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Writer's pictureAnushka Mahashabde

Women with PCOS- Surviving and struggling every day

Polycystic ovary syndrome or PCOS is a condition that affects hormone levels.


Introduction

Polycystic ovary syndrome or PCOS is a condition that affects hormone levels. Women with PCOS generate higher levels of male hormones which cause irregular periods. The ovaries develop small fluid-filled sacs called follicles and fail to release an egg for ovulation, leading to missed or irregular menstrual cycles. The lack of ovulation also alters the production of estrogen and progesterone, while the male hormone androgen is higher than usual. Symptoms of PCOS may differ from person to person and some may not experience them at all. There are three main features of PCOS:

  1. Cysts in ovaries

  2. Higher levels of male hormones

  3. Missed or irregular periods

The exact cause of PCOS is unknown but genetics and family history play an important role in the development of this disorder. It is likely to be caused by a combination of environmental and genetic factors.


Insulin resistance is the condition where the pancreas has to generate more of the hormone insulin in order to help glucose enter cells. This increases blood sugar levels. Insulin resistance is a key feature and a major driver of this condition. It affects ovulation which causes excess production of male hormones.


PCOS is virtually incurable, meaning it cannot go away. But, there are medicines and treatments to control it and reduce the symptoms. It is usually diagnosed by an ultrasound and a blood test to look for high levels of male hormones (androgens) and other hormones. Losing weight and lifestyle changes have been proven to reduce the symptoms and help the medications work better. Hormonal birth control and treatments are often prescribed by doctors to get the menstrual cycle back on track, clear acne and help with other symptoms of PCOS.


Symptoms and Effects of PCOS

Thickened endometrial lining

One of the most obvious symptoms of PCOS is an irregular menstrual cycle. Some may even experience an absence of a menstrual cycle called amenorrhea. Without ovulation, the uterine lining does not shed and becomes thickened. A thickened endometrial lining can have adverse effects like heavy and prolonged bleeding, bleeding between menstrual cycles and can also increase the risk of endometrial cancer.


Infertility

Lack of ovulation due to insulin resistance and production of male hormones is a significant symptom of PCOS. It interferes with the release of eggs and affects ovulation. Ovulation is required to get pregnant, and women with PCOS often don’t ovulate regularly. This may lead to problems with conceiving and even infertility.


Excess facial and body hair (hirsutism)

Excess facial hair is a symptom of PCOS that is caused by the production of abnormal levels of male hormones. This is can lead to anxiety, frustration and also body image and self-esteem issues.


Metabolic syndrome

This is a group of symptoms that increase the risk of cardiovascular diseases. These include high cholesterol levels, high blood pressure and high blood sugar levels. These symptoms increase the risk of diabetes and heart disease.


Weight gain

Women with PCOS are often affected by hormonal imbalance and problems with metabolism, which result in weight gain. It is also extremely difficult to lose weight in this condition due to insulin resistance, hormonal problems and inflammation. PCOS affects insulin and other hormones which leads to fat storage and increased appetite.


PCOS and Mental Health

PCOS and mental health are closely related to each other.


Depression

Women with PCOS are at a higher risk of depression, anxiety as well as OCD and eating disorders. The symptoms and effects of this disorder can be triggering for women with underlying mental health problems and may have a detrimental effect on overall health. The exact cause of this is unclear, but it could be due to hormonal imbalances and the bodily symptoms caused by PCOS.


Low self-esteem

PCOS causes excess facial hair (hirsutism) and weight gain, which can cause anxiety and frustration. Being overweight or obese only exacerbates the effects of PCOS and due to hormonal imbalance, it becomes extremely difficult to lose or maintain a healthy weight. Due to this, body image issues and low self-esteem may send women down unhealthy paths such as OCD, eating disorders or even exercise addiction.


Difficulties with conceiving

Infertility is the biggest risk factor involved with this disorder. The absence of ovulation makes it extremely difficult to conceive and get pregnant. Anxiety and stress that is caused by this may have an unhealthy effect on existing conditions as well as mental health. It is possible to use assisted reproductive techniques to conceive, but these methods can be emotionally, physically and financially draining.


The overall lack of control over their body like weight, hair growth and other things also acts as a factor in the stress caused by this disorder.


According to some studies, low levels of neurotransmitters like serotonin in the brain may play a role in depression and anxiety affecting women with PCOS.


Medication and Treatment

Most women find themselves lost after they are diagnosed with PCOS due to the lack of awareness of the medication and treatment for it. Some women are dismissed when they bring up concerns about their irregular menstruation, which can lead to harmful and life-threatening diseases. PCOS is virtually untreatable but that does not mean that there is no way to control it and live a healthy life.


Infertility is a huge risk in PCOS but with proper medication, it is possible to conceive and get pregnant. Losing weight and lowering blood sugar levels have been prescribed as a way to increase the chances of pregnancy. Moreover, fertility treatments are also suggested for a healthy pregnancy.


PCOS treatments start with basic lifestyle changes like a healthy diet and basic exercise to keep weight in check. Losing just 5-10% of body weight has been proven to be helpful in the management of symptoms. Hormonal birth control may be prescribed for regular menstrual cycles, clearing acne, reducing body hair and also decreasing the risk of endometrial cancer.

Talk therapy can be helpful in managing the mental health problems that may arise or exasperate due to symptoms of PCOS.


Conclusion

Living with PCOS is a struggle mentally as well as physically. The physical symptoms of weight gain, acne, facial hair and infertility are major contributors to mental health problems. Anxiety, depression and often body image issues, eating disorders and other behavioural issues affect daily life in a significant way. But, with a good support system and effective treatment, the symptoms and effects can be manageable. PCOS is a disorder that can be managed rather than being cured and treatment may vary from person to person. It is important to figure out a treatment plan that is comfortable and effective in the long run.


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