PCOS Overview and Pathophysiology

Polycystic Ovary Syndrome (PCOS)

• PCOS is a hormonal condition affecting women, causing higher-than-normal male hormone levels.
• This imbalance leads to skipped menstrual periods and difficulty getting pregnant.
• PCOS also causes increased hair growth on the face and body, as well as baldness.
• It can contribute to long-term health issues like heart disease.
• PCOS involves fluid-filled sacs (follicles) inside the ovaries.
• These sacs contain immature eggs, preventing ovulation.
• This disruption alters hormone levels (estrogen, progesterone, FSH, LH) and increases male hormone levels.
• Women with PCOS tend to have fewer periods than usual.

Pathophysiology of PCOS

• Doctors don't fully understand the causes of PCOS.
• High male hormone levels, genes, insulin resistance, and inflammation are believed to be linked to excess male hormone production in PCOS.
• Genetic factors may play a role in PCOS development (runs in families).

Insulin Resistance in PCOS

• Up to 70% of women with PCOS have insulin resistance.
• This means cells cannot properly utilize insulin.
• Insulin resistance causes the body to produce more insulin to compensate.
• Increased insulin triggers the ovaries to produce more male hormones.
• Obesity is a major cause of insulin resistance.
• Both obesity and insulin resistance increase the risk of type 2 diabetes.

PCOS Symptoms

• Irregular Periods: Fewer than eight periods a year and unpredictable bleeding cycles are common.
• Heavy Bleeding: Periods with heavier flow than normal are sometimes seen.
• Hair Growth: More than 70% of women with PCOS experience increased hair growth on their face, body (hirsutism), back, belly, chest.
• Acne: Increased oil production and breakouts are common, particularly on the face, chest, and upper back.
• Weight Gain: PCOS is often linked to weight gain, with approximately 80% of women with the condition overweight or obese.
• Male-pattern Baldness: Hair thinning or loss on the scalp.
• Skin Changes: Darkening of skin in body folds (neck, groin, under breasts).
• Headaches: Hormone changes can trigger headaches.

PCOS and Fertility

• Ovulation is necessary for pregnancy.
• Women with PCOS often don't ovulate regularly. This significantly impacts fertility.
• This is one of the leading causes of infertility in women.

PCOS and Metabolic Syndrome

• Up to 80% of women with PCOS are overweight or obese.
• PCOS increases the risk of high blood sugar, high blood pressure, low "good" cholesterol (HDL), and high "bad" cholesterol (LDL).
• These conditions create a metabolic syndrome, further raising the risk of heart disease, diabetes and stoke.

PCOS and Sleep Apnea

• Sleep apnea, which causes repeated pauses in breathing, is more common in obese women who also have PCOS.
• The risk is 5-10 times higher in women with PCOS.

PCOS and Endometrial Cancer

• Irregular ovulation can lead to uterine lining thickening.
• A thickened uterine lining increases endometrial cancer risk.

Diagnosis of PCOS

• Doctors typically diagnose PCOS in women showing at least two of these three symptoms:
  • High androgen levels
  • Irregular menstrual cycles
  • Cysts in the ovaries

PCOS Management

• Treatment often starts with lifestyle changes focusing on diet, exercise, and weight loss.
• Losing 5-10% body weight can improve menstrual regularity, insulin levels, and cholesterol.
• Low glycemic index (low-GI) diets emphasizing fruits, vegetables, and whole grains may help regulate menstrual cycles more effectively.
• Medical treatments (birth control pills, metformin, anti-androgens) help manage specific symptoms.

Explore the complexities of Polycystic Ovary Syndrome (PCOS) in this quiz. Learn about its hormonal imbalances, symptoms, and potential long-term health effects. Understand how genetics and insulin resistance may influence the condition's development.