Polycystic Ovary Disorder (PCOD) or Syndrome(PCOS), from here on, PCOS is a hormonal disease in women which leads to irregular menstrual cycles. If one is to observe an ultrasound of the lower abdomen of a woman, one may be able to observe a series of abnormally large eggs, which looked like a string of pearls. PCOS may be caused due to a lot of reasons, including genetic. Even though this disease has been steadily on the rise in the past few years, it was first recognized by physician Antonio Vallisneri in 1721 in Italy. Further depictions of PCOS are found in 1844, followed by a specific diagnosis and naming of the disease in 1935 by Irving F. Stein Sr. and Michael L. Leventhal. This disease was originally known as Stein-Leventhal Syndrome.
What is PCOS?
Polycystic Ovary Syndrome (PCOS) or Polycystic Ovary Disorder (PCOD) is a hormonal and metabolic disease. It is caused when a female’s body is not able to complete its monthly ovulation process. Women suffering from PCOS have less than 8 menstruation periods in a year. The cysts observed on the lining of the ovaries are actually, immature eggs that have not matured enough to be ejected out of the body and hence are stuck on the ovary walls. This leads to an imbalance in the hormone levels of the body, leading to the rise of the androgen levels. These hormones lead to body hair in unwanted places, weight gain, hair loss and other health problems.
It is the most common health issue women face today, nearly 2% to 40% of women within the range of 12 years to 45 years face this issue world over. The range and frequency of the problem make it a difficult one to tackle, not to mention, no one really knows why a woman develops PCOD. While obesity is named as a cause that causes the symptoms, not every obese woman suffers from PCOS.
Causes, Symptoms and Risk Factors for PCOS
The causes for PCOS are to date unclear, however, it is widely believed that the most common causes are genetic, obesity, high blood pressure and insulin resistance. However, it is still not clear how blood sugar is affected by hormonal imbalance. Scientists are still researching the genetic link between hormones and insulin resistance. Having established this, the risk factors and symptoms of PCOS are:
1. Is PCOS Hereditary?
PCOS is not a widely researched subject yet, which means there is still a lot more to discover about the disease. However, based on the data from available research, it could be said that PCOS does have hereditary factors. This in no way means that PCOS is only hereditary. It simply means that PCOS can be passed down through generations. Any woman with a family history of PCOS is at 50% risk of developing it herself. If she skips it, her daughter or granddaughter is still at risk. This because PCOS becomes a part of the genetic code and the genes affected are the most common genes. However, the exact genetic defect is yet to be detected. No one can say for sure, which information is altered to cause PCOS. The fact that even in siblings, one sister gets PCOS while the other doesn’t, makes PCOS as much a cause of surroundings as genes.
To conclude, yes, PCOS is hereditary but how much of this hereditary factor contributes to the development of PCOS is still a matter of further investigation.
2. Why is PCOS on the Rise these Days?
In the last two decades, more and more women have complained of suffering from PCOS. In India, nearly 18% to 20% of women of fertile age suffer from PCOS. In fact, according to some gynaecologists, more and more teenagers are suffering from PCOS. There are debates on what is leading to a rise in the cases of PCOS. One of the most common causes is their lifestyle which includes exposure to high levels of stress, lack of exercise, erratic eating habits and lack of proper sleep. The second most common cause is obesity, which is a direct result of a sedentary lifestyle.
However, some gynaecologists argue that the rising trend is a result of misdiagnosis. Some gynaecologists argue that the presence of cysts in the ovaries is not evident enough to diagnose a woman with PCOS. They also lament the fact, that today, an ultrasound is enough to diagnose a woman with PCOS, despite her other reports being normal.
According to these gynaecologists, cysts in the ovaries can be created because of many reasons. All of these causes do not contribute to PCOS. In fact, at times, cysts go away on their own too. However, the cysts in PCOS, need medication and in some cases, surgery to be removed or dissolved.
Types of PCOS / PCOD:
As established before, PCOS is a relatively new field of study, which means that there is still a lot of ambiguity attached to it. PCOS has been broadly divided into two types:
1. Insulin Resistant PCOS:
Insulin Resistant or Type 1 PCOS is generally associated with all the classical signs of PCOS which include obesity, facial hair, hair loss and acne caused by higher levels of male hormones in the bloodstream. This type of PCOS is indicated by the body’s inability to process blood sugar, which leads to its storage as fat. Patients with type 1 PCOS are at risk of developing type 2 diabetes and heart diseases. Such patients are generally advised to go on a diet and lose weight. However, it should be kept in mind that weight loss for such patients is not easy.
Along with weight loss, patients may also be given supplements to control blood sugar.
2. Non-Insulin Resistant PCOS:
Non-Insulin Resistant or Type 2 PCOS is a situation when a patient does not show any signs of insulin resistance and yet, suffers from PCOS. Non-Insulin PCOS is caused by other reasons like adrenal stress, thyroid, vitamin D or iodine deficiency and so on. The treatment for Type 2 PCOS focuses more on healing the body naturally, which includes more rhythmic and relaxing exercises.
Latest Development in PCOS Research:
There are several clinical trials being conducted in India currently to understand PCOS and its cure. While some studies are focused on medicines and their PCOS reversal effects, others are focused on the effects of PCOS.
In March 2018, one such study revealed that women with Type 1 PCOS have higher chances of developing liver diseases. The presence of high amounts of male hormones in the body makes women obese and leads to the development of the non-alcoholic fatty liver. The researchers concluded that women suffering from PCOS require holistic healthcare throughout their lives, rather than specifically when they want to get pregnant.
PCOS: Screening and Diagnosis:
The visible symptoms of PCOS are such that they can be confused with any other disease. This means that a doctor generally requires a series of test results to diagnose PCOS. These tests include physical examination, blood tests and pelvic scans. Here are some of the common tests your doctor may ask you to plan for:
1. Physical Examination:
Your doctor may conduct a physical examination where he/she may measure your weight and waist. Calculate your BMI, observe abnormal hair growth in unwanted parts like the face, chin or chest. Observe hair loss and increase in dandruff. Observe an increase in acne on the face, back and arms.
2. Pelvic Examination:
The doctor may conduct a physical examination, where he/she may feel any abnormal growth in the pelvic area. This includes looking for abnormalities in ovaries, clitoris, vagina, fallopian tubes, rectum, cervix and so on.
3. Blood Tests:
Physical evidence generally leads to a battery of tests, especially if the clear indicators include weight gain and hair growth. Based on your symptoms, your doctor may ask you to take these tests, to remove all doubts.
- TSH, T3, and T4
The most common test assigned to the physical symptoms is a thyroid test. The TSH, T3, and T4 blood tests calculate the level of thyroid hormones in your bloodstream. This is more of an elimination test, if your thyroid hormone results are normal, you may be assigned other tests.
- Hormone Tests (FSH, LH, Testosterone, Estrogen, Androgen)
Follicle Stimulating Hormone (FSH) regulates your ability to get pregnant, while Luteinizing Hormone (LH) promotes ovulation. If you have PCOS, FSH would be lower than normal while LH would be higher. Similarly, Testosterone is a male sex hormone, which would be higher. Estrogen level, as well as Androgen level, would be high too.
- Serum Prolactin And/Or hCG
Prolactin is a protein that helps mammals in producing milk. hCG is a hormone that is released by the placenta once impregnation has taken place. Either or both of these tests could be used to eliminate the possibility of or confirm pregnancy as lack of menses also indicates pregnancy.
4. Pelvic Ultrasound:
Pelvic ultrasound is the testing process where sounds from your pelvis are interpreted to create an image, this provides a visual for internal organs. The ultrasound could be used to create an image of the ovaries to detect the presence of cysts in one or both.
Can PCOS/PCOD Cause other Chronic Diseases?
In one small word, Yes, PCOS can cause other chronic diseases. It is rather unfortunate that despite the threat PCOS poses to health, it is brushed off as something easily manageable. Yes, it is true that PCOS can be reversed through weight loss. But weight loss in itself is difficult with PCOS. Here are some common chronic disease caused by PCOS:
As has been established before, no one can say why Type 1 PCOS leads to Type II Diabetes but it does. However, PCOS does not just lead to type II diabetes, it also leads to gestational diabetes. We all know that diabetes is a lifelong chronic disease and the underlying cause behind 50% of deaths globally. In fact, in 2016-17, it was the largest killer in India. It is also true, that given the Indian society, most cases of PCOS remain undiagnosed, leading to a rise in instances of diabetes in women.
2. Blood Pressure:
Diabetes and blood pressure go hand in hand. Nobody knows if diabetes causes blood pressure or blood pressure causes diabetes. But the presence of one is a sure shot indication of the other.
3. Liver Diseases/Non-Alcoholic Fatty Liver:
As has been established before, yes, PCOS affects the liver, making it weak and exposing it to infections. This reality was revealed and confirmed in a recent study. Hormonal imbalance in the body directly contributes to the deterioration of liver health. This also leads to obesity which leads to the development of the non-alcoholic fatty liver.
4. Depression and Anxiety:
Female sex hormones also have an effect on a woman’s psyche. This means that any disturbance in the delicate balance of hormones leads to mood swings. Furthermore, obesity results in social seclusion and damaged self-image. All these factors together, along with long periods of continuous stress may lead to the development of depression or anxiety in women. In fact, a study revealed, that women with PCOS are prone to suffer from Postpartum Depression.
PCOS is the largest cause of infertility in women. While this infertility can be cured with medication that helps reverse PCOS, some women can only get pregnant through IVF or after an operation.
6. Sleep Apnea:
Obesity causes sleep apnea, which further leads to putting stress on the body and mind, which leads to psychological issues, as well as the development of more adipose tissue in the body.
7. Heart Disease:
PCOS does not only leads to the development of diabetes and blood pressure. It creates the deadly cocktail of high cholesterol, blood pressure and diabetes. This leads to higher risks of developing heart diseases, leading to strokes or heart attack.
Things you should know about PCOS:
1. Is PCOS Curable?
There is no definite cure for PCOS so far. It can be eliminated or reversed through an operation or through a strict lifestyle regime but it is not completely cured. PCOS tends to come back as soon as a woman falls off the wagon. This means that women with PCOS have to maintain a healthy weight, follow a strict diet chart, avoid stressful situations and take medication regularly, to help reverse or control PCOS.
2. Can PCOS be Terminal?
PCOS in itself is not terminal. However, it can lead to the development of life-threatening chronic diseases like diabetes and blood pressure. If looked at closely, even diabetes and BP are not terminal on their own. But they do lead to circumstances that inhibit, one or the other bodily function leading to the death of the patient. Scientists also believe that elongated exposure of the endometrial lining to estrogen may cause endometrial cancer.
It has been established before that PCOS is not curable. However, with the correct lifestyle changes its symptoms can be managed. Since PCOS is incurable, there have been several approaches to managing its symptoms. Many women generally, opt for a combination of different approaches. Here the various approaches to managing PCOS:
Allopathy employs a series of medicines and weight loss programs to manage symptoms of PCOS. To encourage regular menstruation, women may be asked to go on monthly oral contraceptive pills. To help treat infertility or to make a woman pregnant, she may be assigned a medicine to coax ovulation. Some women are also assigned periodic menses inducing medicines, which are taken around the menstrual cycle. These medications can be taken after every 3-4 months.
In addition to these patients may also be put on diets to help reduce weight. The doctor may also prescribe some high energy exercises to achieve the same.
In fact, fertility is enhanced when a woman loses even 3% of her body weight.
Allopathic medicine is the mainstream medicine, and it is well known that this kind of medicine is invasive to the body. In fact, PCOS and infertility due to PCOS are also caused by the regular use of the birth control pill most women subscribe to. Thus, it is but obvious that most women prefer less invasive treatment options. Homoeopathy has been ridiculed by modern medicine as a placebo medication. Luckily, India recognizes Homoeopathy as a legitimate form of alternative medicine. The reason being that homoeopathy does not seek to suppress symptoms. Homoeopathy believes in identifying and rectifying the root cause. Homoeopathy also believes that symptoms are indicators of the body’s attempt to remain disease-free. There are several homoeopathic medicines that can be used to reverse more than one symptom of PCOS.
It should be noted that homeopathy believes in the “Principle of Same” that is, only the cause can cure the disease. This means that homoeopathic practitioners, provide an extremely low dosage of disease-causing substances in the bodies of the patients. The symptoms ideally get worse, before they get better. It should be understood that homoeopathy is a long term treatment and symptoms may take time to subside.
Patients should also consult their doctors before mixing homoeopathic and allopathic treatments.
Ayurvedic or herbal medicines are more body-friendly, natural and safe. They also emerge from a wealth of thousands of years of medical practice. Ayurveda believes that PCOS is caused because of an imbalance of the rakta and Shukra dhatu. PCOS also caused an imbalance between all three doshas. According to Ayurveda, cysts are cumulated impurities in the body. Women suffering from PCOS are put on a strict diet and one hour of exercise daily. There are several herbs that could help with treating PCOS:
Shilajit is also known as the ‘mountain sweat’. It boosts immunity, regulates menses and also regulates blood flow. Shilajit also helps improve the symptoms of iron deficiency and also contributes to heart health.
- Vrikshamla (Garcinia)
Vrikshamla or Garcinia is known to aid with weight loss. Several types of researchs have proved that Garcinia does lead to weight loss and aids in maintaining a healthy BMI without having any invasive effects on the body.
Haridra or Haldi is the caretaker of a woman’s body. Haridra helps improve immunity, lose weight, reduce inflammation, erase acne and so on. Haridra also helps to clear skin, as well as, helps in managing insulin tolerance and detoxifies the ovaries.
Curcumin as well as haridra belong to the family of curcuma longa, however, a physician must be consulted before exchanging on with the other.
Amalaki or Amla is rich in vitamin C, which is a strong antioxidant. It reduces inflammation, helps in reducing weight and improves the immune system.
Neem purifies the blood and reduces acne. It also helps improves hair and skin health.
Ashwagandha is known as an adaptogen, which means that it adapts to the needs of the body. Ashwagandha is an excellent, natural medication for controlling mood swings, anxiety and depression.
Exercise is an important part of weight loss to control PCOS. But not everyone favours the gym. Especially, if one is suffering from anxiety, calming exercises help more. For your reference, here are names of some yoga asanas to help control symptoms of PCOS:
- Butterfly Pose
- Chakki Chalanasana
- Polycystic ovaries mean that there are cysts in the ovaries
Polycystic ovaries do not mean cysts in the ovaries. On the other hand, the ovary is lined with immature follicles which appear like a line of pearls on the ovaries. However, it is also true that at times, some patients do not outwardly show the presence of multiple cysts in the ovaries.
- Only birth control pills can regulate periods
Birth control pills may regulate periods but they are not the only options for controlling the symptoms of PCOS. There are other medicines, herbals and home remedies that can help with the same symptoms.
- PCOS cause infertility
PCOS does not cause infertility. Yes, getting pregnant with PCOS may become difficult, but the right medication can help improve ovulation and help women get pregnant. However, it is also possible that women get pregnant without any aid and with PCOS.
- It is impossible to lose weight
It is not impossible to lose weight. Yes, everybody responds differently. But given the correct diet and proper exercise, women with PCOS can reduce weight. Even a loss of 3% of their body weight, can help improve the symptoms of PCOS.
- Metformin is the ideal medicine to control symptoms of PCOS
It has not been scientifically proven but metformin a drug to manage blood sugar is believed to help improve the symptoms of PCOS. Metformin reduces blood sugar and may help regulate periods. The medicine, however, has no effect on non-insulin resistance PCOS.
PCOS or PCOD FAQs:
Frequently asked questions about Polycystic Ovary Disorder (PCOD) or Polycystic Ovary Syndrome (PCOS).
- What is PCOS?
PCOS is a hormonal disease where immature follicles are deposited on the lines of one or both ovaries, which look like a string of pearls on ultrasound. PCOS also causes symptoms like irregular periods, adult acne, hair growth in unwanted places and male pattern baldness.
- Who is at risk of getting PCOS?
Women in their fertile years, which is between 12 years to 45 years are at a risk of developing PCOS. The cause of PCOS is unclear, hence, women of all races and nationalities are at a risk of developing PCOS.
- How is PCOS diagnosed?
A doctor may employ a battery of tests to diagnose PCOS. These tests include physical and pelvic examination, blood tests, and ultrasound.
- Is PCOS curable?
There is no cure for PCOS. However, with the correct diet, medication and lifestyle its symptoms can be reversed, till they look like they are eliminated.
- How common is PCOS in India?
PCOS is steadily on a rise in India. More and more teenagers suffer from PCOS because they lead sedentary lifestyles. On average, nearly 20% of women in India are diagnosed with PCOS. However, this data captures the urban and semi-urban population. Since menstruation is a very sensitive topic, many women in rural, even urban and semi-urban India do not speak of it and as a result, are never diagnosed. The actual number may be larger than the projected ones.
Disclaimer: The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.