Polycystic Ovarian Syndrome

What Is Polycystic Ovarian Syndrome?

The polycystic ovarian syndrome is a condition in which women have an abnormal level of male hormones, also known as androgens. Affected individuals usually have a high level of androgenic hormones. The signs and symptoms of this condition include abnormal and irregular menses, menorrhagia, hirsutism, fatigue, pain in the pelvic region, obesity, arrhythmia, problems with getting pregnant, dark skin, sudden mood changes and cancer. The polycystic ovarian syndrome is usually caused by a combination of both genetics and environmental factors.

What Really Happens In Polycystic Ovarian Syndrome?

Two major things happen in polycystic ovarian syndrome, that however, leads to the development of other diseases.

1. Hormonal imbalance: Androgen (the male hormone) shoots up in the body of the female. The ovaries produce androgen, but they are usually in a negligible amount. However, in Polycystic ovarian syndrome, the ovaries produce a high amount of androgen. This would subsequently manifest in the physical appearance, as well as the reproductive life of the female. As an illustration, the female would start showing male features such as hair on the face and body, acne. Also, the high level of androgen might cease ovulation. Women that have the Polycystic ovarian syndrome, find it difficult to get pregnant.
2. Insulin resistance: Patients that have the Polycystic ovarian syndrome, usually do have a condition called insulin resistance. Insulin is needed by the body to drive in glucose into the cells. However, in this case, the body cells are resistant to insulin. If this persists for a long time, it might lead to diabetes mellitus type 2.

What Causes Polycystic Ovarian Syndrome?

The causes of this condition are still unknown, although it has been suggested that it is a combination of both genetics and environmental factors. Below are the factors that play an important role in the etiology of this disease.

1. Genetics: It has been observed that Polycystic ovarian syndrome might be inherited by autosomal dominance. This implies that a daughter will have a fifty-percent of having the disease if born to parents that have It can be inherited from either the father or the mother, although it expresses variably in females.
2. Insulin resistance: Insulin is a hormone, that is produced by the islet cells of Langerhans in the pancreas. The function of insulin is to drive glucose into the body cells, so they can be used as energy, however in insulin resistance, the cells become resistant to this hormone, thereby creating a glucose starvation in the body. However, because the cells lack glucose, the body will continue to produce insulin. Excess insulin in the body can trigger the production of male hormones, leading to ovulation problems.
3. Abnormal production of androgen: The ovaries produce androgen, but in small amounts, however, in Polycystic ovarian syndrome, the ovaries produce high quantities of androgens. This suppresses ovulation and also leads to the development of some male features, such as the growth and appearance of hair on the face and neck. Also, the individual might have acne.
4. Inflammation: According to studies, it has been shown that women that have Polycystic ovarian syndrome, usually have low-grade inflammation. This inflammation induces the polycystic ovaries to produce male hormones.

The Signs And Symptoms Of Polycystic Ovarian Syndrome

There are many signs and symptoms. Some of these symptoms might be mild initially, but they become more serious as the disease progresses.

1. Menstrual period becomes irregular: This can be attributed to the excessive androgen hormones that are produced by the ovaries. This may lead to oligomenorrhea, while others might have menorrhagia.
2. Fertility: This can also be attributed to the excessive androgen hormones produced by the ovaries. It has the ability to suppress or totally stop ovulation. This is why most women suffering from Polycystic ovarian syndrome do have fertility problems.
3. Acne
4. The abnormal and progressive gain of weight: Patients that have Polycystic ovarian syndrome have been shown to have insulin resistance. This leads to the excessive production of insulin in the body. High level of insulin in the body leads to hyperlipidemia. This eventually leads to the accumulation of weight.
5. Abnormal growth of hair on the face, neck and other parts of the body: the Male pattern-like growth of hair is one of the symptoms to be noticed in Polycystic ovarian syndrome.
6. Depression: This is common among women suffering from this disease because of the problems associated with it, especially in women who’re trying to get pregnant. This leads a lot of women into depression. In addition, the sudden and progressive weight gain, and the difficulty associated with losing it worries the affected persons.

What Are The Complications Of Polycystic Ovarian Syndrome?

The complications of polycystic ovarian syndrome are essentially due to hormone imbalance, and also insulin resistance. Some of the complications include

1. Diabetes mellitus: It has been proven that polycystic ovarian syndrome is always associated with insulin resistance. However, when this is not well managed, it can lead to diabetes mellitus, especially diabetes mellitus type 2. Diabetes mellitus type 2 is caused by insulin resistance, and this occurs mostly as a result of the deposition of fat in the abdominal area. Diabetes mellitus can be managed by making changes in diet and doing more physical exercises. If this doesn’t work, then the patient would have to start taking anti-diabetic medications.
2. Infertility: This is due to the overproduction of androgen hormones by the ovaries. These androgen hormones have the ability to suppress or totally stop ovulation. This is the reason most women suffering from Polycystic ovarian syndrome do have fertility problems.
3. Metabolic syndrome: This can be attributed to the insulin resistance that comes with the polycystic ovarian syndrome. There is a high buildup of sugar in the extracellular. The overproduction of insulin also leads to hyperlipidemia. Hyperlipidemia increases the risk of having coronary artery diseases, and other heart-related diseases too.
4. Obstructive sleep apnea
5. Liver disease: As earlier said, hyperlipidemia accompanies insulin resistance because of insulin build up in the body. Some of this excess fat also deposits in the liver. An example of a disease caused is nonalcoholic steatohepatitis.

Management

The management of PCOS include some lifestyle modifications, such as eating healthier and clean food, exercising more. In addition to this, patients are often placed on birth control pills.

References

Alanbay, I., Ercan, C., Sakinci, M., Coksuer, H., Ozturk, M. and Tapan, S. (2012). A macrophage activation marker chitotriosidase in women with PCOS: does low-grade chronic inflammation in PCOS relate to PCOS itself or obesity?. Archives of Gynecology and Obstetrics, 286(4), pp.1065-1071.

Karipcin, S. (2017). Interesting Facts about PCOS: Why does PCOS Require 30 Days of Recognition?. Endocrinology&Metabolism International Journal, 5(6).

Noroozzadeh, M., Ramezani Tehrani, F., Bahri Khomami, M. and Azizi, F. (2017). A Comparison of Sexual Function in Women with Polycystic Ovary Syndrome (PCOS) Whose Mothers Had PCOS During Their Pregnancy Period with Those Without PCOS. Archives of Sexual Behavior, 46(7), pp.2033-2042.