: Vegetables like spinach, broccoli, and carrots; whole grains such as brown rice and quinoa; and legumes like chickpeas and lentils. These help maintain steady blood sugar levels and keep you full longer.
- Lean protein sources: Chicken, fish, tofu, and lentils are great options to build your meals around. Protein stabilizes blood sugar and supports muscle health.
- Healthy fats: Incorporate nuts, seeds, avocados, and olive oil. These fats support hormone production and keep inflammation in check.
- Anti-inflammatory foods: Add vibrant colors to your plate with turmeric, fresh berries, and leafy greens, which combat inflammation naturally.
- Low-glycemic index (GI) foods: Foods like quinoa, oats, sweet potatoes, and whole fruits digest slowly, helping you avoid insulin spikes.
Foods to Avoid
Some foods may worsen PCOS symptoms or disrupt your body’s balance. Reducing or avoiding these can significantly improve how you feel:
- Refined carbohydrates: White bread, pastries, and sugary drinks can lead to rapid blood sugar spikes and worsen insulin resistance.
- Processed foods: Chips, packaged snacks, and instant meals often contain unhealthy additives and offer little nutrition.
- Trans fats: Fried and junk foods are inflammatory and harmful for hormone health.
- High-sugar foods and beverages: Say goodbye to soda, candies, and sugary desserts, as they can aggravate symptoms like weight gain and acne.
Myths and Misconceptions about PCOS
Myth 1: Only overweight women get PCOS.
PCOS affects women of all body types. While obesity can worsen symptoms, lean women can also have PCOS.
Myth 2: PCOS and infertility go hand in hand.
While PCOS can make conception challenging, many women with PCOS can conceive with proper treatment and lifestyle changes.
Myth 3: PCOS is caused by poor lifestyle choices.
PCOS has genetic and hormonal causes. Though lifestyle factors can influence symptoms, they are not the sole cause.
Myth 4: Losing weight cures PCOS.
Weight management can reduce symptoms but does not “cure” PCOS, as it’s a chronic condition.
Myth 5: Irregular periods mean you definitely have PCOS.
Irregular periods can result from various reasons like stress, thyroid disorders, or excessive exercise—not just PCOS.
Myth 6: Birth control pills treat PCOS.
Birth control pills help manage symptoms like irregular periods and acne but do not address the root causes of PCOS.
Myth 7: PCOS is a rare condition.
PCOS is one of the most common hormonal disorders, affecting 1 in 10 women of reproductive age.
Myth 8: PCOS only affects the reproductive system.
PCOS impacts overall health, including metabolic, cardiovascular, and mental health.
Myth 9: Women with PCOS cannot lose weight.
Weight loss may be more challenging due to insulin resistance, but with consistent effort, it is achievable.
Myth 10: Excessive hair growth happens to everyone with PCOS.
Hirsutism (excess hair growth) is a symptom of PCOS, but not all women with PCOS experience it.
Myth 11: PCOS goes away after menopause.
Symptoms like irregular periods may subside, but PCOS-related risks (e.g., diabetes, heart disease) can persist post-menopause.
Myth 12: PCOS can be self-diagnosed.
PCOS requires medical tests and professional diagnosis; symptoms alone are not enough to confirm it.
Myth 13: PCOS is completely curable.
There is no cure for PCOS, but symptoms can be managed effectively with medical intervention and lifestyle changes.
Myth 14: All women with PCOS have ovarian cysts.
Despite the name, not all women with PCOS have cysts on their ovaries.
Don’t Have Time To Read?
- Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. In PCOS, the ovaries produce more than the normal amount of male hormones called androgens, which results in irregularities with ovulation and menstrual cycles.
- “PCOS” and “PCOD” are the same condition. “PCOD” is an older terminology, which is now being replaced by “PCOS”.
- Factors that play a role in causing PCOS include insulin resistance, low-grade inflammation, heredity, and excess androgen levels in your body.
- PCOS symptoms include infertility, irregular menstrual cycles, darkened skin, skin tags, acne, excess unwanted hair growth on your body, etc.
- PCOS can be diagnosed through a pelvic examination, blood test, and an ultrasound.
- PCOS can be effectively managed through a healthy diet, regular exercise, maintaining a healthy body weight, and medications. Your doctor may prescribe medications based on whether you want to get pregnant or not.
- PCOS may cause long-term complications like infertility, prediabetes, Type 2 Diabetes, blood pressure, obesity, liver disorder, anxiety, depression, sleep apnea, endometrial cancer, etc.
