PCOS

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Overview

Poly Cystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. Women suffering from PCOS present with a constellation of symptoms associated with menstrual dysfunction and androgen excess, which significantly impacts their quality of life. They may be at increased risk of multiple morbidities, including obesity, insulin resistance, type II diabetes mellitus, cardiovascular disease (CVD), infertility, cancer, and psychological disorders. This review summarizes what the literature has so far provided from guidelines to diagnosis of PCOS. It will also present a general overview about the morbidities associated with this disease, specifically with its more severe classic form. Finally, the review will stress on the various aspects of treatment and screening recommendations currently used in the management of this condition.

Symptoms

Missed periods, irregular periods, or very light periods.

Ovaries that are large or have many cysts.

Excess body hair, including the chest, stomach, and back (hirsutism)

Weight gain, especially around the belly (abdomen)

Acne or oily skin.

Male-pattern baldness or thinning hair.

Infertility.

Causes

The exact cause of PCOS is unknown. There is evidence that genetics play a role. Several other factors also play a role in causing PCOS:


Higher levels of male hormones called androgens: High androgen levels prevent the ovaries from releasing eggs (ovulation), which causes irregular menstrual cycles. Irregular ovulation can also cause small, fluid-filled sacs to develop in the ovaries. High androgen also causes acne and excess hair growth in women.

Insulin resistance: Increased insulin levels cause the ovaries to make and release male hormone (androgens). Increased male hormone, in turn, suppress ovulation and contribute to other symptoms of PCOS. Insulin controls the way your body processes glucose (sugar) and uses it for energy. Insulin resistance means your body doesn't process insulin correctly, leading to high glucose levels in your blood. Not all individuals with insulin resistance have an elevated glucose or diabetes, but insulin resistance can lead to diabetes. Being overweight or having obesity can also contribute to insulin resistance. An elevated insulin level, even if your blood glucose is normal, can indicate insulin resistance.

Low-grade inflammation: People with PCOS tend to have chronic low-grade inflammation. Your healthcare provider can perform blood tests that measure levels of C-reactive protein (CRP) and white blood cells, which can indicate the level of inflammation in your body.

Risk factors

Risk factors for PCOS in adults includes type 1 diabetes, type 2 diabetes, and gestational diabetes. Insulin resistance affects 50%–70% of women with PCOS leading to a number of comorbidities including metabolic syndrome, hypertension, dyslipidemia, glucose intolerance, and diabetes.

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Complications

Infertility.

Gestational diabetes or pregnancy-induced high blood pressure.

Miscarriage or premature birth.

Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver.

Prevention

There is no proven way to prevent PCOS, but you can take small steps to reduce your symptoms. For example, eating nutritious foods, exercising regularly and managing your weight can help you avoid the effects of PCOS.