Everything You Need to Know about PCOS: Symptoms, Causes and More

Some women experience irregular periods throughout their lives and think it’s completely normal. But if you delve a little deeper, you might find out that it’s one of the signs of Polycystic Ovary Syndrome (PCOS). A 2019 study run by Universiti Putra Malaysia on their female staff found that 12.6% of them had PCOS symptoms.

What is this condition, and why is it under diagnosed? Learn to identify PCOS symptoms, causes, some prevention methods and possible remedies here. 

What is PCOS? 

PCOS is a common condition that affects how a woman’s ovaries work. When a woman has PCOS, the ovaries become enlarged with many harmless fluid-filled sacs or follicles surrounding the eggs. These follicles are underdeveloped and can grow up to 8 millimetres in size. Because of this problem, the sacs are often unable to release an egg, hindering ovulation.

Causes of PCOS 

Until now, the exact cause of PCOS is still unknown, but it has been known to be hereditary and is linked to insulin.

Possible causes include: 

Hormone disorder 

Abnormal insulin levels and insulin resistance can increase the amount of testosterone (androgen) in women, leading to PCOS symptoms. Higher hormones during pregnancy can also cause the condition.

Heredity 

PCOS can run in the family. If you have a close family member with the condition, you have about a 50% chance of getting PCOS too.

It has been discovered that women from certain ethnic backgrounds have a higher risk of developing PCOS. This finding further suggests that PCOS has a genetic link. The ethnicities at a higher risk are those who are Asian, Aboriginal, Torres Strait Islander, North African and Caucasian European.

PCOS Symptoms 

PCOS symptoms may vary from one person to another. Some women might not show any signs at all.

PCOS symptoms to look out for include: 

1. Irregular or no menstruation at all
2. Periods with heavy or light bleeding
3. Difficulty conceiving 
4. Problems during pregnancy such as miscarriage, preeclampsia, gestational diabetes
5. Excessive hair growth, usually on the face, chest, back or buttocks
6. Dark patches of skin on the neck, arms, breasts or thighs
7. Thinning hair on top of the scalp
8. Weight gain around the waistline
9. Oily skin or severe acne 

Doctors sometimes take a while before they can identify if you have PCOS, especially since some of its symptoms are similar to other conditions.

If you experience unpredictable periods and display other PCOS symptoms regularly, you should see a healthcare practitioner for a blood test and an ultrasound. A blood test will let you know if you have higher levels of androgens, while an ultrasound will show whether there are partly developed eggs in your ovaries. 

More recently, experts have been trying to improve awareness of the condition. For example, in 2020, researchers at the Australia-based Monash Centre for Health Research and Implementation released an app to provide information and resources about PCOS. The app is completed with a range of features such as a quiz where women who think they have PCOS can try to self-diagnose. 

Treating PCOS Symptoms

There is no cure for PCOS, but the symptoms can be managed. Treatments to help with PCOS symptoms include: 

Medications to control hormones or periods 

Oral contraceptives can be prescribed to reduce the production of androgens and the stimulation of oestrogen on the lining of the uterus. Women with PCOS who plan to get pregnant could take ovulation-stimulating drugs. Insulin sensitisers can regulate the liver’s production of glucose, reduce insulin secretion, inhibit androgen secretion and improve ovulation. 

Starting a healthy lifestyle  

Healthy habits will go a long way in reducing PCOS symptoms. Try eating a balanced diet, exercising regularly, stopping smoking, and limiting alcohol intake to lose weight and manage periods. 

Laparoscopic Ovarian Drilling  

A minimally invasive procedure called laparoscopic ovarian drilling, where heat or laser is used to destroy the tissue in the ovaries that produce androgen, may be recommended if medication doesn’t work. Ovarian drilling breaks through the ovaries’ thick outer surface and lowers the amount of testosterone produced. Doing this can help the ovaries release an egg monthly and allow you to regain regular monthly menstrual cycles. It could also make it easier for you to get pregnant. 

How Traditional Chinese Medicine Treats PCOS Symptoms 

In Traditional Chinese Medicine (TCM), the major therapeutic principles of PCOS include tonifying the Kidneys, dispersing Stagnated Liver Qi (vital life force), regulating blood, and clearing Dampness and resolving phlegm. 

Herbal decoctions  

A 2018 study run by researchers in Taiwan detailed the commonly prescribed herbal formulas by TCM physicians for their patients with PCOS. Jia Wei Xiao Yao San (加味消遥散) is used for women with mood disorders and anxiety. The formula can increase levels of tumour necrosis factor, which can affect one’s mood and emotions. 

Wen Jing Tang(温经汤), Gui Zhi Fu Ling Wan (桂枝茯苓丸), Dang Gui Shao Yao San (当归芍药散), and Bak Foong pills (白凤丸) are used for conditioning menstruation and regulating blood, common in PCOS patients.

Gou Qi Yin (构气饮), Tao Hong Si Wu Tang (桃红四物汤), Si Wu Tang (四物汤), Xue Fu Zhu Yu Tan (血府逐瘀汤), and Nu Ke Bo Zi Ren Nang (女科柏子仁囊) are prescribed to promote blood circulation and remove Blood Stasis. Si Wu Tang can also decrease the serum follicle-stimulating hormone ratio and testosterone levels in PCOS patients, increase hair follicle development and establish regular menstruation cycles. 

TCM physicians prescribe Gui Pi Tang (归脾汤) to supplement qi and blood, which improves menopausal symptoms. Wen Jing Tang and Dang Gui Shao Yao San are also able to correct luteal insufficiency, where there is a deficiency in progesterone production after ovulation. 

Remember to consult with a qualified TCM practitioner prior to taking any of the above herbal formulas.

Complications of PCOS 

Without treatment, PCOS symptoms may worsen and cause complications, for example: 

• Infertility 
• Obesity, which may lead to type 2 diabetes 
• Sleep apnea 
• Metabolic syndrome 
• Irregular or absent menstruation may result in abnormal endometrial growth and eventually raise the risk of endometrial cancer 

• Being overweight and having excessive hair growth can put a damper on a woman’s self-esteem and may trigger depression 

Preventing PCOS Symptoms 

Since the condition is linked to insulin resistance, one way to prevent PCOS is to be more insulin sensitive. The following habits can help: 

• Be physically active 
• Maintain a healthy weight 
• Maintain lower blood sugar levels 
• Reduce stress 
• Get enough sleep 

The dangers of PCOS symptoms lie in ignorance. Familiarising yourself with the condition is one way to manage symptoms early and prevent it from worsening. 

This is an adaptation of an article, “女性宿敌–多囊性卵巢症候群”, which first appeared on the Health123 website.