What are polycystic ovaries?
Polycystic ovaries are slightly larger than normal ovaries and have twice the number of follicles (small cysts). Polycystic ovaries are very common affecting 20 in 100 (20%) of women. Having polycystic ovaries does not mean you have polycystic ovarian syndrome. Around 6 or 7 in 100 (6–7%) of women with polycystic ovaries have PCOS.
What causes PCOS?
The cause of PCOS is not yet known. PCOS sometimes runs in families. If any of your relatives (mother, aunts, sisters) are affected with PCOS, your own risk of developing PCOS may be increased. The symptoms of PCOS are related to abnormal hormone levels. Testosterone is a hormone which is produced by the ovaries. Women with PCOS have slightly higher than normal levels of testosterone and this is associated with many of the symptoms of the condition.
Insulin is a hormone which regulates the level of glucose (a type of sugar) in the blood. Women with PCOS have what is called insulin resistance. This means that cells in the body are resistant to the effect of a normal level of insulin. More insulin is then produced to keep the blood sugar normal. This raised level of insulin in the bloodstream is thought to be the main underlying reason causing PCOS. It causes the ovaries to make too much testosterone. A high level of insulin and testosterone interfere with the normal development of follicles in the ovaries. As a result, many follicles tend to develop but often do not develop fully. This causes problems with ovulation - hence, period problems and reduced fertility.
It is this increased testosterone level in the blood that causes excess hair growth on the body and thinning of the scalp hair.
Increased insulin also contributes towards weight gain
Being overweight or obese is not the underlying cause of PCOS. However, if you are overweight or obese, excess fat can make insulin resistance worse. This may then cause the level of insulin to rise even further. High levels of insulin can contribute to further weight gain producing a 'vicious cycle'. Losing weight, although difficult, can help break this cycle.
How is PCOS diagnosed?
Women with PCOS often have different signs and symptoms and sometimes these come and go. This can make PCOS a difficult condition to diagnose. Because of this, it may take a while to get diagnosed.
A diagnosis is usually made when you have any two of the following:
● irregular, infrequent periods or no periods
● more facial or body hair than is usual for you and/or blood tests which show higher testosterone levels than normal
● an ultrasound scan which shows polycystic ovaries.
Visit a gynaecologist as soon as you get any of these symptoms.
Can PCOS affect my long-term health?
If you have PCOS, over time you have an increased risk of developing
- type 2 diabetes
- a high cholesterol level
- Possibly high blood pressure
-If you have no periods, or very infrequent periods, you may have a higher-than-average risk of developing cancer of the womb (uterus)
To have a complete understanding of PCOS, please read the complete series by Dr Ritu Hinduja
To read suggestions of a nutritionist, read on: Battling PCOS & Pregnancy Weight
To consult Dr Ritu Hinduja in person, click here.