Polycystic ovary syndrome (PCOS)

By: MARY GRACE M. FERMIN,RN.RM.MAN.PhD.N.

Polycystic ovary syndrome (PCOS) is a multifaceted hormonal disorder that primarily affects women of
reproductive age, though it can also manifest in adolescent girls. It's characterized by a constellation of
symptoms, including irregular menstrual periods, excess androgen levels (male hormones), and the
presence of small cysts on the ovaries, hence its name. These cysts are actually follicles that have not
developed properly, often leading to hormonal imbalances and disrupted ovulation.

The symptoms of PCOS can vary widely among individuals. Some may experience acne, excessive hair
growth (hirsutism), weight gain, or thinning hair on the scalp. Others may struggle with infertility due to
irregular ovulation or anovulation (lack of ovulation). The exact cause of PCOS is still not fully understood,
but it's believed to involve a combination of genetic predisposition and environmental factors.

One significant contributing factor is insulin resistance, where the body's cells become less responsive to
insulin, leading to increased insulin levels in the blood. This can further exacerbate hormonal imbalances
and contribute to symptoms like weight gain and difficulty regulating blood sugar levels.

Management of PCOS typically involves a multifaceted approach. Lifestyle modifications such as regular
exercise, a balanced diet, and maintaining a healthy weight can help improve symptoms and reduce
insulin resistance. Medications such as oral contraceptives may be prescribed to regulate menstrual cycles
and lower androgen levels. Additionally, anti-androgen medications can help manage symptoms like acne
and excessive hair growth.

For those trying to conceive, fertility treatments such as ovulation induction with medications like
clomiphene or assisted reproductive technologies like in vitro fertilization (IVF) may be recommended.
Early diagnosis and intervention are crucial in managing PCOS and reducing the risk of long-term
complications such as type 2 diabetes, cardiovascular disease, and endometrial cancer.

Regular monitoring by healthcare professionals, along with a tailored treatment plan, can help women
with PCOS effectively manage their symptoms and improve their overall health and quality of life.

PCOS can impact fertility through various mechanisms:

1. *Ovulation Disruption:* PCOS often causes irregular menstrual cycles or even the absence of
menstruation altogether due to irregular or absent ovulation. Without regular ovulation, the chances of
conceiving naturally are significantly reduced.

2. *Hormonal Imbalances:* Hormonal imbalances, particularly elevated levels of androgens (male

hormones) such as testosterone, can disrupt the delicate hormonal balance necessary for normal
ovulation and egg development. This imbalance can impair the maturation of eggs within the ovaries,
making it harder for them to be released for fertilization.
3. *Anovulation:* In some cases, PCOS can lead to anovulation, where no egg is released during the
menstrual cycle. This further reduces the chances of conception.

4. *Ovarian Cysts:* While not always present, ovarian cysts are a common feature of PCOS. These cysts
can interfere with normal ovulation and menstrual cycles, contributing to fertility issues.

Despite these challenges, many women with PCOS can still conceive with appropriate management and
treatment. Lifestyle modifications such as weight management, dietary changes, and regular exercise can
help improve hormonal balance and increase the likelihood of ovulation. Medications such as oral
contraceptives, ovulation induction agents like clomiphene citrate, or assisted reproductive technologies
(ART) such as in vitro fertilization (IVF) may also be utilized to improve fertility outcomes in women with
PCOS. Early diagnosis and proactive management are key to optimizing fertility in women with PCOS