Polycystic Ovary Syndrome (PCOS) is a complex hormonal condition affecting about 10% of women of reproductive age. Characterized by an imbalance in hormones such as insulin and androgens (male-type hormones), PCOS can lead to a variety of symptoms and potential long-term health complications. With early diagnosis and appropriate management, women with PCOS can reduce their symptoms and lower the risk of related health issues.

Symptoms of PCOS

The symptoms of PCOS can vary greatly, ranging from mild to severe. These symptoms may also change at different stages of life, such as during puberty, pregnancy, or menopause. The most common symptoms include:

• Irregular or absent periods: Menstrual cycles may be infrequent, absent, or irregular, reflecting hormonal imbalances.
• Excess hair growth (hirsutism): Many women with PCOS experience excessive hair growth on the face, chest, or other parts of the body.
• Hair loss (alopecia): Thinning hair or hair loss from the scalp can also occur.
• Acne and skin conditions: PCOS can cause acne, oily skin, or skin tags.
• Weight gain: Women with PCOS often struggle with weight gain or difficulty losing weight, which can further exacerbate symptoms.
• Reduced fertility: Irregular ovulation may lead to difficulty conceiving.
• Emotional issues: Anxiety, depression, and stress are common among women with PCOS due to the impact of symptoms on self-esteem and daily life.

Not all women with PCOS will experience every symptom, and some may have only one or two.

Causes of PCOS

While the exact cause of PCOS remains unknown, research points to a combination of genetic, environmental, and lifestyle factors. Key contributing elements include:

• Hormonal Imbalance: A major feature of PCOS is the overproduction of insulin, which can lead to insulin resistance. This, in turn, can elevate androgen levels, triggering many of the symptoms associated with the condition.
• Genetics: PCOS often runs in families, suggesting a genetic component. Up to one-third of women with PCOS have a female relative with the condition, and the prevalence may be higher in certain ethnic groups.
• Weight: Although PCOS can affect women of all body types, being overweight or obese can worsen insulin resistance and exacerbate symptoms. Weight management is crucial for improving symptoms and hormone regulation.

Diagnosing PCOS

Early diagnosis is key to managing PCOS and preventing long-term complications. To diagnose PCOS, doctors typically look for the presence of two or more of the following criteria:

• Irregular or absent periods
• Elevated androgen levels (detected through symptoms like hirsutism or blood tests)
• Polycystic ovaries visible on an ultrasound, where multiple underdeveloped eggs (cysts) are present

In some cases, a blood test to measure the anti-müllerian hormone (AMH) can help confirm the diagnosis.

Managing and Treating PCOS

Managing PCOS requires a comprehensive approach that includes lifestyle changes, medical treatment, and emotional support.

1. Healthy Lifestyle: Maintaining a balanced diet, engaging in regular physical activity, and managing body weight are crucial in managing PCOS symptoms. Even a small amount of weight loss can improve insulin sensitivity, regulate menstrual cycles, and reduce symptoms like acne and hirsutism.
2. Medications: Hormonal contraceptives may be prescribed to regulate periods, while Metformin is often used to improve insulin resistance. Additional treatments may address specific symptoms such as acne, excessive hair growth, or fertility concerns. In some cases, fertility treatments or surgery may be required to improve ovulation.
3. Emotional Wellbeing: PCOS can affect emotional health, leading to stress, anxiety, and depression. Seeking support from a mental health professional, practicing relaxation techniques, and making healthy lifestyle choices can all help improve emotional well-being.

Long-term Health Risks

PCOS is linked to several long-term health risks, including:

• Type 2 diabetes: Due to insulin resistance, women with PCOS are at a higher risk of developing type 2 diabetes.
• Cardiovascular disease: PCOS increases the risk of heart disease due to factors like obesity and high cholesterol levels.
• Sleep apnoea: This condition, marked by disrupted breathing during sleep, is more common in women with PCOS.

Regular health checks, including monitoring blood pressure, cholesterol, and blood glucose levels, alongside lifestyle modifications, can help mitigate these risks.

In conclusion, while PCOS is a lifelong condition, early intervention, proper treatment, and a healthy lifestyle can significantly improve quality of life and reduce the risks of related health problems.