PCOS

PCOS often causes depression. What is PCOS ?

Polycystic ovary syndrome (say “pah-lee-SIS-tik OH-vuh-ree SIN-drohm”) is a problem in which a woman’s hormones are out of balance. It can cause problems with your periods and make it difficult to get pregnant. PCOS may also cause unwanted changes in the way you look. If it is not treated, over time it can lead to serious health problems, such as diabetes and heart disease.

Polycystic ovary syndrome (or PCOS) is common, affecting as many as 1 in 15 women. Often the symptoms begin in the teen years. Treatment can help control the symptoms and prevent long-term problems.


What are the symptoms?

Symptoms tend to be mild at first. You may have only a few symptoms or a lot of them. The most common symptoms are:

  • Acne.
  • Weight gain and trouble losing weight.
  • Extra hair on the face and body. Often women get thicker and darker facial hair and more hair on the chest, belly, and back.
  • Thinning hair on the scalp.
  • Irregular periods. Often women with PCOS have fewer than nine periods a year. Some women have no periods. Others have very heavy bleeding.
  • Fertility problems. Many women with PCOS have trouble getting pregnant (infertility).
  • Depression.

Most women with PCOS grow many small cysts on their ovaries. That is why it is called polycystic ovary syndrome. The cysts are not harmful, but lead to hormone imbalances.


How is PCOS diagnosed?

To diagnose PCOS, the doctor will:

  • Ask questions about your past health, symptoms, and menstrual cycles.
  • Do a physical exam to look for signs of PCOS, such as extra body hair and high blood pressure. The doctor will also check your height and weight to see if you have a healthy body mass index (BMI).
  • Do a number of lab tests to check your blood sugar, insulin, and other hormone levels. Hormone tests can help rule out thyroid or other gland problems that could cause similar symptoms.

You may also have a pelvic ultrasound to look for cysts on your ovaries. Your doctor may be able to tell you that you have PCOS without an ultrasound, but this test will help him or her rule out other problems.

BMI :

Body mass index (BMI) is a number based on a person's weight and height that provides a way to estimate the effect of weight on health. The higher the BMI, the greater the risk of some diseases, including high blood pressure, coronary artery disease, stroke, osteoarthritis, some cancers, and type 2 diabetes.

To calculate exact BMI, one of the following equations is used:

  • The person's weight in pounds and height in inches: BMI = (pounds x 700) divided by (inches squared)
  • The person's weight in kilograms and height in meters: BMI = kilograms divided by (meters squared)
Menstrual cycle:

The menstrual cycle is the female body's monthly pattern of preparing for a possible pregnancy. The uterus grows a new lining called the endometrium; one of the ovaries releases an egg; and then, if the egg is not fertilized by sperm, the endometrium sheds from the uterus as a menstrual period.

  • Menstrual phase (period).The thickened lining of the uterus (endometrium) is shed, causing menstrual bleeding. Day 1 of the cycle is the first day of menstrual bleeding. Bleeding usually lasts for 4 to 6 days.
  • Follicular phase.The lining of the uterus thickens to prepare for pregnancy. Also, inside a sac (follicle) on the surface of an ovary, an egg becomes ready to be released.
  • Luteal phase.The egg is released (ovulation). Women's ovulation days can range from about day 7 to day 22 of the cycle. But for an individual woman, the ovulation day is usually quite consistent.
    • If the egg is fertilized by sperm, it may attach to (implant in) the lining of the uterus, and pregnancy begins.
    • If the egg is not fertilized or does not implant, the lining of the uterus is shed during the menstrual period, and the cycle starts again.

There is a broad range of "normal" among menstruating women. The average cycle takes 28 days, but 21 to 35 days is considered normal for women in their 20s and 30s. Unpredictable or long menstrual cycles are normal for teenagers and women in their 40s. For teens, normal cycles can be as short as 21 days or as long as 45 days. If you are a teen, you can expect cycles to even out over time. If you are nearing the age of menopause, you can expect menstrual cycles to become longer and eventually to stop.

Blood pressure

High blood pressure, or hypertension, is a condition in which the force of blood against artery walls is too strong. Over time, high blood pressure can damage the arteries, heart, and kidneys and can lead to heart disease and stroke.

High blood pressure can be treated effectively with lifestyle changes and medications that can reduce the risk of complications.

Blood pressure readings consist of an upper number and a lower number (such as 120 over 90 or 120/90). The upper number is systolic blood pressure; the lower number is diastolic blood pressure. Blood pressure readings are measured in units called millimeters of mercury (mm Hg). Normal blood pressure is 119 mm Hg systolic over 79 mm Hg diastolic or below.

A person has high blood pressure (hypertension) when either or both of the following are present:

  • The top number (systolic) is 140 mm Hg or higher.
  • The bottom number (diastolic) is 90 mm Hg or higher.
Treatment

Regular exercise, healthy foods, and weight control are key treatments for PCOS. Medicines to balance hormones may also be used. Getting treatment can reduce unpleasant symptoms and help prevent long-term health problems.

The first step in managing PCOS is to get regular exercise and eat heart-healthy foods. This can help lower blood pressure and cholesterol and reduce the risk of diabetes and heart disease. It can also help you lose weight if you need to.

  • Try to fit in moderate activity and/or vigorous activity on a regular basis. Walking is a great exercise that most people can do.
  • Eat a heart-healthy diet. In general, this diet has lots of vegetables, fruits, nuts, beans, and whole grains. It also limits foods that are high in saturated fat, such as meats, cheeses, and fried foods. If you have blood sugar problems, try to eat about the same amount of carbohydrate at each meal. A registered dietitian can help you make a meal plan.
  • Most women with PCOS can benefit from losing weight. Even losing 10 lb (4.5 kg) may help get your hormones in balance and regulate your menstrual cycle. PCOS can make it hard to lose weight, so work with your doctor to make a plan that can help you succeed.
  • If you smoke, consider quitting. Women who smoke have higher androgen levels that may contribute to PCOS symptoms.1 Smoking also increases the risk for heart disease.

A doctor may also prescribe medicines, such as:

  • Birth control pills. They can help your periods be regular and can reduce symptoms such as excess facial hair and acne. An androgen-lowering medicine, spironolactone, may be used with birth control pills to help reduce symptoms even more. These medicines are not used if you are trying to get pregnant.
  • A diabetes medicine called metformin. It can help control insulin and blood sugar levels and reduce androgen levels. This lowers your risk for diabetes and heart disease and can help restore regular menstrual cycles and fertility.
  • Fertility medicines, if you are trying to get pregnant.

It is important to see your doctor for follow-up to make sure treatment is working and adjust it if needed. You may also need regular tests to check for diabetes, high blood pressure, and other possible problems.

It may take a while for treatments to help with symptoms such as facial hair or acne. In the meantime:

  • Over-the-counter or prescription acne medicines may help with skin problems.
  • Waxing, tweezing, and shaving are easy ways to get rid of unwanted hair. Electrolysis or laser treatments can permanently remove the hair but are more expensive. Your doctor can also prescribe a skin cream that slows hair growth for as long as you use it regularly.

It can be hard to deal with having PCOS. If you are feeling sad or depressed, it may help to talk to a counselor or to other women who have PCOS. Ask your doctor about local support groups, or look for an online group. It can make a big difference to know that you are not alone.


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