From the Research
Introduction to Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is a complex endocrine and metabolic disorder that affects women of reproductive age, characterized by a combination of environmental and genetic factors 1. The syndrome is marked by raised levels of androgens, such as testosterone, and the presence of multiple ovarian cysts, leading to anovulation, infertility, and irregular menstrual cycles.
Risk Factors for PCOS
The risk factors for PCOS include:
- Lifestyle or diet
- Environmental pollutants
- Genetics
- Gut dysbiosis
- Neuroendocrine alterations
- Obesity 2 These factors may contribute to the development of metabolic syndrome, hyperinsulinemia, oxidative stress, hyperandrogenism, and impaired folliculogenesis.
Prevention Methods for PCOS
Prevention methods for PCOS focus on lifestyle modifications, including:
- A healthy balanced diet
- Regular exercise to prevent excess weight gain and limit PCOS complications
- Targeted weight reduction when needed 3 Additionally, restoration of gut microbiota through probiotics, prebiotics, or fecal microbiota transplant (FMT) may serve as an innovative way to prevent and mitigate PCOS 2.
Signs and Symptoms of PCOS
The signs and symptoms of PCOS are heterogeneous and may include:
- Hyperandrogenism (clinical or biochemical)
- Irregular menstrual cycles
- Polycystic ovary morphology
- Infertility
- Obesity
- Insulin resistance
- Hirsutism
- Acne
- Alopecia 1, 3
Treatment Options for PCOS
Treatment options for PCOS involve a combination of lifestyle alterations and medical management, including:
Lifestyle Modifications
- Weight loss to improve endocrine profile and increase likelihood of ovulation and pregnancy
- Modifications in lifestyle (diet and exercise)
Medical Management
- Metformin to improve insulin resistance and metabolic features
- Combined oral contraceptive pill for menstrual cycle regulation and hyperandrogenism
- Anti-androgens for refractory hyperandrogenism
- Clomiphene citrate, tamoxifen, aromatase inhibitors, glucocorticoids, or gonadotropins to treat anovulation
- In vitro fertilization as a last option to achieve pregnancy
- Alternative medicine, such as herbal remedies, may also be effective in managing PCOS symptoms 1, 3, 4
Treatment Considerations
When treating PCOS, it is essential to consider the following:
- Dosage and duration of medication may vary depending on the individual and the specific treatment goals
- Potential side effects and interactions with other medications should be carefully monitored
- Lifestyle modifications should be tailored to the individual's needs and preferences
- Regular follow-up and monitoring are crucial to adjust treatment plans as needed 3, 4
Differential Diagnosis and Caveats
PCOS should be differentiated from other endocrine and metabolic disorders, and a comprehensive diagnosis should be made based on the 2003 Rotterdam criteria 3. Additionally, it is essential to consider the potential risks and benefits of each treatment option and to individualize treatment plans according to the patient's specific needs and circumstances.