Commonly Asked Questions About PCOS

Q: What are the First Signs of PCOS?

The first signs of Polycystic Ovary Syndrome (PCOS) are-

  1. Irregular periods
  2. Acne
  3. Excess hair growth
  4. Weight gain
  5. Difficulty getting pregnant

These symptoms are caused by a hormonal imbalance in the body, which can lead to the growth of small cysts on the ovaries. It’s important to note that not all women with PCOS will have all of these symptoms, and some women may have no symptoms at all. If you suspect you may have PCOS, it is important to see a healthcare provider for a proper diagnosis.

Q: Can PCOS Cause Weight Gain?

Yes, PCOS women have a higher tendency to gain weight because of the associated hormonal imbalance. They also find it more difficult to lose weight.

Insulin resistance is a major cause of this obesity. The body has difficulty in keeping the blood sugar under check and therefore, produces more insulin to do so. Over time, the insulin levels are high and this contributes to the weight gain as insulin promotes fat storage mostly around your belly. Also, whenever there is increase in the weight, the symptoms of PCOS become worse. Thus, it is a vicious cycle. More than half of PCOS women are obsessed.

However, with regular exercise and eating healthy meals, it is very much possible to lose weight which also improves the symptoms of PCOS.

Q: What is Best PCOS Diet Plan?

One of the most common questions asked by PCOS patients is about diet. Diet and exercise play a significant role in treatment of PCOS. A healthy PCOS diet consists of the following

  1. Healthy natural unprocessed foods like whole grains, nuts, fresh fruits and vegetables
  2. High fibre foods like spinach, apples, broccoli
  3. Green leafy vegetables like spinach, kale, asparagus, sarson
  4. Fruits like apple, orange, raspberries, blueberries, cherries
  5. Whole grains like bajra, jowar, ragi, millets
  6. Fish like tuna, salmon
  7. Healthy fats like olive oil, coconut oil
  8. Nuts like walnuts, almonds and apricots

The aim is to choose such food items which do not cause a rapid rise in blood sugar levels. Such foods are said to have low GI Index. Drinks like aloe vera juice, green tea, apple cider vinegar and ginger lemon water are good for PCOS.

Q: Can PCOS Cause Cancer?

No, Polycystic ovaries are not cancers. The association between polycystic ovaries and breast and ovarian cancer is uncertain. However, PCOS is associated with 2.5-fold increased risk of Endometrial cancer. In PCOS, there is hormonal imbalance and anovulation. this leads to chronic exposure to the unopposed action of estrogen. This may cause endometrial hyperplasia and endometrial cancer later on in life.

However, with proper medication and treatment and regular follow ups, cancer is not a cause for concern in PCOS.

Q: What Happens if Polycystic Ovaries Left Untreated?

Polycystic ovaries are not life threatening. PCOS is a metabolic disease and with proper treatment it can be kept under control. However, if the symptoms and hormonal imbalance is not controlled, it may lead to long term complications.

Uncontrolled PCOS may lead to deranged blood sugar levels and development of Diabetes Mellitus. PCOS also leads to impairment in lipid levels. This leads to atherosclerosis and cardiovascular or heart disease and high blood pressure later on in life.

Because PCOS patients have anovulation and there is unopposed estrogen hormone in the body, the uterine lining becomes thickened. It may lead to development of uterine cancer.

However, with proper diet and exercise and treatment with medications, all these hormonal imbalances and metabolic impairment can be controlled and PCOS patients can lead a healthy life.

Q: Is Polycystic Ovaries Normal?

Polycystic ovaries is a very common condition. When ultrasound is done in the general population, as many as 20-22% of ladies may have polycystic ovaries but no other associated symptoms.

 However, there is another subset of women who have polycystic ovaries on ultrasound and also have other symptoms like irregular menstrual cycles, acne, facial hair or infertility. This is known as polycystic ovarian syndrome or PCOS. It is seen in 6-12%of young women. Teenage girls who have irregular menstrual cycles, acne excess facial and body hair should be screened for PCOS by hormonal tests and ultrasound.

Q: Do Polycystic Ovaries Get Worse With Age?

Certain features of PCOS get worse with age however few symptoms of PCOS may improve with age. As a PCOS woman grows older, the testosterone levels decline and so the menstrual cycles may become regular. However, the elevated insulin levels may cause development of type 2 Diabetes and cardiovascular disease. As women enter menopause, abdominal obesity or belly fat, dyslipidaemia, increase in LDL levels and increased insulin resistance is seen. Such changes are also experienced by PCOS women. Because the PCOS woman has been exposed for a longer number of years to insulin resistance and dyslipedimia therefore, some studies show increased risk of metabolic abnormalities and heart disease and diabetes in PCOS women.

Q: Can Polycystic Ovaries Cause Pain?

No, polycystic ovaries are never a cause of pain. It is important to understand that the “cysts “in polycystic ovaries are not actually cysts. They are simply antral follicles. When a child is born, she has many potential eggs at birth nearly one million. But these are not visible to the naked eye and 99 percent of these potential eggs never mature and simply disintegrate. Only few of these progresses further and develop a very very minute cavity called “antrum” and thus are called antral follicles. They can now be seen on ultrasound. The size of these antral follicles is very small is around 2-9mm. These antral follicles have the potential to develop into mature egg. However, not all antral follicles grow and release eggs. In one menstrual cycle, only one follicle grows to become the dominant follicle.

In a normal ovary, there are 8-10 antral follicles (AFC-Antral Follicle Count). But in PCOS the AFC count is more than 12 per ovary.

Several studies later have revealed that the AFC count may be as high as 25 or more in PCOS. However, these antral follicles are not large cysts and the term “polycystic” is misunderstood.

The antral follicles referred to as “cysts” are less than 10mm and are not painful at all.

Q: Can Polycystic Ovaries be Seen on Ultrasound?

Yes, polycystic ovaries can be seen on ultrasound. Polycystic ovaries are characterized by bulky ovaries which have an increased ovarian volume more than 10ml. They have the presence of many antral follicles (more than 12). These antral follicles are very tiny around 2-9mm in size and have a miniscule cavity. On ultrasound they appear as tiny black dots in the ovary. The arrangement of these follicles also follows a characteristic pattern. Usually, follicles are arranged in the periphery of the ovary all around and give the appearance of “STRING OF PEARLS“ pattern.

Q: Can Polycystic Ovaries Burst?

No, polycystic ovaries never burst. As already explained, the “cysts” in polycystic ovaries are not truly cysts but are small antral follicles. They measure only 2-9mm and have a very small cavity called antrum. Therefore, these only cause hormonal imbalance and are otherwise harmless and never rupture. The risk of rupture is only with larger ovarian cysts. The larger the cyst, usually more than 8-10cm, the more the risk for rupture.

Q: Should I be Worried About Polycystic Ovaries?

The incidence of PCOS is around 5-10 percent in young females. It is a common hormonal disorder with metabolic side effects. However, with a combined holistic approach of healthy life style modifications and medicines. it can be controlled. It is not a life-threatening condition and should not be a cause for worry and stress, since it is known that worry and stress are factors that worsen the symptoms of PCOS.

Therefore, whenever there are symptoms like irregular periods, excessive hair growth on face, acne tests should be done. These include blood tests and an ultrasound. Once the diagnosis of PCOS is made, medicines are started along with dietary changes and regular exercise to keep the symptoms under check. Thus, with timely diagnosis, treatment is possible and there is no cause for concern.

    Dr Mona Dahiya

    Dr Mona Dahiya

    IVF Specialist & Consultant

    Dr Mona Dahiya has performed over 5,000+ IVF cycles and is considered a global expert in IVF, ICSI, IUI and male fertility treatment. She is an eminent writer on Infertility Treatment and has over 100 Publications in both International and National Journals. Dr Mona Dahiya has immensely contributed to the field of infertility through her Research and articles.

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