PCOS is one of the most common hormonal disorders affecting women in the 18-45 age group. It affects 1 in 10 to 1 in 20 women in the United States and around 1 in 5 to 1 in 4 women in India.
Before we go into PCOS, I just want to give a quick overview of what happens in a woman’s body during a menstrual cycle.
From the start of one period to the the next, it maybe between 21 to 35 days long in adult women and up to 45 days in adolescents. The hormone estrogen plays an important role in thickening the lining of the uterus in the first half of the menstrual cycle. This provides a suitable place for the fertilized embryo to implant and grow if a pregnancy occurs.
Simultaneously, an egg begins to mature in one of the ovaries, and is released around 12-16th day of your cycle. It passes through the fallopian tube to reach the uterus.
This release is called ovulation, and lutenizing hormone (LH) and follicle stimulating hormone (FSH) play an important role in it.
LH in turn, triggers the production of another important hormone, progesterone, which is responsible for sustaining a pregnancy if it has taken place. If no fertilisation has occured (no pregnancy), then, the progesterone levels will fall after about 11-14 days and the uterine lining will shed, resulting in a period or menstruation. This typically last about 4-7 days and marks the beginning of the next menstrual cycle and so on.
In PCOS, the hormones which are responsible for ovulation (lutenizing hormone and follicle stimulating hormone) and testosterone maybe out of sync and show abnormal levels.
A diagnosis of PCOS is not merely the presence of cysts in the ovaries in an ultrasound scan.
The Rotterdam criteria for diagnosis of PCOS requires two out of three of the following symptoms:
1.Oligo-ovulation or Anovulation :
That means either you are not ovulating every cycle or not ovulating at all. You can have a seemingly normal period without ovulating.
Increase in androgens (male sex hormones) which may show as:
Increased facial or body hair (hirsutism), male pattern baldness (alopecia)
Increase in levels of free testosterone (detected by a blood test)
3. Polycystic ovaries on ultrasound :
Multiple small cysts in the ovaries are characteristic of PCOS.
Other symptoms of PCOS include:
- Irregular or absent periods (could be very long or very short menstrual cycles)
- Acne (Pimples)
- Obesity or excess body weight/BMI
- Reduced fertility or infertility
- Anxiety or depression
- Diabetes/ insulin resistance
PCOS doesn’t have a cure, but can be managed to an extent with lifestyle changes. Diet, exercise and certain medications has been proven to help with keeping symptoms at bay.
For women who are trying to conceive, PCOS may definitely be a hurdle, but not one that cannot be crossed through various treatment modalities.
I hope this is a fairly helpful overview for anyone who is dealing with a recent diagnosis or even someone who has been living with PCOS for a long time.
The only advice I have, is to stay strong, be positive and don’t let the disease define who you are.
Fight it tooth and nail and strive to overcome.