Authored by

DR. NITIKA SOBTIDGO (Gynecology and Obstetrics)Consultant Gynaecologist, specialized in minimally invasive laparoscopy & Certified birth psychology educator

Polycystic Ovarian Syndrome (PCOS)

+ What is PCOS?

Polycystic ovary syndrome is a set of symptoms related to a hormonal imbalance that can affect women and girls of reproductive age. It is estimated that approximately 10 million women  worldwide suffer from PCOS

+ Symptoms

1. Irregular Mensuration

  • Absent menses
  • Frequent periods
  • Heavy or scanty periods  
  • Unpredictable periods

2. Skin ChangesExcess hair growth on face chest, abdomen and upper thighs (Hirsutism) and is present in 70% of women with PCOS.1. Oily Skin & Severe Acne2. Patches of thickened dark velvety skin around the neck  3. Multiple fluid filled sacs in the ovaries diagnosed on ultrasound  4. Obesity/weight gain/inability to lose weight  5. Breathing problems while sleeping 6. Depression 7. Medical Conditions8. High Cholesterol Levels9. Elevated Blood Pressure10. Abnormal Sugar Levels

+ How is PCOS Diagnosed?

There is no specific test to definitely diagnose PCOS, which is why it is commonly misdiagnosed.  In addition to assessing common PCOS symptoms, a doctor will do a blood test to measure male hormone levels for irregularities and an ultrasound offers a closer look at the ovaries to see if they meet PCOS criteria. Three Characteristic Features of PCOS are 1. Absence of Ovulation with Irregular menses 2. High Androgen Levels 3. USG features suggestive of Cysts in the Ovaries

+ How is PCOS Treated?

The Treatment for PCOS is decided based on 3 factors -

  • Your Symptoms
  • Your other Medical Health Problems
  • Whether you want to get Pregnant

+ Treatment Plan for PCOS

1. Oral ContraceptivesThese are hormonal contraceptives and can be used for the long-term treatment of women with PCOS who do not wish to become pregnant. Oral contraceptive pills contain a combination of the hormones estrogen and progestin, and these help by -

  • Making your Menstrual periods more regular
  • Reducing the level of androgens produced by the ovaries, thus reducing its activity
  • Clearing Acne and Reducing excessive Hair growth
Caution
Like all medications, Oral contraceptives also have associated side effects, some of which can get critical. A discussion on all the possible risks and side effects with your treating doctor is a must before starting any treatment.

2. Insulin-Sensitizing Agents and Anti–Androgens These medications make the body more responsive to insulin and keep glucose levels in normal range.

  • Regulates your Menstrual periods
  • Helps in Weight loss
  • Stabilizing Cholesterol Levels
  • Clearing Acne and Reducing excessive Hair growth
  • Aids in treating infertility associated with PCOS

3. Managing Hirsutism (excessive hair growth on face chest, abdomen, upper thighs) and AcneHirsutism|

  • Daily application of an Eflornithine cream slows hair growth especially on the face.
  • Shaving, Bleaching, Waxing
  • Electrolysis, Laser Hair Removal

Acne|Your Dermatologist may prescribe Retinoid Antibacterial agents and Antibiotics available as Pills, Creams or Gels to treat Acne.4. Dietary Restrictions

  • Reduce your Sugars and Carbohydrates since women with PCOS have resistance to insulin.
  • Avoid dairy and processed foods
  • Regular eating schedules
  • Avoid crash diets
  • Add whole grain products, seeds, fibers, protein , green leafy vegetables and fruits with low glycemic index

5. Managing your WeightMany overweight women with PCOS who lose 5 to 10 percent of their body weight notice that their periods become more regular. Weight loss can often be achieved with a program of diet and exercise. Exercising regularly has shown to be very beneficial for PCOS. The optimal exercise routine should be at least -

  • For Weight Management| 30 Mins / Day for 5 days a Week AND 150 minutes / Week
  • For Weight Loss | 250 Mins / Week

6. Adequate SleepDevelop a healthy sleep schedule and follow Sleep Hygiene recommendations like -

  • Avoiding caffeine, smoking and alcohol use.
  • De-stress by taking walks in nature, meditation or playing with your pets.
  • Reduce ambient noise in the night time
  • Avoid daytime napping
  • Stop using devices with bright screens, like television, laptops and mobile phones from an hour before bedtime

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