Why does one get PCOS? Breaking down the causes

Polycystic Ovary Syndrome or PCOS affects women who are in their reproductive years. It is a hormonal disorder where a woman experiences irregular menstrual cycles. In women, ovaries are responsible for the release of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) that help in the development of eggs and their timely release. This balance is disturbed in the case of PCOS wherein the ovaries release an excess of the male hormone androgen. This triggers the growth of fluid-filled follicles in the ovaries known as “cysts”. Each one of these cysts contains an immature egg that does not get released during ovulation. 

What exactly leads to PCOS is still not certain; however, early diagnosis of the condition may help the affected woman and prevent long-term illnesses such as type-2 diabetes and other heart ailments from occurring. 

Symptoms of PCOS

Most women start experiencing the symptoms of PCOS right from their first period. While in others, PCOS can be triggered at a later age by sudden weight gain. PCOS symptoms vary from woman to woman. Most common ones are: 

• Irregular menstrual cycles – Due to the absence of ovulation, a woman’s menstrual cycle gets disturbed. The cycle becomes infrequent; that is, some women get less than 8 periods a year. In extreme cases, women suffering from PCOS might stop having periods altogether. 
• Heavy flow – Since the uterine lining remains in existence for a longer duration, between two cycles, women experience heavy flow whenever the periods occur. 
• Excess hair growth – Over 70% of women affected with PCOS develop a condition called “Hirsutism” wherein they experience excessive hair growth on the face, chin, back, and other parts of the body. 
• Weight gain – 80% of women with PCOS are overweight or obese. 
• Acne – Excess male hormone causes acne on the face, chest, and upper back. 
• Hair thinning – Male pattern baldness or thinning of hair on the scalp. 
• Dark skin patches – Skin becomes dark in areas around the neck, groin, and under the breasts. 

What are the causes of PCOS?

Although medical science is yet to find the exact cause of PCOS, there is a common consensus that the following factors play an important role:

1. High Insulin Resistance – Every time you eat food, your body releases a hormone called insulin. The hormone is responsible for the movement of glucose inside the body and into the cells where it is broken down further to release energy. In a woman affected by PCOS, this system is challenged. It is found that PCOS increases the body’s resistance to insulin, causing an imbalance in blood glucose level.

   To compensate for the resistance, the pancreas releases more and more insulin to maintain the glucose level. The extra insulin released in the body causes ovaries to release more male hormone, thus, altering and interfering with the rhythm of the menstrual cycle. 

   Insulin resistance further worsens the PCOS condition by triggering weight gain. Extra weight causes the body to produce even more insulin, thus, making it a cyclical event. The high resistance to insulin in women, coupled with obesity, can lead to type-2 diabetes. 
2. Hormonal Imbalance – PCOS is often triggered by a disbalance in the woman’s hormonal ecosystem. Women with PCOS have been observed to have:
   • Increased androgen – Androgens are produced in a small amount in every woman. However, women with PCOS have unusually high-level androgens in their bodies that prevent egg follicles from maturing and cause acne, hair growth, etc. 
   • High level of Luteinising Hormone – Responsible for activating ovulation, the hormones high level might affect ovaries abnormally. 
   • Low amount of Sex Hormone Binding Globulin (SHBG) – This is a protein molecule that binds itself to androgen reducing their effects in women. Their low amount means there is more androgen in the bloodstream.
   • High Prolactin Level – Few women suffering from PCOS have been found to have high levels of prolactin – a hormone that induces production of milk during pregnancy. 

     The exact reason behind this irregularity in hormone levels has not been ascertained yet. Though, some believe that it may again be due to increased resistance of the body to insulin.

3. Genetics – Some studies have suggested and linked the occurrence of PCOS to a person’s genetics. In research done at the University of Alabama, Birmingham, it was found that over 24% of women with PCOS reported that their mothers too suffered from the condition and about 32% had a sister. Researchers and scientists have not yet been able to identify a single gene responsible for PCOS. A wide variety of symptoms expressed in the condition suggest that there are several genes involved that cause hormonal imbalance and resistance to insulin.

Treatments

There is no special treatment that is administered to tackle the PCOS condition. Its treatment depends on specific symptoms, age, and individual concerns. The main treatment options are:

1. Modification in Lifestyle – Since the symptoms are exacerbated in women who are overweight or obese, even a modest loss in body weight will lead to a significant improvement in PCOS. It might also help in increasing the effectiveness of the medication recommended by the doctor. 
2. Medications – Depending on the symptoms, there are several medicines administered for PCOS: 
   1. A combination of birth control pills to regulate estrogen production and reduce the levels of androgen
   2. Taking progestin pills for 10-14 days every other month can help regulate your menstrual cycle
   3. Doctors might recommend Clomiphene, Letrozole, and others to activate ovulation 

PCOS is a troublesome disorder and causes a lot of problems in women. The best and most effective treatment is to adopt a better and healthy lifestyle. Lower body weight can reduce the force of PCOS symptoms and help you in getting pregnant and maintaining a regular menstrual cycle. 

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