Polycystic ovarian syndrome: A cause of infertility and irregular menstrual cyclesArticle
27. 04. 2020 Gynecology
Excessive body hair, weight gain, thinning hair, problematic skin, amenorrhea or irregular ovulation. These are just a few physical symptoms that cam make a woman feel less feminine, but they are not just an aesthetic problem. They are often an indication of polycystic ovarian syndrome. The culprit is hormonal imbalance, causing increased levels of male sex hormones (testosterone in particular). What can a doctor do to help, and what can a patient do to help herself?
Polycystic ovarian syndrome (PCOS) is described as a simultaneously metabolic and endocrine disorder, affecting 5-20% of women of reproductive age. The exact causes of PCOS are not yet known, however there are speculations leaning towards hereditary predispositions, unhealthy lifestyle (unbalanced diet, obesity, lack of exercise), as well as the presence of bisphenol type A, a hormone disruptor (a chemical substance that interferes with the endocrine system).
Dr. Miroslav Verner, head of the gynaecology department at Canadian Medical emphasises the importance of preventive care, “Apart from having an irregular menstrual cycle and infertility, women suffering with PCOS have an increased risk of uterine cancer- more specifically endometrial cancer. For this reason, they should undergo regular (at least once a year) gynaecological examinations.”
Symptoms that can crush self-confidence
The increased concentrations of androgens (male sex hormones) cause the symptoms that are so commonly seen in PCOS- oily skin, hair loss, acne, as well as hirsutism. Women with this syndrome grow excess hair in uncommon places (for females), on the upper lip, chin or face, as well as on their back and breasts. Another common symptom trait of PCOS is insulin resistance, which often causes a rapid increase in weight. The hormone insulin is being produced in excess, but the receptors on the cells in our muscles stop responding to its presence, which prevents the uptake of glucose into our cells. Consequently, our blood sugar concentration increases, and the glucose acts as a source of energy, and therefore any excess calories consumed from food go directly to our stores (fat). That being said, PCOS affects even the most slender of women. Not many people know that many familiar, celebrity faces suffer from this syndrome: popular fitness coach Jillian Michaels, fashion icon Victoria Beckham, actress and screenwriter Emma Thompson.
Diagnosis and indications for treatment
What do ovaries affected by PCOS look like? They can be up to twice the size compared to normal ovaries. However, the main feature are small cysts that are present on the ovaries, formed from immature follicles (eggs).
The syndrome is diagnosed by a gynaecologist through an ultrasound examination, and an evaluation of the hormonal profile- in particular the levels of FSH (follicle stimulating hormone), LH (luteinising hormone), and testosterone, however, prolactin, thyrotropin (TSH) and other hormones also help to rule out other possible causes of the symptoms (hyperprolactinemia, hypothyroidism, etc.).
As of yet, there is no cure for polycystic ovarian syndrome, but with the advancement of medicine we can help manage the symptoms as best as possible. “One of the main aims is to suppress the excessive production of the male sex hormones (androgens). This is usually achieved by using hormonal contraception, or some medication used to treat diabetes (oral anti-diabetics)” explains Dr.Verner.
PCOS and pregnancy
The most common time PCOS is diagnosed, is when a woman discontinues her use of the contraceptive pill in an effort to conceive, and her menstrual cycle is overdue. Women with obesity are advised to lose weight (and maintain it) with the help of an obesity specialist. According to experts, weight loss and regular exercise can stimulate ovulation, stabilise hormonal misbalance, and also reduce the glycaemic index. The next step for infertility treatment is the use of medication to promote ovulation, or undergo a procedure called ovarian drilling. During this laparoscopic surgery, the outer layer of the ovaries is surgically punctured, which can help the ovaries release an egg each month and start a more regular monthly menstrual cycle.
5 tips for managing life with PCOS
An alternative (complementary) therapy that has been used in the fight against PCOS includes hormonal yoga therapy by Dinah Rodrigues. The set of consecutive asanas activates the endocrine glands in the ovaries, thyroid, and pituitary, and thanks to specific breathing techniques these areas become stimulated with increased blood flow.
Limit the consumption of simple sugars and excess carbohydrates in the diet. Lemonades and fizzy drinks can be replaced by unsweetened water, which can be sweetened with stevia or honey. Try to avoid refined sugars and get inspired by the low-carb style diets. Treat yourself to fruit early on in the day and try to prioritise vegetables in the afternoon and evening.
Keep active- anything from walking, Nordic walking, swimming, Pilates, dancing, cycling, etc. Choose a type of physical activity that suites you and move regularly. Regular exercise naturally reduces insulin resistance.
The use of myo-inositol, preferably in combination with D-chiro-inositol (dietary supplements) in women with PCOS has been proven to have beneficial effects on egg quality as well as glucose metabolism. Vitamin D also has beneficial properties.
How to deal with excessive hair growth? There are several options to choose from- classic razor shaving, depilatory creams, sugar paste, wax, IPL or laser hair removal.