Overview – Polycystic Ovarian Syndrome, Causes, Symptoms & More

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What is PCOS?

Polycystic Ovarian Syndrome [PCOS] is a hormonal imbalance affecting women during their reproductive years [age 15 to 44]. This condition develops when the ovaries create excess or unusual hormone levels called androgen.

Although androgens are typically regarded as a male hormone, they are essential for women’s reproductive health. In women, androgens are produced within the ovaries and adrenal cortex, then converted into estrogen. Producing unusual amounts of androgen results in an imbalanced reproductive system. This can lead to irregular periods, increased hair growth, unpredictable ovulation, and other symptoms of PCOS.

Even though the real cause of polycystic ovary syndrome is unknown, it’s considered a widespread condition. In 2022, the World Health Organization [WHO] reported that nearly 116 million women are affected by PCOS globally, thus putting the prevalence of PCOS between 4% and 20%. PCOS is also one of the most common causes of infertility in women and often puts affected women at risk of other serious health conditions.
In this article, we sat down with Dr. Mozhgan Sayyad from Dubai. With over 25 years of invaluable experience, she shares everything we need about polycystic ovary syndrome!

The Causes of PCOS

The root cause of PCOS remains undiscovered. But several studies have linked its connection to genetic and environmental factors. Although further research is essential to understand its underlying cause, here’s a list of the possible factors:

1. Excess Androgen: With PCOS, high levels of androgen prevent the ovaries from releasing eggs, thus interfering with ovulation and causing irregular periods. Irregular ovulation can also cause small fluid-filled sacs [cysts] to develop outside the ovaries. Fortunately, these cysts aren’t dangerous or painful. Excess androgen levels also cause hirsutism [too much growth of dark hair on the face, chest, and back] and acne.

2. Insulin Resistance: Insulin is an essential component created by the pancreas. It’s responsible for converting glucose into energy. With insulin resistance, it means that the cells become resistant to the process of insulin, thus leading to high glucose levels in the blood. In an attempt to bring the blood sugar levels down, the body produces high amounts of insulin. As a result, insulin produces too much androgen, which results in polycystic ovary syndrome. It should be kept in mind that not all individuals with insulin resistance will have diabetes or elevated glucose. Some symptoms of insulin resistance include; [a] dark and velvety patches of skin on the lower parts of the neck, below breasts, groin, or armpits, [b] increased appetite and [c] weight gain.

3. Low-Grade Inflammation: Low-grade inflammation is when white blood cells create substances in response to an infection or injury. It’s understood that people with PCOS have chronic low-grade inflammation.

4. Heredity: Having a family history [mother or sister] of PCOS can also result in someone developing the condition down the line. It’s believed that many genes contribute to polycystic ovary syndrome.

The Symptoms of PCOS

Individuals will start showing PCOS symptoms soon after starting their first menstrual cycle. And, sometimes, they can develop it even after a while. Although the signs can differ, the diagnosis is made when someone experiences two of the following symptoms:

1. Irregular periods: The most common signs of PCOS are having irregular periods, fewer cycles, or periods that last longer than the usual cycle.
2. Excessive Androgen Levels: As mentioned earlier, unusual amounts of androgen can lead to excess body hair growth, acne, and male-pattern baldness. These are the notable symptoms.
3. Polycystic ovaries: For individuals with polycystic ovary syndrome, they may have ovaries that are larger or don’t work as they should.
4. Abnormal hair growth: It’s common to see people with PCOS struggle with heavy hair growth on their arms, chest, back, and face.
5. Acne: Acne is another common symptom due to excess androgen levels. Typically, acne appears on the back, chest, and face. Unlike teenage acne, these may be harder to treat.
6. Obesity: According to statistics, around 40-80% of individuals with PCOS struggle with obesity and a healthy weight.
7. Darkening of the skin: Another common symptom of this condition is darkening of the skin or acanthosis nigricans. It’s a skin condition that causes dark and velvety layers of skin on the folds and creases of the body. It usually develops around the neck, groin, and armpits.
8. Skin tags: Skin tags are soft, small, and skin-colored layers of flaps that grow on the top layer of the skin. It usually develops when the skin rubs against itself, so it’s more commonly seen in overweight individuals.
9. Thinning hair: Individuals with PCOS may lose patches of hair or begin balding.
10. Infertility: Due to irregular periods and ovulation, PCOS is known to be the most common cause of infertility in women.
11. Bleeding Irregularities: People with PCOS may also experience heavy bleeding or bleeding without ovulation [anovulatory periods].
12. Oily Skin: Oily skin is also regarded as one of the common symptoms.