Understanding Polycystic Ovarian Syndrome (PCOS)

Illustration Normal Ovary Vs. Polycystic Ovary

Polycystic ovarian syndrome (PCOS) is a condition where the ovum or egg cells in women do not develop normally due to hormonal imbalances. In PCOS, the ovaries produce excessive androgen hormones. Androgens are male sex hormones that are typically present in small amounts in women. This excess hormone can cause the ovaries to produce many fluid-filled sacs or cysts. This condition ultimately causes egg cells to develop imperfectly and fail to be released regularly. That's why PCOS often makes it difficult for women to get pregnant and makes them more susceptible to diabetes and high blood pressure.

Causes of Polycystic Ovarian Syndrome (PCOS)

To date, the exact cause of polycystic ovarian syndrome remains unknown. However, several factors can increase one's risk of developing this condition:

1. Hormonal Imbalances in PCOS

a. High Androgen Levels

• What are Androgens? Androgens are hormones known as "male hormones," but they are actually produced in small amounts in women and function to support various body functions. However, in women with PCOS, androgen levels can increase dramatically, causing unwanted side effects.

• Impact of High Androgen Levels on Women's Bodies

  • Ovulation Disorders: Excessive androgens disrupt the menstrual cycle and inhibit ovulation, which is the release of eggs from the ovaries. As a result, women with PCOS often experience irregular menstrual cycles or even no menstruation at all, making it difficult to conceive.

  • Excessive Hair Growth (Hirsutism): One effect of excess androgens is excessive hair growth in unusual areas for women, such as the face, chest, lower abdomen, or back. This condition is called hirsutism and can affect one's confidence and comfort level.

  • Skin Problems: High androgens also increase oil gland activity in the skin, causing acne and oily skin. Acne in women with PCOS tends to be more severe and difficult to treat compared to regular acne because it's caused by chronic hormonal imbalances.

b. LH and FSH Imbalance

• What are the functions of LH and FSH in Ovulation? Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are hormones that play important roles in regulating the ovulation cycle in women. FSH is responsible for stimulating follicle growth in the ovaries that contain egg cells. When the follicle matures, an LH surge triggers ovulation, which is the release of the egg from the ovary.

• LH and FSH Imbalance in PCOS:

  • Higher LH than FSH: In women with PCOS, LH levels are often higher compared to FSH, creating an imbalance in the ovulation cycle. This inhibits follicle development and disrupts the ovulation process, causing mature follicles to fail to release.

  • Impact: Because immature follicles don't ovulate, they remain in the ovaries and can form small cysts. This is the origin of the term "polycystic," as the ovaries often appear to have many small cysts due to disrupted ovulation.

c. Insulin Resistance

• What is Insulin? Insulin is a hormone that helps body cells absorb glucose from the blood for energy. In women with PCOS, the body often shows resistance to insulin, meaning that body cells cannot use insulin effectively. As compensation, the pancreas produces more insulin to overcome this resistance.

• Connection between Insulin Resistance and Increased Androgens:

  • Excess Insulin Production: When the body experiences insulin resistance, insulin levels in the blood increase to try to maintain stable blood sugar levels. This increase in insulin levels directly stimulates the ovaries to produce more androgens, worsening the existing hormonal imbalance in PCOS.

  • Impact on Health: Insulin resistance can lead to increased risk of type 2 diabetes, high blood pressure, and cardiovascular disorders in women with PCOS. This condition also worsens PCOS symptoms such as irregular menstruation, weight gain, and skin problems.

  • Effect on Body Weight: Insulin resistance makes the body tend to store more fat, especially in the abdominal area. This causes weight gain that often occurs in women with PCOS, and this weight gain can worsen insulin resistance itself.

2. Genetic Factors

PCOS often runs in families. If a mother or sister has PCOS, the risk of experiencing this condition is higher. Although no specific gene has been identified as a single cause, genetic factors play an important role in the development of PCOS. A combination of various genes that regulate metabolism, insulin resistance, and hormone regulation is believed to influence one's risk of developing PCOS.

3. Environmental and Lifestyle Factors

• Diet and Physical Activity: Although PCOS can occur in women of various body sizes, obesity or excess weight can worsen its symptoms. Diets high in sugar and saturated fats and low in fiber tend to increase the risk of insulin resistance, which contributes to the development of PCOS.

• Environmental Toxin Exposure: Some research shows that exposure to certain chemicals or pollutants can affect hormone function in the body. For example, exposure to certain chemicals like BPA (bisphenol-A) found in plastics is associated with hormonal disorders that can worsen PCOS symptoms.

Risk Factors for Polycystic Ovarian Syndrome

A woman is at higher risk of developing PCOS if she:

• Has a mother or sister with this condition

• Experiences insulin resistance

• Has an unhealthy lifestyle, such as lack of exercise

• Has poor eating habits, such as excessive consumption of sweeteners

• Has inflammation in the body

• Has a history of type 1 diabetes

• Is overweight or obese

Symptoms of Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome symptoms can appear when women experience their first menstruation during puberty. Although PCOS symptoms often appear during adolescence, some PCOS patients only experience symptoms in adulthood or during certain periods, for example, when their weight increases significantly.

Here are the symptoms of PCOS:

• Menstrual Disorders. PCOS is often marked by irregular or prolonged menstrual periods. For example, PCOS patients may only experience menstruation less than 8-9 times in 1 year. The interval between periods can be less than 21 days or more than 35 days, or menstrual blood flows heavily.

• Symptoms Due to Increased Androgen Hormone Levels. Increased androgen hormone levels in women with PCOS can cause male-like physical symptoms, such as thick hair growth on the face and body (hirsutism), as well as severe acne and baldness.

• Multiple Ovarian Cysts In PCOS patients, multiple cyst sacs can be found around the egg cells (ovaries).

• Skin Darkening Some body parts of PCOS patients may become dark, especially in folded areas, such as neck folds, groin, and under the breasts.

Prevention of Polycystic Ovarian Syndrome (PCOS)

PCOS is difficult to prevent entirely due to its underlying genetic and hormonal factors. However, maintaining a healthy lifestyle can help reduce the risk of complications and symptoms. Here are some ways to maintain ideal body weight and reduce risk:

• Limit Sweet Food Consumption

• Increase Fiber Consumption

Learn more : How to Treat PCOS

FAQs about PCOS

1. What is PCOS?

   PCOS (Polycystic Ovarian Syndrome) is a condition where a woman's eggs do not develop normally due to hormonal imbalances.
   This condition is marked by excess production of androgen hormones by the ovaries.

2. What are the main causes of PCOS?

   The exact cause of PCOS is unknown. However, several contributing factors include:

   • Hormonal imbalance

   • Genetic factors

   • Insulin resistance

   • Environmental and lifestyle factors

3. Who is at high risk for PCOS?

   • Women with a family history (mother/sisters) who have PCOS

   • Those experiencing insulin resistance

   • Women with unhealthy lifestyles

   • Individuals with type 1 diabetes

   • Women who are overweight or obese

4. Does PCOS affect the menstrual cycle?

   Yes, those with PCOS may:

   • Have only 8-9 periods a year

   • Have cycles less than 21 days or longer than 35 days

   • Experience heavy menstrual flow

5. How does PCOS affect fertility?

   PCOS can lead to:

   • Irregular ovulation

   • Failure to release eggs

   • Difficulty in getting pregnant

PCOS is a complex condition with multifactorial causes, including hormonal imbalances, genetic factors, insulin resistance, and environmental influences. Managing PCOS effectively requires a comprehensive approach and often involves lifestyle changes, medical interventions, and nutritional and exercise support.