About PCOS
Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects people with ovaries, typically during their reproductive years. It involves a combination of symptoms related to hormone imbalance, metabolic issues, and ovarian dysfunction.
What Happens in PCOS?
In PCOS, the ovaries may:
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Not regularly release eggs (irregular or absent ovulation)
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Have many small, fluid-filled sacs (follicles), often seen on ultrasound – hence the term “polycystic”
The root issue is a hormonal imbalance, especially involving:
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Excess androgens (male hormones like testosterone)
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Insulin resistance, which can lead to elevated insulin levels and increased androgen production
Common Symptoms:
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Irregular or absent periods
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Excess hair growth (hirsutism) – face, chest, back
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Acne and oily skin
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Thinning hair or male-pattern baldness
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Weight gain or difficulty losing weight
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Darkened skin patches (acanthosis nigricans)
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Fertility problems (due to irregular ovulation)
Some people with PCOS are lean and don’t have all these symptoms – it varies widely.
Diagnosis:
No single test can diagnose PCOS. Doctors typically use the Rotterdam criteria, which require 2 out of 3 of the following:
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Irregular or absent ovulation (irregular periods)
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Excess androgen signs or high androgen levels in blood
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Polycystic ovaries on ultrasound
Other conditions must be ruled out first (e.g., thyroid issues, adrenal disorders).
Underlying Causes:
PCOS is likely due to a mix of genetic and environmental factors, but exact causes are still unknown. Key contributors include:
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Insulin resistance: leads to increased insulin and androgens
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Hormonal imbalances: increased LH (luteinizing hormone) and androgens
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Genetics: tends to run in families
Treatment Options:
There's no cure, but symptoms can be managed based on individual goals (e.g., fertility vs. symptom relief):
1. Lifestyle Changes (first-line treatment)
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Weight loss (even 5–10% can improve symptoms)
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Diet: low-glycemic, balanced diet helps insulin sensitivity
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Exercise: improves insulin resistance
2. Medications
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For periods & hormones: Birth control pills, progestins
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For fertility: Clomiphene, letrozole, or IVF
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For insulin resistance: Metformin
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For excess hair/acne: Anti-androgens (e.g., spironolactone)
3. Hair and Skin Treatments
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Topical creams, laser hair removal, acne treatment
PCOS and Fertility:
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PCOS is a leading cause of infertility, but many with PCOS can still conceive with treatment.
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Irregular ovulation is the main barrier.