ABOUT POLYCYSTIC OVARY SYNDROME (PCOS)
As an infertility specialist, it surprises me that many infertilities Doctors in India talk and share literature about Polycystic Ovaries & PCOS which is not factual. Even the internet is flooded with misleading myths about PCOS Syndrome without any evidence-based conclusion. As a consequence, most women have alarming misinformation about Polycystic Ovaries, causes of PCOS, diagnosis, symptoms and of course PCOS treatment. All in all, misguided information about Polycystic Ovaries has raised fear, stress and anxiety among women. As an infertility Doctor, I thought it is important to share meaningful and factual information about PCOS so that words “Polycystic Ovaries” do not earn a Life threating status that is currently being made out.
WHAT ARE POLYCYSTIC OVARIES (PCO)?
Every woman has Ovaries and they ovulate during her reproductive age. During ovulation, follicles are formed inside the ovaries which contain very microscopic Egg’s. In a normal ovulation scenario, usually (2-5) Follicles are formed which can grow up to 30 Millimetre in Diameter depending upon the stage of menstrual cycle. However, in a PCO situation about 12 or more of small sized follicles are formed inside the ovaries. This excessive formation of follicles is also now known as “Pearl Necklace Pattern” or Polycystic Ovaries. Read FAQs About PCOS.
PCO VS PCOS
PCO VS PCOS, they are not the same. It is important to note that if a woman has Polycystic Ovaries, it does not mean that she is suffering from PCOS. About 25% of women are known to have polycystic ovaries but only a handful may exhibit symptoms of PCOS.
PCOS is an ovarian dysfunction syndrome wherein the ovaries start producing an excess of male hormones along with appearance of Polycystic Ovaries. Excess of Male Hormones can be measured through a Blood test but a common physical indicator is the presence of excessive physical hair. One must note that Excess of Male Hormones called androgen can also be caused by the adrenal gland producing excessive levels of the male hormones, rather than by PCOS.
The following equation describes what is PCOS.
PCOS = Male Hormone Excess + Polycystic Ovaries
One can read more details about the above simplified explanation at Rotterdam ESHRE/ASRM Sponsored Consensus PCOS Workshop Group, 2004.
WHAT IS MALE HORMONE EXCESS?
There are two categories of Sex Hormones.
- Female Hormones: Oestrogen& Progesterone.
- Male Hormones: Androgens.
Every Human Being produces the above two Hormones and it is only the amount of Hormone levels that differs between a Male and a Female. Women need male hormones such as testosterone for normal functioning of menstrual cycles. However, a small percentage of free testosterone is dissolved in bloodstream and is basically biologically active. Women with PCOS tend to have higher blood levels of free testosterone than women with normal ovaries leading to skin problems like acne as excessive body hair. Read top 10 things about PCOS one must know.
POLYCYSTIC OVARIES DOES NOT MEAN INFERTILITY
Women with Polycystic Ovaries are able to conceive naturally if they have menstrual cycles every (4-8) Weeks. Women with Polycystic Ovaries who are unable to conceive must visit an infertility specialist to check for other female infertility issues like Block Fallopian tubes or male infertility factors related to sperm Count and/or sperm motility.
PCOS SYMPTOMS
Symptoms of Polycystic Ovary Syndrome (PCOS) include irregular menstrual periods, heavy or prolonged periods, excessive hair growth on the face, chest, stomach, thumbs, or toes, acne, weight gain, and difficulty getting pregnant. Other symptoms may include darkening of the skin, particularly around the neck, groin, and under the breasts, and skin tags in those areas. Some women with PCOS may also experience depression, anxiety, and sleep disorders. It’s important to note that not all women with PCOS experience all of these symptoms and that each woman’s experience with PCOS is unique.
POLYCYSTIC OVARIES DIAGNOSIS
Below are the following 3 Methods for diagnosing the presence of Polycystic Ovaries-
- Vaginal Ultrasound-
A Vaginal Ultrasound is the simplest way to diagnose the presence of Polycystic Ovaries. In this painless procedure, an ultrasound probe measuring about 1 Inch in width, coated with a lubricating gel is gently inserted into the vagina of a woman. The vaginal probe is placed onto the wall next to the ovary and it captures high-quality images of the Ovaries. Vaginal Ultrasound is not recommended for sexually inactive women as it can tear the hymen. Although it is still a painless process, it can cause bleeding as is the case during first time intercourse. For Married and/or sexually active women, Vaginal Ultrasound is the simplest way to detect the presence of Polycystic Ovaries.
- Abdominal Ultrasound-
An abdominal ultrasound is an imaging ultrasound test that uses sound waves to see the inside of an abdomen. An abdominal ultrasound is an industry accepted benchmark to check for Gall Bladder, Intestines, Liver, Pancreas, Kidney stones, Tumours, Blood vessels Blockages and Ovaries. A woman undergoing an abdominal ultrasound has to have a full Bladder and the ultrasound is done on the lower abdomen area, ideally one needs to avoid food and drinks for 8 hours before an abdominal ultrasound as it helps prevent the presence of gas in the abdomen, which can affect the results.
- Laparoscopy-
Polycystic Ovaries can also be investigated through laparoscopy, although it is recommended only in select exceptional cases. Laparoscopy is a minimal invasive procedure done under general anaesthesia to insert a small telescope to investigate the uterus, fallopian tubes and the Ovaries. Laparoscopy is typically done to investigate abnormalities in the fallopian tubes, ovaries or uterus to assess unexplained causes of infertility. It is generally the last advised technique to diagnose polycystic Ovaries but it provides a very clear 3-Dimensional view of the Ovaries.
Globally acclaimed Dr Mona Dahiya, one of the Best IVF Doctor and an expert on Polycystic Ovaries Treatment shares her priceless view to some the common Questions that patients usually have.
