Understanding PCOS: Polycystic Ovary Syndrome commonly abbreviated as PCOS is a hormonal disorder that predominantly affects women of reproductive age. It is a complex condition that results in the enlargement of either one or both ovaries along with small cysts that appear on the outer edges. Women with PCOS may experience infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. Apart from that, the ovaries may also develop numerous small collections of fluid (follicles) and fail to regularly release eggs. PCOS primarily occurs due to certain factors such as hyper-inflammation, ethnicity predisposition, low vitamin D levels, and hyperandrogenism.

Other Common Warning Signs

The symptoms of PCOS develop over time between the first to the most recent menstrual cycle. Apart from that, these symptoms also vary from one person to another depending on their lifestyle and body. However, there are certain basic symptoms that can determine that the person might be suffering from PCOS. These are:

  •  Irregular or delayed periods that can sometimes lead to no periods at all due to lack of ovulation
  • Excess androgen that results in excess facial hair (hirsutism), acne and even baldness because of higher levels of male hormones
  • Polycystic ovaries- When seen in an ultrasound, the ovaries appear to be enlarged and surrounded by multiple small cysts
  • Darkened skin patches
  • Weight gain or trouble losing weight

Risk Factors

Although the exact cause of PCOS is still unknown, it is most likely caused by some genetic as well as environmental factors. Some of the common causes include:

  • Heredity- Women with family members who have a history of PCOS are at a higher risk of inheriting it
  • Excess insulin- Women whose family has a history of Type 2 diabetes are also most likely to develop PCOS. Excess insulin hampers the process of ovulation that triggers the condition
  • Obesity- Excess weight due to lack of exercise and an unhealthy diet can further trigger the symptoms of PCOS
  • Low-grade inflammation- It is seen that most women with PCOS have relatively low-grade inflammation that other that stimulates the polycystic ovaries to produce more androgen

Management

A 31-year-old married woman was unable to conceive for the last 3 years and had a history of irregular periods, acne, excessive body hair growth. She was suffering from obesity, facial hair growth, and was hypothyroid with normal blood sugar and prolactin levels. Since lifestyle plays a very crucial role in preventing infertility issues, she was advised by her doctors for lifestyle modification, regular exercise for 45 minutes and following a low-fat diet and medication. As there are a number of ways to tackle infertility caused by PCOS, the patient was able to conceive in the first cycle of IUI treatment despite having complications with her pregnancy.

While there is no permanent cure for PCOS, managing the hormone level and weight can surely help to reduce it. If one is diagnosed with PCOS, one must focus on maintaining their weight. This can be achieved with regular exercise and a balanced, healthy diet. There are a number of ways in which diet and nutrition can help in preventing PCOS:

  • High-fiber food which includes cabbage, broccoli, sprouts, almonds, beans, lentils berries, and pumpkins must be included to increase insulin resistance and slow down digestion in the body
  • A rich source of lean- protein like tofu, chicken, fish, tomatoes, walnuts, spinach, and olive oil must also be included
  • Avoid foods high in refined carbohydrates, such as white bread, sugary snacks, and drinks, inflammatory foods, such as processed and red meat
  • Pasta and noodles that have their main ingredient as semolina, durum flour, or durum wheat flour are high in carbohydrates and low in fiber. Instead, pasta made from bean or lentil flour can become a good alternative
  • Apart from that, our lifestyle choices can directly impact maintaining PCOS. Therefore, it is also recommended that at least 15 minutes of physical exercise is needed
  • Sticking to the medication prescribed by the doctor and maintaining a healthy weight can help with infertility.

Apart from maintaining a healthy lifestyle, one must visit a gynecologist if they have any symptoms of PCOS for better consultation. Ignorance of these symptoms can make it even worse and further lead to infertility. In terms of infertility in women, PCOS is one of the most common causes and should be dealt with in a timely and effective manner.

(Inputs by Dr. Rachita Munjal, Consultant, Birla Fertility and IVF)