What is Poly Cystic Ovarian Syndrome (PCOS)?

  

I really wanted to write a piece on what PCOS actually was. Not everyone knows and as I am sharing our journey via this blog, I felt it would be ideal to talk about what it is preventing us doing what so many others can do with half the amount of trouble. 

So for most couples, they decide they want a baby, and they manage this no problem. For us, my PCOS is preventing that process from happening quite so simply.  Here is a brief explanation as to what is happening with my ovaries and preventing the patter of tiny feet for us.  Please note this is from what i have read of the condition, I am not a doctor or any kind of expert and if you are concerned for your own health you should seek medical advice. I will provide links to sources for further information at the bottom of this page. 

 
PCOS is when the ovaries are covered in many tiny cysts (measuring up to 8mm each).  These cysts are under developed sacs, or follicles, that are unable to release eggs from the ovaries, preventing ovulation to occur and causing a hormonal imbalance.  In PCOS there is a higher then normal amount of androgens (male sex hormone) produced by the ovaries which may prevent ovulation as well as acne and excess body and facial hair. 

Insulin resistance is also very common in PCOS.  This is where the body is unable to effectively use the amount of insulin produced, causing high blood sugars and an increased risk of developing diabetes. 

 
Common symptoms include:

  • Acne and oily skin
  • Issues with weight gain and difficulty loosing weight
  • Excess facial and body hair
  • Hair thinning (scalp)
  • Irregular or missing periods
  • Insulin resistance or hyperinsulinemia
  •  Not being able to ovulate
  • Infertility and/or repeated miscarriages
  • Depression/mood swings

Reproductive issues include a higher risk of gestational diabetes, high blood pressures, very large or very small birth weights orfbabies carried full term and premature birth is also a known issue. During the reproductive ages sufferers are three times likely to develope uterine cancer.  Precancerous uterine lining is also thought to be a risk factor caused by a reduced amount of periods not clearing the lining of this part of the body. 

Insulin resistance can lead to high levels of insulin and in turn cause atherosclerosis, coronary artery disease, heart attack, increased blood pressure, high cholesterol and/or stroke. 

One in five women in the United Kingdom are thought to suffer with pcos and fifty percent of these sufferers are thought to be asymptomatic. 

 
The cause of PCOS is currently unknown; there are various papers available on the syndrome (Click here). Many sources discuss a genetic link. There is one strong theory that suggests insulin resistance causes too much hormone production in the ovaries, causing an increased level of testosterone. This effects the developement of follicles (sacs) where eggs develop (becoming cysts) hindering ovulation.  Insulin resistance can additionally lead to weight gain and the excess weight in turn causes a high insulin production.  Insulin is produced to control blood sugar and plays an important role in energy production. 

Hormonal imbalances affect many with PCOS but again it is not known why. One theory is that it is either an issue within the ovary, hormonal glands or the part of the brain that controls hormonal production or it could be insulin resistance. Common imbalances include:

  • High level of testosterone (usually produced in small amounts in women)
  • High level of Luteinising hormone (LH; stimulates ovulation, prevents in high amounts)
  • Low level of Sex hormone binding globulin (SHBG; reduces effect of testosterone)
  • High level of prolactin (stimulates milk production in pregnancy)

 
There is no known cure for PCOS. Treatments available on the NHS include advice to change ones lifestyle to reduce weight and risk of developing associated long term conditions.  Irregular periods can be treated with the pill, and there are various contraceptive pills available. Fertility issues can be treated with three main drugs, metformin and clomifene are often used together for egg production and if this is unsuccessful gonadotropin can be used. Surgically laparoscopic ovarian drilling has proved successful in aiding egg release without the associated risk of multiple births that is linked with the medication. Unwanted hair growth/loss can be treated with various medication (Click here) which block effects caused by male hormones and surprises their production. Eflornithine cream can slow facial hair growth down but is not readily available on the NHS.  

This is a bit of a whistle stop tour on what PCOS actually is and hope this has helped anyone reading this blog. Thankfully, there is a wealth of information available these days compared to when I was diagnosed back in 2000 thanks to more research and the Internet.   Click Here and Here and also Here for more information (a simple google search will also bring up a whole variety if information, such as this One.)

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