PCOS Symptoms : Hormonal Imbalance in Women

Recognising Hormonal Imbalance in Women : A Complete Guide

PCOS symptoms can vary from woman to woman, but they commonly include irregular periods, acne, unwanted hair growth, and difficulty conceiving. Caused by a hormonal imbalance, this condition affects reproductive and metabolic health. Early diagnosis, lifestyle changes, and appropriate treatment are essential for managing PCOS effectively and reducing the risk of long-term complications.

Polycystic Ovary Syndrome (PCOS) is a complex condition that impacts a woman’s reproductive, hormonal, and metabolic health. Despite its prevalence, many women remain unaware of their condition due to the wide variation in symptoms. PCOS can influence fertility, skin, weight, and mental well-being, often going undiagnosed for years. Understanding how it develops, how it presents in different individuals, and the available management options is essential for long-term health and improved quality of life.

Let us keep reading to know more in detail.

What is Polycystic Ovarian Syndrome (PCOS)?

Polycystic Ovary Syndrome (PCOS) is a hormonal imbalance that occurs when the ovaries produce an unusually high amount of male hormones, called androgens. This excess androgen disrupts the balance of reproductive hormones and affects ovulation.

Due to this hormonal imbalance, people with PCOS often face irregular menstrual cycles, missed periods, or unpredictable ovulation. In some cases, small fluid-filled sacs (follicles) develop on the ovaries. A key feature of PCOS is anovulation, which is when the ovaries do not regularly release an egg. However, the presence of cysts is not a requirement for PCOS diagnosis. These cysts are typically neither painful nor harmful.

PCOS is a leading cause of female infertility and is associated with several health complications. A healthcare provider can recommend treatment based on your symptoms, especially if you are trying to conceive.

How Common is PCOS?

PCOS is one of the most prevalent endocrine disorders among women worldwide. It affects approximately 6-13% of women of reproductive age. Alarmingly, around 70% of PCOS cases remain undiagnosed due to the variability of symptoms and lack of awareness.

The condition is especially prevalent among certain ethnic groups and is often accompanied by metabolic complications such as insulin resistance. In addition to physical symptoms, PCOS can affect mental well-being, contributing to issues like anxiety, low self-esteem, and depression due to weight gain, infertility, and skin changes.

What are the Common Signs and Symptoms of PCOS?

PCOS symptoms can vary greatly among individuals. It is important to understand these signs, especially since many women remain unaware they have the condition.

Here are the common symptoms to look for:

• Irregular Periods: Women may experience infrequent, absent, or prolonged menstrual cycles. Irregular periods indicate that the ovaries are not regularly releasing eggs (anovulation).
• Excess Hair Growth: Unwanted hair on the face, back, chest, or chin is common. This condition, called hirsutism, results from increased androgen levels.
• Acne: Hormonal imbalances often lead to acne, particularly on the face, chest, and back.
• Hair Thinning or Baldness: Hair loss or male-pattern baldness on the scalp may occur due to excess androgens.
• Multiple Cysts on Ovaries: Some women with PCOS have multiple small cysts on their ovaries, typically detected via ultrasound.
• Weight Gain: Many women with PCOS struggle to lose weight due to insulin resistance, which affects how the body processes sugar.
• Fatigue or Tiredness: Sleep disturbances like sleep apnoea are more common in women with PCOS. Even after sufficient sleep, they may feel fatigued.
• Infertility: PCOS is a leading cause of infertility due to lack of ovulation or irregular ovulation. Treatments such as IVF or ovulation-inducing medication are often recommended.
• Mood Changes: Anxiety, depression, and mood swings are frequent and linked to hormonal fluctuations and the psychological impact of PCOS symptoms.
• Heavy and Painful Periods: Some women experience very heavy bleeding during menstruation, which may lead to anaemia. The periods can also be painful and distressing.
   

Does PCOS Always Cause Cysts?

Despite its name, not every woman with PCOS develops cysts on her ovaries. The term “polycystic” refers to the appearance of the ovaries on an ultrasound, where multiple immature follicles may be visible. These are not true cysts but fluid-filled sacs where egg development has stalled.

Some women may have all the hormonal and metabolic symptoms of PCOS without any cysts visible. Therefore, the presence or absence of cysts is not the only basis for diagnosis.

How Can Polycystic Ovary Syndrome (PCOS) Be Diagnosed?

Diagnosis of PCOS typically involves a combination of medical history, physical examination, blood tests, and imaging studies.

Your doctor may conduct the following for diagnosis:

• Ask about your symptoms, menstrual history, and any related concerns.
• Measure your weight and blood pressure.
• Review your family history to check for PCOS or related conditions.
• Conduct a physical exam to identify acne, excess facial/body hair, hair thinning, or skin discolouration.
• Recommend blood tests to measure hormone levels and glucose or insulin resistance.
• Suggest a pelvic ultrasound to inspect the ovaries for follicles and assess the uterine lining.
• A diagnosis is usually made if you meet at least two of the following criteria (known as the Rotterdam criteria): irregular periods, elevated androgen levels, or polycystic ovaries on ultrasound.
   

What are the treatment options for polycystic ovary syndrome?

Treatment for PCOS depends on your symptoms, whether you plan to become pregnant, and other existing health conditions. A combination of lifestyle changes and medications is typically recommended.

If You Are Not Planning for Pregnancy

Following are the treatment options to consider for PCOS if you are not planning for pregnancy:

• Hormonal Birth Control: Options like birth control pills, patches, vaginal rings, or intrauterine devices (IUDs) help regulate your menstrual cycle, reduce acne, and limit unwanted hair growth.
• Anti-Androgen Medications: These help reduce the effects of excess male hormones, improving acne and hirsutism. Your doctor will guide you on suitable options.
• Insulin-Sensitising Medications: Metformin, commonly prescribed for diabetes, helps the body process insulin better. It can regulate menstrual cycles and support weight loss.
• Lifestyle Modifications: Maintaining a balanced diet, regular physical activity, and achieving a healthy weight can improve symptoms and enhance insulin sensitivity.
   

If You Are Planning for Pregnancy

Here are the treatment options to consider for PCOS if you are planning for pregnancy:

• Ovulation-Inducing Drugs: Medications such as clomiphene citrate or letrozole stimulate ovulation. In some cases, injectable hormones (gonadotropins) may be used.
• In Vitro Fertilisation (IVF): IVF may be recommended if medication fails to help you conceive. Eggs are fertilised with your partner’s sperm in a lab and transferred to the uterus.
• Surgery: A procedure called ovarian drilling uses heat or a laser to destroy small areas of ovarian tissue that produce androgens, which can help to encourage ovulation. Though effective in some cases, surgery is now rarely used due to the success of medications.
   

Long-Term Health Risks Linked to PCOS

Untreated PCOS may increase the risk of several long-term health issues, including type 2 diabetes, heart disease, high blood pressure, and endometrial cancer. It also increases the risk of sleep apnoea, anxiety, and depression. Monitoring glucose levels, managing cholesterol, and receiving ongoing medical support are crucial in minimising these risks, along with maintaining long-term health.

Final Thoughts

PCOS impacts hormonal balance, fertility, and overall well-being, often leading to symptoms like weight gain, acne, and fatigue. Timely diagnosis, lifestyle changes, and appropriate treatment can help manage the condition effectively. Since every woman’s experience with PCOS is unique, ongoing medical guidance is essential to reduce complications and maintain long-term health.