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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:

  • Not regularly release eggs (irregular or absent ovulation)

  • Have many small, fluid-filled sacs (follicles), often seen on ultrasound – hence the term “polycystic”

The root issue is a hormonal imbalance, especially involving:

  • Excess androgens (male hormones like testosterone)

  • Insulin resistance, which can lead to elevated insulin levels and increased androgen production

 

Common Symptoms:

  • Irregular or absent periods

  • Excess hair growth (hirsutism) – face, chest, back

  • Acne and oily skin

  • Thinning hair or male-pattern baldness

  • Weight gain or difficulty losing weight

  • Darkened skin patches (acanthosis nigricans)

  • 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:

  1. Irregular or absent ovulation (irregular periods)

  2. Excess androgen signs or high androgen levels in blood

  3. 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:

  • Insulin resistance: leads to increased insulin and androgens

  • Hormonal imbalances: increased LH (luteinizing hormone) and androgens

  • 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)

  • Weight loss (even 5–10% can improve symptoms)

  • Diet: low-glycemic, balanced diet helps insulin sensitivity

  • Exercise: improves insulin resistance

2. Medications

  • For periods & hormones: Birth control pills, progestins

  • For fertility: Clomiphene, letrozole, or IVF

  • For insulin resistance: Metformin

  • For excess hair/acne: Anti-androgens (e.g., spironolactone)

3. Hair and Skin Treatments

  • Topical creams, laser hair removal, acne treatment

 

PCOS and Fertility:

  • PCOS is a leading cause of infertility, but many with PCOS can still conceive with treatment.

  • Irregular ovulation is the main barrier.

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