Polyscystic Ovary Syndrome
- jennifernavarro292
- 1 day ago
- 5 min read
By Jennifer Navarro MSN, RN, NPD-BC
What is Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is a constellation of symptoms affecting the genetic, hormone, metabolic, and reproductive systems. It is a hormonal imbalance of the reproductive system.This disorder is the leading cause of female infertility. PCOS affects 1-in-10 women and is associated with amenorrhea (the absence of a menstrual cycle for 3 or 4 months in women who have had a regular menstrual cycle).This is called secondary amenorrhea. PCOS is also often linked to both ovaries having many small cysts.
Common signs and symptoms
· Mood changes,
· Acne
· fatigue,
· insulin resistance,
· high testosterone levels
· excessive body hair growth
· weight changes (trouble losing weight)
· ovarian cysts
· low sex drive
· irregular or missed periods
· male pattern baldness
· thinning of hair
· trouble conceiving or infertility
Normal regulation of female hormones
In the normal process of female hormone production, a part of the brain called the hypothalamus sends out a signal called GnRH. This signal tells another gland in the brain, the pituitary gland, to release two important hormones: LH and FSH. These hormones travel to the ovaries, where special cells called theca cells respond to LH by making hormone-like substances called androgens. Then, other cells in the ovaries called granulosa cells change these androgens into estrodial (a key female hormone) when they get the FSH signal. This whole process helps regulate female hormones naturally.
What happens when female hormones are disrupted due to PCOS
When female hormones get out of balance because of PCOS, the brain sends its signals too quickly. This makes the pituitary gland release too much LH hormone. In response, the ovaries’ theca cells produce too many male hormones called androgens. These extra androgens go into the body’s fat tissue and get changed into a hormone called estrone. Estrone then stops the body from making enough FSH, which leads to lower levels of estrodial (the main female hormone). This disruption causes problems with hormone balance in women with PCOS.
Diagnosis:
Diagnosing PCOS typically involves a combination of a medical history review physical exam blood tests and sometimes an ultrasound here's how doctors usually diagnose it in simple terms.
1. Medical History: the doctor will ask about your menstrual cycles how regular or irregular they are any symptoms like excess hair growth acne weight changes and family history of PCOS or diabetes.
2. Physical Exam: the doctor may check for signs such as excess hair growth acne and measure blood pressure and body mass index (BMI).
3. Blood Tests: these tests look at hormone levels to check for:
High levels of male hormones called androgens
Imbalance of other hormones like LH and FSH
Blood sugar and insulin levels to check for insulin resistance
Thyroid function and other conditions that might cause similar symptoms
4. Ultrasound: A pelvic ultrasound can be done to look at the ovaries in PCOS the ovaries often have multiple small cysts which are fluid like sacs visible around the edges sometimes described as a string of pearls in appearance the ultrasound can also check the thickness of the uterine lining.
Diagnosis Criteria:
Doctors usually diagnose PCOS if you have at least two of the following three:
Irregular or absent menstrual periods due to lack of ovulation
Signs of high androgens like excess hair or high blood hormone levels
Polycystic ovaries seen on ultrasound
It’s important to rule out other conditions that can cause similar symptoms before diagnosing PCOS if you suspect PCOS talk to a healthcare provider who can perform the right tests.
Management:
The syndrome comes with many undesirable symptoms that can be managed or mitigated. Weight gain is one of those undesirable manifestations. Diet and lifestyle should not be overlooked, maintaining a healthy body mass index and insulin levels through daily exercise and healthy nutrition can help manage this syndrome. There are medications that you might be placed on depending on your lab values to keep your hormones in check as well as reducing insulin resistance. For managing PCOS, several hormone based treatments can be prescribed to help balance symptoms and improve outcomes. Here are some common hormone therapies used for women with PCOS:
Birth Control Pills (Combined Oral Contraceptives): These contain estrogen and progestin which help regulate menstrual cycles reduce androgen levels decrease acne and excess hair growth and protects against uterine lining overgrowth.
Progestin Therapy: taking Progestin alone for a certain. Can help regulate periods and reduce the risk of uterine lining problems if birth control pills aren't suitable.
Metformin is prescribed for PCOS (polycystic ovary syndrome) because it helps improve how the body uses insulin. Many women with PCOS have insulin resistance, meaning their bodies don’t respond well to insulin, which can cause higher insulin levels. This can lead to weight gain, increased male hormones (androgens), irregular periods, and problems with ovulation.
Metformin helps by:
Lowering insulin levels and making the body more sensitive to insulin
Helping to reduce blood sugar levels
Improving hormone balance which can help restore more regular menstrual cycles and support ovulation.
Sometimes aiding in weight management.
By addressing insulin resistance, metformin can help reduce some of the symptoms of PCOS and improve fertility in women who want to conceive.
Clomiphene citrate often called clomid helps increase fertility by encouraging the body to release eggs. Here's how it works in simple terms. Normally the brain sends signals to the ovaries to make eggs through hormones like FSH sometimes in conditions like PCOS the signal system doesn't work properly, and eggs may not be released regularly. Clomid tricks the brain into thinking there isn't enough estrogen a female hormone in response the brain releases more signals (FSH and LH ) to stimulate the ovaries. This extra stimulation helps the ovaries develop and release an egg called ovulation. By promoting ovulation clomid helps women who have trouble releasing eggs naturally to increase their chances of getting pregnant.
Spironolactone is often used to treat conditions like PCOS that cause excess male hormones (androgens) which cause increased acne, excessive hair growth (hirsutism). It helps reduce the effects of these hormones on the skin and hair. It is usually taken as a pill and prescribed by a doctor.
Hirituism is excess hair growth and can be removed cosmetically via laser therapy hair removal.
The choice of hormone treatment depends on the woman's symptoms, whether she wants to become pregnant, and other health factors. It’s important to work with a healthcare provider to find the best option.
References
Bringham & Women’s Hospital. (2015, July 16). Understanding Polycystic Ovary Syndrome [Video]. You Tube.
Ganie, M. ,Vasudevan, V., Wani, I., Baba, M., Arif, T., & Rashid, A. (2019). Epidemiology, pathogenesis, genetics &
management of polycystic ovary syndrome in India. The Indian journal of medical research, 150(4), 333–344.
Huether, W., & McCance, K., (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children. Elsevier, Mosby
Pfieffer, M., (2019). Polycystic ovary syndrome: Diagnosis and management. Nurse Practitioner, 44, 30-35.
The National Polycystic Ovary Syndrome Organization. (2020). Important Facts and Research Regarding PCOS.
Tortora, G. , & Anagnostakoss, N., (1984) Principals of Anatomy and Physiology. Harper &
Row
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