Polycystic Ovarian Syndrome – a frequent cause of irregular periods: What is it? Do I need to treat it?

pcosThere are many of us who must have heard that some lady or a girl is having irregular periods or is unable to conceive because she has cystic ovaries or PCOS – Polycystic Ovarian Syndrome. There would be a lot many clinicians who will treat the syndrome with few medications that will normalize periods and cure infertility. But do all patients need treatment and what is the actual meaning of having cysts in the ovaries?  Lets find these answers….

PCOS (polycystic ovary syndrome), a common problem in teenage girls and women, occurs due to hormonal imbalance.  Causation for most women is probably a combination of factors that includes genetic inheritance among other factors though the exact etiology is still unclear.

The signs and symptoms include having:

  • Irregular menstrual periods, which means having your period more than once a month or every few months, or never having your period
  • Unwanted hair growth on your face, chest, back, hands, upper arms and legs, or around your nipples and loss of hair from head
  • Acne
  • Patches of dark, thickened skin on your neck, armpits, or between your breasts
  • Weight problems

Testing for PCOS is important as Teens and women with PCOS also are at higher risk for type 2 diabetes, high blood pressure, and/or high cholesterol. Increased risk of infertility and cancer of uterus has been found in patients with PCOS.

Evaluation of PCOS includes detailed history of menstrual cycle and of diabetic background in family.

Few blood tests are required to evaluate hormone levels, blood glucose (sugar), or cholesterol. An ultrasound (imaging) test of the ovaries and uterus may be done to see whether you have ovarian cysts, which are fluid-filled bubbles in or on the ovaries.

Before doctors diagnose PCOS, they must first rule out or exclude other conditions with similar symptoms. This is why they call PCOS “a diagnosis of exclusion.”

Some Conditions That Mimic Polycystic Ovary Syndrome (PCOS)
Condition What it is Features similar to PCOS
Thyroid disease Overactive or underactive thyroid gland Irregular menstrual cycle
Prolactin excess The body makes too much of the hormone prolactin Male-type hair growth in women Irregular periods or lack of periods
Cushing syndrome The body makes excess cortisol hormone Weight gain
Depression
Too much hair in women
Abnormal menstrual periods
Congenital adrenal hyperplasia Inherited disorder that causes the body to make too little cortisol and too much male hormone Acne that is severe and early (before the teen years)
Infertility or decreased fertility
Facial hair in women and teen girls
Infrequent or absent menstrual periods

Treatment options for PCOS include one or more of the following:

  • Lifestyle Modification to control weight and exercising each day.
  • Medicines to regularize your menses and these medication contain the female hormones estrogen and progesterone (or just progesterone)
  • Medicines like Metformin which help your body use insulin better; but this medication only indicated if you have for pre-diabetes or diabetes
  • Medication for excessive facial hairs, loss of hair from head and/or acne.
  • Cosmetic treatment for unwanted body and facial hair, such as bleach, wax, shaving, electrolysis, or laser treatment

Coping with PCOS is not that difficult if you have enough background knowledge of disease process.

Seeing a doctor who knows about PCOS is the first step. Choose a doctor who specializes in hormone problems (an endocrinologist).

Remember that the sooner you get help for your PCOS, the sooner you could lower your risk for related health problems such as diabetes.

Author: Dr. Rajiv Singla

A leading endocrinologist and diabetologist from New Delhi. An alumnus of University College of Medical Sciences, Dr. Singla completed his MD (Medicine) from Maulana Azad Medical College (MAMC). He went on to pursue DM (Endocrinology & Diabetes) from reputed AIIMS, Delhi.

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