Polycystic Ovary Syndrome (PCOS) Overview

Introduction

PCOS stands for polycystic ovary syndrome. It is a complex hormonal condition that can affect how the ovaries work by affecting a woman's hormone levels. For example, women with PCOS produce higher levels of male hormones than usual, which causes a hormone imbalance that, as a result, causes their bodies to skip menstrual periods, making it harder for them to get pregnant.1

What is PCOS?

As mentioned above, PCOS is a complex hormonal condition that can affect a woman anytime after puberty. Most are diagnosed in their 20s or 30s. This syndrome is a disorder which typically affects up to 15% of women of reproductive age (between 15 and 44). 

PCOS is commonly associated with three main factors which come together to cause the collection of symptoms recognised as PCOS. First, it is characterised by the coexistence of hyperandrogenism, referring to an excessive presence of the male sex hormones, ovulatory dysfunction and polycystic ovaries where several fluid-filled sacs surround the egg in the ovaries (despite the name of the condition being polycystic ovaries they are not cysts).6

There is no cure for PCOS, but the symptoms can be managed and treated. It is essential to book an appointment with your GP if you think you have PCOS, as they will recommend lifestyle changes which will help you manage the condition. Here we will briefly go over the symptoms and causes of PCOS and the lifestyle changes that are most useful for managing symptoms. 

Symptoms

The main symptoms associated with PCOS are irregular periods. However, many other signs and symptoms characterize PCOS, including:

  • Difficulty getting pregnant is usually a result of irregular ovulation. 
  • Excessive hair growth
  • Fatigue and lethargy
  • Weight gain
  • Difficulty losing weight
  • Craving sugary foods
  • Hair loss from the head 
  • Acne and oily skin
  • Darkening of the skin, especially around the neck folds, armpits, between the legs, and under the breast

These symptoms most commonly manifest themselves during the late teens or early 20s. 

Furthermore, PCOS is often associated with an increased risk of developing various other health conditions later in life, such as type 2 diabetes. 

Causes

The cause of PCOS is unknown. However, professionals recognise that PCOS is related to abnormal hormone levels in the body, for example, high levels of insulin, a hormone that controls sugar levels in the body or high levels of testosterone.8  Although professionals have recognised the mechanisms behind the syndrome, they have not yet found out why such hormonal imbalances occur in some and not others. 

Risk factors

As mentioned above, the exact cause of PCOS is still undetermined. Similarly, professionals are also unclear about the risk factors associated with PCOS. Risk factors refer to elements which increase your likelihood of developing a disorder. In the case of PCOS, the syndrome is often associated with the following risk factors: 

  • ​​Genetics. You may be more likely to get PCOS if other family members have PCOS.
  • Insulin resistance is linked to PCOS - but it’s unclear precisely. Still, women with PCOS experience higher rates of insulin resistance than women who don’t have it, where insulin is a critical hormone affecting our body’s ability to use blood sugar for energy. 
  • Obesity - You may have a higher chance of getting PCOS if you are overweight or have obesity.

You can reduce your risk of PCOS by making a few changes to your lifestyle

The following lifestyle factors have the most significant impact on your risk of PCOS. We will also look at what you can do to reduce your risk from today. 

Nutrition

A healthy balanced diet can significantly help you manage your symptoms of PCOS. There are several changes you can make to the way that you are eating which can help ease symptoms, including: 

  • Eating regularly helps keep your blood sugar levels stable, reducing insulin resistance. 
  • Choosing low GI carbohydrates and whole grains - these foods raise your blood sugar levels slowly, which helps reduce the symptoms of PCOS.
  • Focusing on having balanced meals, such as adding protein and fats too low GI carbohydrates, reduces the impact of the whole meal on blood sugar levels. 
  • Including omega-3 fats can help lower inflammation commonly observed in those with PCOS. 

Physical activity

It can also be a great way to help you manage the symptoms of PCOS. Physical daily activity, such as brisk walking, jogging, or swimming, can significantly improve symptoms. This is because exercise increases our body's sensitivity to insulin. 

Obesity

Being overweight can put you at higher risk of developing type 1 or 2 diabetes or becoming prediabetic, affecting your chance of developing a condition such as PCOS.9 This is why it is possible to minimize the risk of PCOS by minimizing the risk of obesity. 

Alcohol

Even for the average person without PCOS, high levels of alcohol consumption can lead to higher blood sugar levels, aggravate hormonal imbalances, and increase the risk for liver disease and depression.3 When consumed regularly, alcohol has similar, if not increased, harmful effects for those with PCOS. However, even though it is frequently believed that alcohol can worsen symptoms of PCOS, it has been found that it depends on the type of alcohol consumed. Although reducing alcohol intake can help improve symptoms, the occasional.

Hydration

Staying hydrated is essential whether you have a medical condition or not. However, PCOS can increase your risk of related conditions such as diabetes, heart disease, and high cholesterol. Therefore, ensuring you drink enough water becomes even more critical than doing so is part of maintaining a healthy diet and lifestyle and has been proven to reduce the risk of developing related diseases and easing symptoms of PCOS. 

Sleep

Sleep is a crucial part of health and well-being. PCOS can often be associated with trouble sleeping and sleep disturbances. It was found that sleep disturbances and disorders, such as sleep apnea and daytime sleepiness, are more frequent in women with PCOS than in women without the syndrome.2 Hence it is advised to get 6-9 sleep a day and to focus on good sleep hygiene, such as avoiding caffeine two hours before going to bed and establishing a relaxing nighttime routine, among others. 

Mental health

Often overlooked, PCOS can also lead to mental health issues such as anxiety, depression and eating disorders. Women with PCOS are much more likely to report symptoms of anxiety and depression, and those symptoms are more likely to be severe.4,5 However, it is unclear what causes the increased risk for depression and anxiety - it could be due to PCOS symptoms or the hormonal imbalances associated with the syndrome. Either way, it is essential to see your doctor if you are experiencing a low mood or other symptoms related to mental health. 

Wellness

Keeping your emotional health balanced is necessary for your physical health. Allocating time for self-care, including walks in nature and reading a book. Looking out for your overall well-being and managing stress levels can positively affect long-term conditions. 

Conclusion

PCOS is a complex hormonal disorder which affects how the ovaries work but also impacts many other aspects of a person’s health, including mental health. The main symptom of PCOS is irregular periods, but many different symptoms, such as fatigue, lethargy, infertility, and weight gain, are often associated. Lifestyle choices such as the type of food you eat and physical activity can improve and manage symptoms. See your doctor if you have concerns about irregular menstrual periods.

Diagnostic testing

At Klarity, we use the latest technology when it comes to diagnostic testing. Our home blood tests give you health insights and personalised recommendations. Find out which test you should take.

References

  1. Sirmans S, Pate K. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clinical Epidemiology. 2013;:1.
  2. Fernandez R, Moore V, Van Ryswyk E, Varcoe T, Rodgers R, March W et al. Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies. Nature and Science of Sleep. 2018;Volume 10:45-64.
  3. de Angelis C, Nardone A, Garifalos F, Pivonello C, Sansone A, Conforti A et al. Smoke, alcohol and drug addiction and female fertility. Reproductive Biology and Endocrinology. 2020;18(1).
  4.  Brutocao C, Zaiem F, Alsawas M, Morrow A, Murad M, Javed A. Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis. Endocrine. 2018;62(2):318-325.
  5. Cooney LG, Lee I, Sammel MD, Dokras A. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2017;32(5):1075-91.
  6. Escobar-Morreale HF (2018) Polycystic ovary syndrome: Definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol 14: 270-284.
  7. Hiam D, Moreno-Asso A, Teede HJ, Laven JSE, Stepto NK, Moran LJ, Gibson-Helm M. The Genetics of Polycystic Ovary Syndrome: An Overview of Candidate Gene Systematic Reviews and Genome-Wide Association Studies. J Clin Med. 2019 Oct 3;8(10):1606. 
  8. De Leo V, Musacchio M, Cappelli V, Massaro M, Morgante G, Petraglia F. Genetic, hormonal and metabolic aspects of PCOS: an update. Reproductive Biology and Endocrinology. 2016;14(1).
  9. Sam S. Obesity and Polycystic Ovary Syndrome. Obesity Management. 2007;3(2):69-73.

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