When Hormones Play Havoc with Your Body: Learn How to Manage PCOS

Unwanted body hair, scalp hair fall, oily skin, acne breakouts, and weight gain are some of the challenges life throws at you when dealing with hormonal imbalances. Polycystic Ovary Syndrome (PCOS) is a rapidly growing metabolic disorder in adolescent girls and women of reproductive age. The current global prevalence of PCOS is around 9.2%, and the prevalence in Indian women has been reported up to 22.5%, making it the most common hormonal disorder in women. While both wellness influencers and healthcare providers have been more vocal about the symptoms, treatments, and prevention of this endocrine disorder online, there’s a lot to unpack here.

PCOS symptoms are typical and easily identifiable. It is important to be self-aware, especially when dealing with such subtle hormonal disorders, as they can snowball into significant complications over time. This helps you maintain your reproductive and overall health.

Polycystic Ovary Syndrome (PCOS), as the name suggests, is a group of disorders that affect the ovaries and the process of ovulation in females in their reproductive years (ages 15–44).

Though PCOS affects majorly the reproductive axis, it can also negatively impact your metabolic, dermatological, and psychological health.

The 3 classic signs of PCOS disorders are :

• Biochemical hyperandrogenism: Excessive production of male hormones (androgens, which are generally present in extremely small amounts in the female body).
• Oligo-anovulation: Infrequent (oligo) or absent (anovulation) ovulation
• Polycystic morphology: Multiple cysts in the ovary

Symptomatically, PCOS may manifest in the following ways:

• Skipped/delayed or irregular periods, painful periods with either too little or too much blood flow
• Unwanted, dark, and coarse hair growth, like in men — facial hair, chest hair, etc.
• Oily skin and facial or back acne
• Gradual hair loss and hair thinning
• Darkened skin patches; appearance of skin tags
• Unexplained weight gain, especially around the belly
• Severe mood swings/ anger/ depression.
• The persistent feeling of fatigue and lethargy

Whether you have a few or more of these symptoms, it’s best to see a gynaecologist at the earliest to understand the risk factors related to PCOS and get evaluated and treated accordingly.

Some years ago, the NIH recommended that PCOS be renamed to something that more aptly reflects the various metabolic, hypothalamic, pituitary, ovarian, and adrenal factors that define the condition.

The causes of PCOS can be uniformly defined. Some studies show a genetic component, while others feel that environmental factors play a major role.

• PCOS can be genetic and may run in families. Not one, but many studies have shown an array of up to 43 proteins responsible for the manifestation of PCOS.
• Poor habits like bingeing on junk food and sugar, irregular sleep patterns, excessive stress, a sedentary lifestyle, and weight gain contribute to inflammatory processes in the body. Excessive inflammation is directly related to androgen overproduction from the ovaries. 
• Many women with PCOS have insulin resistance and vice versa. Abdominal fat makes it difficult to properly use the insulin hormone for blood sugar control. Women with PCOS have greater levels of TNFα, a protein that can reduce insulin effectiveness. Even if you are not overweight and do not have insulin problems, this protein may produce excessive male hormones and inflammation, triggering PCOS.

There are too many interdependent PCOS risk factors, making it all the more important to follow up with your physician and be compliant with PCOS medications and therapy.

The National Institute of Child Health and Human Development (NICHD) says that doctors use three criteria to diagnose PCOS: (1) high levels of male hormones, (2) irregular periods, and (3) ruling out other hormone disorders. A person may be diagnosed with PCOS if at least two of these three criteria are present and after ruling out other causes like thyroid disorders, prolactin disorders, etc.

Diagnosing PCOS in teens is quite a task. Adolescents naturally tend to have irregular menstrual cycles and hormonal fluctuations, and there is no unanimity on the diagnosis. Multiple follicles in the ovaries are common and not limited to PCOS. Hence, prolonged irregular periods, even after 2 years post-menarche, can be an early sign of future PCOS. High androgen levels, irregular periods, or ovarian volume beyond 10 cm³ can be additional diagnostic factors.

Understanding PCOS is easier for adult women in their childbearing years. Doctors can diagnose patients through physical examinations, bloodwork, and imaging tests.

It’s important to properly manage your PCOS symptoms as not doing so could lead to certain complications, such as:

Irregular hormones result in disrupted, untimely ovulation cycles. Moreover, low female hormonal levels and excessive androgens and cysts prevent the eggs from maturing, and immature eggs fail to fertilise.

Hormonal imbalances and related metabolic issues like insulin resistance and high cholesterol may worsen with pregnancy. This increases the chances of preterm delivery, gestational diabetes, hypertension, miscarriages, and more.

Insulin resistance is an ongoing process. If left untreated, it can cause type 2 diabetes, which worsens PCOS.

Elevating your risk for heart disease, this condition is characterised by high triglycerides, reduced 'good' cholesterol (HDL) levels, increased blood pressure, and elevated blood sugar levels.

Irregular periods, difficulty in conceiving, excessive hair growth and acne, weight gain, etc., can lead to body-image issues and can have a detrimental effect on one’s mental well-being.

Speak to your doctor as soon as you notice most of the above-mentioned symptoms consistently for a while. Months of irregular periods, unpredictable menstrual blood flow, facial hair, facial acne, and hair thinning are important reasons for visiting your gynaecologist for PCOS tests.

Complete remission from PCOS may take some time, but the signs, symptoms, and disease progression can be controlled.

It might be recommended that you adhere to a diet suitable for PCOS, which emphasises the importance of foods' glycemic index (how much they raise blood sugar levels), includes daily exercise ranging from moderate to high intensity, incorporates stress reduction techniques, ensures adequate sleep, and complements any PCOS medication you may be taking.

PCOS is slowly becoming a global burden, especially with the increased availability of packaged and processed foods, remote desk jobs, and competitive stress. We need to understand that every female body is different — genetic makeup and coping mechanisms vary. If you’re struggling with painful periods, daily fatigue, hair loss, or unwarranted weight gain, then it’s time to get yourself checked for PCOS disorder. Depending on the symptoms and concerns, a multidisciplinary treatment plan involving an endocrinologist, dermatologist, and gynaecologist-fertility expert is the best way to go.

PCOS stands for polycystic ovarian syndrome. PCOS is a complex cohort of disorders in girls and women in their reproductive years that is typically characterised by cysts in the ovaries, excessive male hormone production, and disrupted irregular ovulation cycles/periods.

The most common symptoms of PCOS are painful/irregular periods, fatigue, hair loss, oily skin, acne, and unwarranted weight gain.

PCOS is commonly diagnosed through evaluation of the PCOS symptoms, ultrasonography of the uterus and ovaries, and blood tests for the hormones.

According to the Rotterdam criteria, there are four types of PCOS: 1) irregular periods/high male hormones/multiple ovarian cysts, 2) irregular periods/high male hormones, 3) high male hormones/multiple ovarian cysts, and 4) irregular periods/ multiple ovarian cysts.