Women with PCOS are more likely to develop certain serious health problems. including type 2 diabetes, high blood pressure, and heart issue.

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age (15-44 years old). In women with PCOS, the ovaries which are responsible for regulating the menstrual cycle often have multiple cysts. 

Women who have PCOS tend to produce more male hormones than normal, which causes a hormone imbalance In turn, this causes their bodies to skip menstrual periods and makes it harder for women with PCOS to get pregnant. As such, PCOS is considered one of the leading causes of female infertility worldwide.

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PCOS is not only connected to fertility, but also affects metabolism, skin, heart, and mental health. It is characterised by irregular periods, hirsutism (excessive hair growth in women on their face, back and chest), hair loss or baldness, obesity, and cystic acne. PCOS can also cause long term health effects such as diabetes and heart disease.

Given the wide range of symptoms, PCOS is, unfortunately, extremely underdiagnosed. While it is estimated that between 6 and 26 percent of women worldwide have PCOS, up to 70 percent of these women don’t know they have it. Prevalence rates vary from country to country, as do diagnostic methods. 

What causes PCOS?

 Scientists remain unclear about what exactly causes PCOS. It is believed that high levels of androgens (male hormones) prevent the ovaries from producing hormones and eggs normally. 

But what causes this excess androgen production? Excess androgen production in women has been linked to several causes including:

• Insulin resistance. Up to 70 percent of women who have PCOS, also have insulin resistance. Insulin resistance is a condition where the cells of the body are unable to use insulin (a hormone that helps the body use sugar from foods for energy) properly. When the body is unable to use insulin properly, this causes the demand for insulin to go up, and so more insulin is made to compensate. Excess insulin then triggers the ovaries to produce more androgens. 

• Obesity. Obesity is considered a major cause of insulin resistance. Therefore, obesity is also considered to increase your risk for type 2 diabetes and PCOS.

• Inflammation. Women with PCOS typically have increased levels of inflammation in their bodies. Being obese or overweight can contribute to inflammation. Studies have shown that excess inflammation leads to the secretion of higher levels of androgen.

Science has shown that genetics also play a role. While PCOS does not have a clear pattern of inheritance, studies have indicated that it does run in families. According to one study, approximately 24 percent of people with PCOS had a mother with PCOS, and 32 percent had a sister with PCOS. 

Common symptoms and diagnosis?

Usually, women begin to discover PCOS symptoms when their periods start. Some, however, will only discover that they have PCOS after struggling to get pregnant. 

Symptoms of PCOS include:

• Irregular periods
• Heavy bleeding
• Excessive hair growth on hair, face, and body
• Male pattern baldness
• Acne
• Weight gain
• Darkening of the skin
• Headaches

Physicians typically diagnose PCOS in women who have at least two of the three following symptoms:

• High androgen levels
• Cysts in the ovaries
• Irregular menstrual cycles

Doctors will also ask about other symptoms such as acne, excessive hair growth and weight gain. 

How is PCOS treated?

It is important to see a doctor if you suspect you have PCOS. If you are diagnosed with PCOS, you will have to plan regular visits with your physician to get checked for diabetes, high blood pressure and other possible health-related complications.

Treatment of PCOS starts with diet and lifestyle changes. Studies have shown that losing between 5 and 10 percent of your body weight can help with the regulation of the menstrual cycle and can relieve PCOS symptoms. 

Exercise is also beneficial, where 30 minutes of moderate intensity exercise at least three days a week has been shown to help women with PCOS to lose weight, thereby improving their ovulation and insulin levels. 

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In addition to lifestyle changes, a number of different medications can also help regulate the menstrual cycle and treat PCOS symptoms. These include:

• Birth control. Doctors prescribe birth control to restore a normal hormonal balance, to regulate ovulation, and to relieve symptoms like excess hair growth. 

• Metformin. Commonly known as Glucophage or Fortamet, Metformin is a drug that helps treat type 2 diabetes. It is prescribed for PCOS given that it improves insulin levels.

In addition to birth control and metformin, fertility drugs such as Clomid can be prescribed to women with PCOS who want to get pregnant. In the case that other treatments don’t work, surgery can also be an option to improve fertility. This includes “drilling” the ovary and making tiny holes in it through a laser or thin heated needle in order to help restore normal ovulation.

Maha El Akoum, MPH, is a public health professional currently working as Head of Content at World Innovation Summit for Health [WISH]. 

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