Polycystic ovary syndrome (PCOS): What does it mean for long-term health and fertility?

Have you ever heard of polycystic ovarian syndrome (PCOS)? You could have if you’re a woman who has had difficulty becoming pregnant.

Almost everyone else? Very likely not.

PCOS is a syndrome that can interfere with your periods, fertility, hormones, and physical appearance. It can also have an impact on your long-term health. Estimates of how many women are affected range from 2 to 26 in every 100.

What are the symptoms of PCOS?

PCOS symptoms include the following:

Irregular or non-existent periods
An increase in facial or body hair (hirsutism)
Being overweight, suffering a quick gain in weight, or having difficulties decreasing weight
Having oily skin, acne, or problems becoming pregnant (reduced fertility).
Depression and psychological issues can also arise as a result of PCOS.

The symptoms differ from one woman to the next. Some women experience only a few modest symptoms, while others experience a broader spectrum of symptoms.

What causes PCOS?

The aetiology of PCOS is unknown, however it frequently runs in families. If any of your family (mother, aunts, sisters) have PCOS, your chances of having it are enhanced.

The following symptoms are caused by abnormal hormone levels:

Testosterone is a hormone that is generated in modest levels by all women’s ovaries. Women with PCOS have slightly higher than normal testosterone levels, which is linked to several of the condition’s symptoms.
Insulin is a hormone that regulates blood glucose levels (a form of sugar). If you have PCOS, your body may not respond to insulin (this is known as insulin resistance), resulting in a greater amount of glucose. Elevated insulin levels can cause weight gain, irregular periods, reproductive issues, and increased testosterone levels.

How is PCOS diagnosed?

The presence of polycystic ovaries does not imply the presence of PCOS.

Women with PCOS may have intermittent symptoms, especially if their weight fluctuates. This can make it difficult to diagnose, therefore it may take some time to acquire a diagnosis.

A diagnosis is given when you have two of the following symptoms:

Irregular, infrequent periods or no periods at all
An increase in face or body hair
Blood tests that reveal greater testosterone levels than normal
An ultrasound examination that demonstrates polycystic ovaries.

You may be sent to a gynaecologist (a doctor who specialises in care for a woman’s reproductive system) or an endocrinologist after a diagnosis is determined (a doctor who specialises in the hormonal system).

Is there a cure for PCOS?

There is currently no treatment, however there are various strategies to reduce or eliminate PCOS symptoms and feel better. Your doctor may recommend several medications to manage problems such as irregular periods, acne, excess hair, and high blood sugar. Fertility therapies are offered to assist women in becoming pregnant. Reducing even 5% of extra weight can help women ovulate more consistently and alleviate other PCOS symptoms. The best method to do this is through diet and exercise.

You may believe that losing excess weight and keeping it off is tough, but it is critical to persevere. Your actions assist to lower the risk of major health concerns, which can affect women with PCOS far sooner than women without PCOS. Diabetes, heart disease, and stroke are the most serious health issues since PCOS is associated with high blood pressure, pre-diabetes, and high cholesterol.

So what happens if you have PCOS and you want to have a baby? Here is what you need to know:

First of all, most women with PCOS become pregnant. However, they generally take longer to conceive and are more likely to require fertility therapy than those without PCOS.

Adopting a healthy lifestyle, which includes maintaining a healthy weight, avoiding smoking, limiting alcohol use, eating a good food, getting plenty of regular exercise, and getting enough sleep, is the first step in improving a woman’s chances of becoming pregnant and delivering a healthy baby.

If you’ve been trying for a baby for 12 months without success (or six months if you’re 35 or older), it’s time to consult a doctor.

If you have highly irregular or merely sporadic periods, you are not ovulating and will require medical assistance to produce a kid. Ovulation inducement is the initial line of medical therapy. This consists of a series of pills or injections that stimulate the ovaries to produce an egg that can be fertilised either during intercourse or by intra-uterine insemination (IUI).

If this doesn’t work, there might be other reasons why pregnancy isn’t possible, and more intrusive therapies like IVF may be required.

IVF comprises a series of injections to stimulate the ovaries to generate a large number of eggs. When the eggs are mature, they are extracted using an ultrasound-guided technique under mild anaesthesia. In the laboratory, sperm is mixed with eggs to create embryos.

A few days later, an embryo is implanted in the uterus, where it may develop into a baby. If there are many embryos, they can be preserved for future use if there is no pregnancy.

While IVF is safe in the hands of trained professionals, there are certain potential side effects to be aware of, such as ovarian hyperstimulation syndrome. This is an overreaction to fertility medicines, which encourage the ovaries to generate numerous eggs. This might result in stomach discomfort, nausea, vomiting, fast weight gain, and blood clots.

For more information, book your appointment with Dr Ahmed Ismail.