I believe women of all ages should know what PCOS or polycystic ovary syndrome is and how to prevent it. It is a common endocrine system disorder among women of reproductive age. The exact cause is unknown but genetics and environmental factors are believed to be involved in the development of PCOS. It is a leading cause of female infertility and affects about 10 million people in the world. In fact, almost 1 out of 10 women have PCOS and it begins during a girl’s teen years. Some of the most common sign of PCOS include: Irregular period that come every few month, not at all or too frequently; Extra hair on face, other parts of body (called hirsutism); Acne; Weight gain and/or trouble loosing weight.
If you give a close look on these symptoms of PCOS, you will find that these aren’t so much annoying. So, women don’t pay much attention on these symptoms and left PCOS untreated. Even . They can’t realize that they have a disease. They think it is their normal physiological condition. Irregular period is main symptom of PCOS. In underdeveloped and developing country like Bangladesh, period is still a matter of shy. Women don’t want to go to doctor for this alarming symptom and PCOS developed gradually.
The hormones involved in PCOS include Androgens, Insulin and Progesterone. All women produce a little amount of androgen in ovaries and adrenal glands but PCOS are caused by high levels of androgen (mainly testosterone) causing hyperandrogenism. Androgens are sometimes called “male hormone” and estrogens are called “female hormone”. Women with PCOS have more androgen than estrogen. Higher than normal androgen level in women can prevent the ovaries from releasing an egg during each menstrual cycle and can cause extra hair growth and acne, two signs of PCOS.
High level of insulin is another suspected cause of PCOS. Many women with PCOS have insulin resistance especially those who are overweight or obese, have unhealthy eating habits, do not get enough physical activity and have a family history of diabetes. Insulin is a hormone that control how the foods (you eat) have changed into energy. Insulin resistance is when body’s cells do not respond normally to insulin. As a result, insulin level in blood becomes higher than normal. Over time, insulin resistance can lead to type2 diabetes.
Women with PCOS always have low progesterone level and lack of progesterone causes increased production of luteinizing hormone (LH). Increased amount of LH stimulates ovary to make more estrogen and androgens which stimulates more follicle toward ovulation. If these additional follicles are also unable to produce a matured ovam, the menstrual cycle is dominated by increased estrogen and androgen production without progesterone. So, this is the fundamental abnormality that creates PCOS and anovulation occurs. Anovulation may produce tiny cysts in the ovary but a study in 2013 found that all women with PCOS don’t have cysts in their ovary. So, it is easily assumed that women with PCOS are t higher risk of pregnancy and delivery complication. This risk increased more when you have PCOS along with diabetes. So, it is suggested that blood sugar level should be checked before pregnancy.
Other complications of PCOS include cardiovascular disease, endometrial cancer, metabolic syndrome, sleep apnea and fatigue. Women with PCOS are at twice as much risk of heart disease and stroke. If a woman has high blood pressure, high blood cholesterol and high levels of inflammatory proteins which lead to insulin resistance by changing function of blood vessel that increase the risk of cardiovascular disease. In PCOS, infrequent period occurs which may increase the risk of endometrial cancer. Chronic anovulation leads to a lack of shedding of the lining of uterus and endometrium can thicken which may increase the abnormal cells, as women ages can develop into cancerous cells. Women with PCOS have a higher prevalence of metabolic syndrome. Metabolic syndrome is a collection of condition include high blood pressure, abdominal obesity, impaired glucose tolerance. It increases the risk of prediabetes and type2 diabetes.
There is no specific treatment of PCOS till now. Some medications are given to improve the symptoms and feel better. For irregular period birth control pill is given and it encourages the ovulation. Now-a-days metformin is recommended which is actually used to treat type2 diabetes. Metformin lowers the insulin and blood sugar level in women with PCOS and help to loose weight. Study suggested that with the loosing weight, the menstrual cycle come back to normal. Drugs that curb androgen levels (Spironolactone) are another common treatment used for PCOS and it improve the androgen related symptom such as excess hair on body.
PCOS Awareness Association says that “Preventing PCOS is possible if right weight is maintained and stay away from stress”. For maintaining weight a healthy diet and physical exercise is mandatory. A study found that women of South Asia are more sensitive to PCOS. The main cause is that carbohydrate (mainly rice) is the main food of most people in South Asia which play an important role in weight gain. So carbohydrate in particular need to be limited especially sugar, sweets, sodas, processed foods and even breads and grains. It is also found that PCOS are transferred generation to generation. So, if your mother has a history of PCOS, you should do blood tests periodically to check blood glucose level and hormone level. So it can goes without saying that PCOS can be prevented by your willpower of maintaining your BMI (body mass index) within 20-25 and don’t ignore any symptom like irregular period. Don’t be shy to go to doctor and PCOS will stay away from you.
Rupali Ghosh is a undergraduate student at Department of Pharmacy, East West University, Bangladesh. She can be reached at firstname.lastname@example.org
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