What is PCOS

What is PCOS?

Often misunderstood and under diagnosed symptom found in women of reproductive age.
If you have been diagnosed with PCOS, don’t panic. It is not such a worst thing in the world as the name sounds. You are one of those people who are lucky enough to get diagnosed with PCOS, for most women it is left undiagnosed. It is good that you identified this in your body so you can make wise decisions about your life style.
The causes of PCOS are not understood completely and nor it is the same for all women. While some women might have it at the time of their birth, for most women it is believed to have developed at a later stage due to their lifestyle. This kind of implies that though there is no specific cure for this syndrome, it is completely reversible. Which means you might have to drastically change the life style factors that cause it.

Please be mindful that most general practitioners don’t have much insight into PCOS. So, you might be better off consulting a gynaecologist or a reproductive endocrinologist if you suspect PCOS or have any of the symptoms. The most common symptoms of PCOS includes:

• Obesity
• Irregular periods
• Prolonged mensuration
• Frequent Abdomen pain
• Ovarian pain
• Acne
• Hair Loss
• Hirsutism
• Anovulation(Absence or lack of ovulation)

It is very important to understand the difference between PCO and PCOS. PCO just means polycystic ovaries. It doesn’t necessarily mean that you have the syndrome. PCOS is diagnosed by a series of blood testes that your endo/gyno would suggest based on your circumstances.

The diagnosis of PCOS typically includes the following:

• Testing the level of male hormones(androgens) in your body
• Diagnosing polycystic ovaries in ultrasound
• Anovulation - Blood tests to diagnose whether you have infrequent or no ovulation at all



Before we jump into possible solutions it is important to understand how your body functions in relation to this situation.

Every woman develops eggs in her ovaries after puberty. Egg development in ovaries is controlled by two hormones produced by the pituitary gland namely the Follicle Stimulating Hormone (FSH) and the Luteinizing hormone (LH).
The pituitary glad is situated behind the eyes and it is of the same size as peanut. The pituitary gland is connected by a stalk to the base of the brain. There is a control is base of the brain just above the pituitary glad which determines the level of production if FSH and LH hormones in pituitary gland. This is also knows as the brain's fertility centre. This centre works in a continuous fashion in men whereas in women it works in a cyclic fashion.

If the women's body starts producing more than average levels of male hormones then it starts to work in a continuous fashion like men rather than the monthly cyclic fashion resulting on anovulation ( infrequent or no ovulation).
Anovulation can also be caused by high levels of a pituitary hormone prolactin. But, this is an uncommon cause of the polycystic ovary syndrome.

Ovulation Cycle

Early in a woman’s cycle the pituitary gland secrete a large amount of follicle stimulating hormone (FSH). FSH stimulates growth of the egg and the cells lining the follicle, the tiny bubble that holds the egg, so that the follicle enlarges and moves out towards the surface of the ovaries. At this stage, the follicle does not respond to stimulation by luteinising hormones (LH).

Around days 10, 11 or 12 of the cycle, the fertility centre stimulates the pituitary gland to make a very large amount of LH. By this time the follicle is 9.5 millimetres in diameter and has become sensitive to LH stimulation. The surge in LH from the pituitary gland always stimulates the final step of maturation of the follicle after which no further growth is possible. At this stage the follicle and egg are mature and the follicle will rupture, releasing the egg. This will result in proper ovulation.

Early in the cycle, the ovary and the developing follicle produce a female hormone called oestradiol or oestrogen. Oestrogen stimulates the lining of the womb to grow and thicken. After the follicle ruptures and releases the egg in the middle of the cycle, the ruptured follicle changes its function and produces the second female hormone, progesterone. Progesterone changes the lining of the womb so that it no longer grows thicker but becomes receptive to the implantation of a fertilised egg. This change also allows the lining of the womb to separate from the womb promptly and evenly after blood oestrogen levels fall if fertilisation and implantation have not occurred that cycle. This will result in a normal menstrual period that lasts from four to six days.

The consequences of lack of ovulation:

If ovulation does not occur, the follicle continues to produce oestrogen for some time, causing the lining of the womb to grow thicker than usual. The situation is made worse because the ovary does not produce progesterone if ovulation has not occurred. The lining of the womb then breaks away in an erratic fashion. This causes the menstrual bleeding to be long, often with large quantities of blood and tissue, causing menstruation that can be heavy, painful and prolonged. This free floating oestrogen is converted to testosterone making the situation worse. High level of testosterone is responsible for causing the typical symptoms such as acne, hair loss and hirsutism. The other obvious consequence of lack of ovulation is reduced fertility.