Polycystic Ovary Syndrome (PCOS)

The exact cause of polycystic ovary syndrome (PCOS) is not known, although it is likely to be the result of both genetic and environmental factors.

How do cysts in PCOS form?

Sometimes, it may be difficult to distinguish the difference between PCOS and ovarian cysts because these are related conditions with similar symptoms. If you have ovarian cysts, the only determinant is if you experience pain in the pelvic area, as most women with PCOS do not experience this.

You may have PCOS without ovarian cysts, or you may develop cysts caused by other reasons. If cysts formed in PCOS, it can be due to eggs not being set free for some time. The follicles scattered throughout the ovary, forming multiple cysts.

Symptoms of polycystic ovary syndrome include:

• Acne (spots), excess hair growth on the body, thinning of the hair on the head (male-pattern hair loss), decreased breast size, and deepening of the voice – these symptoms are related to the increased level of the male hormone androgen, which can lead to development of male sex characteristics
• Dandruff
• High blood pressure
• High cholesterol
• Increased insulin level
• Infertility
• Irregular menstrual periods – there may be irregular or no menstruation, or long phases of very light or very heavy menstruation
• Obesity and weight gain
• Oily skin

Polycystic ovary syndrome (PCOS) can be exceptionally tricky to diagnose, especially in adolescents and menopausal women who experience normal hormonal changes. Some of the symptoms of PCOS can also be seen in other conditions.

Your health care provider may ask you about your medical history and the signs and symptoms you are experiencing. You may undergo some tests to rule out the other causes of your symptoms. These tests include a physical examination, blood test, and an ultrasound.

For you to be diagnosed with PCOS, you need to have at least 3 of the following criteria:

• You have irregular menstrual periods (typically less than 6 periods per year)
• Your blood test result shows high levels of androgen
• You are experiencing symptoms associated with high levels of androgen, such as acne, excessive hair growth on your face or body, and male-pattern balding.
• Your ultrasound exam shows cysts on one or both ovaries

Treatment varies depending on which symptoms bother you most:

• Hormone treatment may be needed in addition to exercise and weight loss to achieve a normal menstrual cycle – the oral contraceptive pill may help to regulate menstruation
• In vitro fertilisation (IVF) may be needed if surgery does not successfully treat infertility
• Laparoscopic keyhole surgery on the polycystic ovaries may be needed if medication fails
• Medication to induce ovulation may be needed to treat infertility
• Some oral contraceptive pills can lower the male hormone levels to reduce facial hair, spots and thinning hair
• Weight loss, healthy diet, and exercise – a normal menstrual cycle may be achieved by exercising and losing weight. The chance of fertility returns with a normal menstrual cycle

Diet and lifestyle recommendations

Since your condition may increase your risk of developing certain diseases, it is imperative to consider changing your diet and lifestyle. Hormonal imbalances and problems with metabolism are some of the primary outcomes of having PCOS. For this reason, you need to focus on weight management and insulin production and resistance. Following a particular diet that meets your nutritional needs – healthy weight and normal insulin levels – will help make you feel better. 

Here are some food sources to consider including in your diet: 

High-fibre foods

• Spinach
• Green leafy vegetables
• Berries
• Pumpkins
• Sweet potatoes

Foods that can help reduce inflammation

• Spinach
• Tomatoes
• Olive oil

Foods that can lower high blood pressure

• Fish
• Poultry
• Whole grains
• Low-fat dairy products

Limit or avoid eating refined carbohydrates like white bread, sugary beverages, and desserts, and processed foods as it may worsen insulin resistance and may cause inflammation. Be conscious of your daily physical movements to manage your insulin resistance and high blood pressure. Activities like meditation and yoga can be helpful in managing your stress levels.

Always consult your doctor and nutritionist to learn more about your medical condition and treatment options before making any significant changes to your diet and lifestyle.

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If you are diagnosed with PCOS, it may increase your risk of developing other health conditions later. Thus, it is crucial to understand these long-term health risks fully.

Due to the disruption to hormones in PCOS, including insulin, you may be at risk for insulin resistance syndrome. Insulin is a hormone that is important for metabolising carbohydrates and maintaining blood sugar levels. As women with polycystic ovary syndrome are often resistant to insulin, which means there is an increased risk of developing type 2 diabetes, heart disease and stroke at a younger age.

Other complications may include:

• Elevated lipids and high cholesterol
• Hypertension or high blood pressure
• Mood swings and depression
• Obstructive sleep apnoea