What is Polycystic Ovary Syndrome (PCOS), Its Symptoms, and Treatment

Polycystic ovary syndrome is a common health issue that affects women of reproductive age. The underlying cause of the syndrome may involve hormonal changes. Androgen hormones, which are typically associated with males, are present in women at certain levels. However, excessive production of these hormones can lead to various disorders. As a result, PCOS can manifest as disruptions in the menstrual cycle, changes in the skin and hair, and the formation of cysts in the ovaries. Although the primary cause of PCOS is still unknown, it is one of the most common causes of infertility. Additionally, there are several risk factors that may predispose individuals to the development of polycystic ovary syndrome. Family history, lifestyle habits, and certain medical conditions can trigger the development of PCOS. If not diagnosed early and treated, polycystic ovary syndrome can lead to long-term complications such as cardiovascular diseases and type 2 diabetes.

What is Polycystic Ovary Syndrome (PCOS)?

Polycystic ovary syndrome, known as PCOS, is a health issue characterized by the excessive production of androgen hormones by the ovaries, which are the female reproductive organs. Androgen hormones are male hormones, and their excessive production in the ovaries can lead to a number of negative outcomes. This hormonal imbalance can frequently lead to reproductive, metabolic, and psychological disorders in women. These disorders may include infertility, hyperandrogenism, insulin resistance and diabetes, cardiovascular diseases, depression, and anxiety.

PCOS can occur at any time after puberty in women. Most women with polycystic ovary syndrome may not be aware of their condition. The risk of developing PCOS may be higher, particularly in those with a family history of the syndrome and in cases of obesity. It often presents itself as irregular menstrual cycles. Additionally, ovarian cysts may be observed in patients with PCOS. However, these symptoms may not always be present.

What are the Causes of Polycystic Ovary Syndrome?

While the exact cause of polycystic ovary syndrome is not known, it can be said that several factors play a role in the development of the disease. Possible contributing factors to the formation of PCOS may include:

• Excess androgen hormone levels: The excessive production of androgen hormones from the ovaries can prevent the development of egg cells and their release from follicles. In this case, ovulation cannot occur. Additionally, high levels of male hormones can lead to hirsutism (excessive hair growth) and acne.
• Insulin resistance: Increased levels of insulin hormone secreted by the pancreas can lead to the excessive production of androgens. As a result, high androgen levels can suppress ovulation. Insulin resistance can cause the body to fail to utilize glucose, leading to elevated blood sugar levels.
• Low-grade inflammation: Leukocytes produce substances in response to injury, trauma, or infection, which is referred to as low-grade inflammation. Individuals with PCOS may have a tendency toward low-grade inflammation.
• Genetics: A family history of PCOS can be a risk factor.

Additionally, environmental factors such as poor nutrition, physical inactivity, and toxins may also play a role in the development of PCOS.

Who is Affected by Polycystic Ovary Syndrome?

Certain risk factors may play a role in the development of polycystic ovary syndrome. PCOS is commonly seen in women of reproductive age. A family history of PCOS in mothers or sisters can increase the risk of developing PCOS in an individual. Furthermore, insulin resistance, characterized by the excessive production of insulin, may provide a foundation for the development of PCOS. Obesity, which can contribute to insulin resistance, may be a risk factor for polycystic ovary syndrome. Therefore, poor nutrition and lack of physical activity can lead to obesity, insulin resistance, and the development of PCOS.

Long-term and low-grade infections may lead to an increase in androgen hormones in the female body. During this process, high levels of androgens and the prevention of ovulation can be observed. Women exposed to environmental toxins may experience hormonal changes, which can affect androgen hormones.

What are the Symptoms of Polycystic Ovary Syndrome?

The symptoms of polycystic ovary syndrome (PCOS) can be obvious or may go unnoticed. However, commonly observed signs and symptoms in PCOS cases may include:

• Irregular menstruation: This may include delayed periods, periods that occur very frequently or infrequently, unpredictable menstrual bleeding, and pain. In some women, it may also manifest as the absence of menstruation.
• Hirsutism (excessive hair growth): This refers to excessive hair growth on the face, chest, abdomen, arms, and thighs.
• Obesity: This may be observed in approximately 40-80% of individuals with PCOS.
• Oily skin, acne, or pimples.
• Acanthosis nigricans: This presents as dark, velvety patches of skin in areas such as the neck, armpits, groin, and under the breasts.
• Hair loss: Individuals with PCOS may experience thinning hair and hair loss.
• Cysts: There may be numerous and large follicular cysts formed in the ovaries.
• Infertility: The prevention of ovulation can hinder pregnancy. This is the most common symptom observed in PCOS cases.

Additionally, increased appetite and weight gain may also be among the symptoms.

How is Polycystic Ovary Syndrome Diagnosed?

The diagnosis of polycystic ovary syndrome can be complex or difficult. The criteria typically used to diagnose PCOS include:

• Having irregular, heavy, long, or short menstrual periods.
• High androgen levels that cause excessive hair growth, male-pattern baldness, and acne.
• Numerous cysts and enlarged ovaries observed through ultrasound.

A diagnosis of PCOS is made if at least two of these criteria are met. However, cysts may not be observed in every patient with PCOS. In this context, several checks may be necessary to confirm the diagnosis of polycystic ovary syndrome, including:

• Measurement of BMI and blood pressure.
• Medical history and medication use.
• Family history.
• Physical examination for hair loss, excessive hair growth, dark skin patches, and acne.
• Blood tests to check blood sugar and hormone levels.
• Pelvic ultrasound for imaging the ovaries.

Treatment of Polycystic Ovary Syndrome

The treatment methods for individuals with PCOS can vary depending on whether they wish to become pregnant or not. Generally, lifestyle changes, medications, and other treatments can be recommended either alone or in combination. The treatment methods for PCOS patients who do not plan for pregnancy may include:

• Birth control methods: Birth control pills, injections, and intrauterine devices can be used to regulate the menstrual cycle. These methods can help prevent excessive hair growth and acne.
• Medications that block androgens: These can be used to inhibit the action of androgen hormones released by the ovaries. They can help prevent acne and excessive hair growth.
• Insulin sensitizers: Medications like metformin, used in diabetes treatment, can assist the body in utilizing insulin. Improving insulin resistance may help regularize menstrual cycles.
• Dietary therapy: Dietary interventions can be applied to prevent obesity, maintain body weight, and improve insulin resistance.

For PCOS patients planning pregnancy, recommended treatment methods may include:

• Medications that promote ovulation: Oral or injectable medications such as clomiphene, letrozole, and gonadotropins can help induce ovulation.
• Surgery: This rarely preferred method involves the removal of tissues that produce androgen hormones from the body.
• In vitro fertilization (IVF): This involves the fertilization of an egg and sperm in a laboratory environment when ovulation cannot be achieved through other treatments.

How Should Nutrition Be in Polycystic Ovary Syndrome?

Polycystic ovary syndrome (PCOS) is a health issue that can develop in parallel with inflammation, insulin resistance, and obesity. In this context, it may be necessary to limit or eliminate the consumption of certain foods. It is recommended to avoid foods that can trigger inflammation, lead to cardiovascular diseases, cause insulin resistance, and contribute to obesity in cases of PCOS. These foods may include:

• Fried foods and those containing trans fats (potato chips, corn chips, fried chicken and fish, French fries, etc.)
• Foods high in saturated fats such as butter and margarine
• Processed and packaged foods
• Sugary drinks like sodas
• Granola, oatmeal, and breakfast cereals with high sugar content
• Foods made with white bread, white rice, pasta, and refined flour

Commonly preferred foods to alleviate obesity, insulin resistance, and inflammation may include:

• Low-glycemic index fruits (blueberries, blackberries, raspberries, strawberries, melons, cherries, plums, apricots, oranges, mandarins, etc.)
• Non-starchy vegetables (broccoli, Brussels sprouts, artichokes, asparagus, cabbage, cauliflower, cucumbers, tomatoes, spinach, eggplant, mushrooms, onions, peppers, leafy greens, zucchini, etc.)
• Small amounts of low-fat milk and dairy products
• Fish rich in omega-3 fatty acids
• Small amounts of red meat and poultry (chicken, turkey, etc.)
• Pumpkin and sunflower seeds, almonds, walnuts, sesame, and poppy seeds
• Whole grain products and legumes.

In addition to dietary therapy, physical activity may be recommended.

Polycystic Ovary Syndrome and Pregnancy

Pregnancy is possible in the presence of polycystic ovary syndrome. However, PCOS can lead to several complications during or after pregnancy. Generally, women with PCOS can conceive without requiring treatment, but in some cases, pregnancy can be challenging. Complications of pregnancy that can arise from PCOS may include:

• Miscarriage
• Gestational diabetes (pregnancy diabetes)
• Preeclampsia (pregnancy poisoning)
• Preterm birth
• Cesarean delivery
• High blood pressure caused by pregnancy

PCOS can have negative effects on both maternal and fetal health. However, it does not always pose a danger. With early diagnosis and treatment of PCOS, the pregnancy process can be managed more easily.

If you suspect you have PCOS and experience related symptoms, please contact a relevant healthcare institution for early diagnosis and treatment options.