From the Research
Introduction to Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting women of reproductive age, characterized by a combination of reproductive and metabolic dysfunction. The syndrome is associated with an increased risk of depression and anxiety symptoms, as well as metabolic comorbidities such as obesity, type 2 diabetes, and cardiovascular risk factors 1, 2.
Risk Factors for PCOS
The exact etiology of PCOS is still unclear, but several factors contribute to the development of the syndrome, including:
- Genetic predisposition
- Environmental factors
- Obesity, which exacerbates metabolic and reproductive disorders
- Insulin resistance and elevated androgens, which may partly contribute to the association with depression and anxiety symptoms 1, 2
Prevention Methods for PCOS
While there is no proven way to prevent PCOS, lifestyle modifications such as:
- Weight loss, which improves the endocrine profile and increases the likelihood of ovulation and pregnancy
- Diet and exercise, which can help manage obesity and insulin resistance
- Stress reduction techniques, which may help alleviate symptoms of depression and anxiety 3, 4
Signs and Symptoms of PCOS
The clinical manifestation of PCOS varies from woman to woman, but common signs and symptoms include:
- Menstrual irregularities, such as oligomenorrhea or amenorrhea
- Hyperandrogenism, characterized by hirsutism, acne, and/or androgenic alopecia
- Polycystic ovary appearance on ultrasound
- Infertility, which affects up to 80% of women with PCOS 2, 5, 4
Treatment Options for PCOS
Treatment of PCOS depends on the symptoms and desired goals, but may include:
Pharmacological Therapy
- Metformin, which improves insulin sensitivity and lowers blood glucose and androgen levels
- Clomiphene citrate, which induces ovulation
- Glucocorticoids, which may be used to treat hyperandrogenism
- Gonadotropins, which may be used to induce ovulation
Lifestyle Interventions
- Weight loss, which can improve reproductive and metabolic function
- Diet and exercise, which can help manage obesity and insulin resistance
Alternative Therapies
- Herbal remedies, such as Glycyrrhiza glabra L., Aloe vera, and Silybum marianum, which may have therapeutic benefits in the management of PCOS
- Alternative medicine, which may be used to treat symptoms such as hirsutism, acne, and/or alopecia 3, 5, 4
Treatment Considerations
Treatment of PCOS should be tailored to the individual woman's needs and goals, taking into account her reproductive desires, disease phenotype, and overall health. It is essential to address the underlying causes of the syndrome, such as insulin resistance and hyperandrogenism, to improve reproductive and metabolic function. Additionally, screening for anxiety and depression is recommended in women with PCOS at the time of diagnosis 1, 4
Dosing Information
The dosing of medications for PCOS may vary depending on the individual woman's needs and the specific medication being used. For example, metformin may be started at a dose of 500 mg per day and gradually increased to 2000 mg per day, while clomiphene citrate may be started at a dose of 50 mg per day for 5 days. It is essential to consult with a healthcare provider to determine the best course of treatment and dosing regimen for each individual woman. 3