PCOS - Polycystic Ovarian Syndrome is a complex and polygenic disorder. Anovulation, hyperandrogenism, and polycystic ovarian morphology are key endocrine system symptoms in females of reproductive age. PCOS is complex in origin and results from a confluence of hereditary and environmental variables.
Pathophysiology (Physiological processes)
The pathophysiology of PCOS is primarily influenced by three organ systems: the hypothalamic-pituitary axis, insulin release and effect, and ovarian activity. PCOS has been related to insulin resistance and obesity. It is not surprising that there is a connection between insulin function and ovarian function because insulin regulates ovarian activity and the ovaries react to excess insulin by releasing androgens, which can cause anovulation. The hallmark of ovarian dysfunction is that follicular maturation stops.
Clinical Presentation
PCOS is a hormonal syndrome that can progress into a number of other disorders. Ovulation irregularities, elevated androgen levels, and cystic ovaries are the three most typical causes connected to PCOS, though indications and symptoms might vary. Most women with PCOS experience ovulatory issues and high androgen levels. Additionally, high levels of androgen are directly linked to hirsutism, acne, and alopecia, and people with PCOS are more likely to have polycystic ovaries on pelvic ultrasound than the general population.
Signs and Symptoms of Polycystic Ovary Syndrome
Multiple tiny cysts and enlarged ovaries
Irregular menstrual cycles
Pelvic pain
Hirsutism - a condition in women that results in excessive growth of dark or coarse hair in a male-like pattern on face, chest and back
Alopecia - Hair loss from the scalp or elsewhere on the body.
Acne
Acanthosis nigricans - A skin condition characterised by dark, velvety patches in body folds and creases.
A full medical history, physical examination, blood testing, and a pelvic ultrasound should be performed if PCOS is suspected. The doctor can learn about unexplained weight gain, irregular menstrual cycles, male-pattern hair growth, skin changes, and high blood pressure from the patient's medical history and physical examination (BP). A pelvic ultrasound is done to check for ovarian cysts, and blood is collected to measure hormone, glucose, and cholesterol levels.
Other potential reasons linked to reproductive, endocrine, and metabolic disorders should be ruled out during the assessment phase. Studies suggest that more than 50% of PCOS patients experience the onset of prediabetes or diabetes after receiving a diagnosis, and there is a higher risk of myocardial infarction (MI), anxiety, depression, dyslipidemia, hypertension, endometrial cancer, and sleep apnea. The increased risks of miscarriage, gestational diabetes, pre-eclampsia, and early delivery should also be made known to pregnant women with PCOS.
PCOS & MetS
The prevalence of PCOS is influenced by genetic, environmental, and racial characteristics as well as diagnostic standards. Metabolic syndrome, on the other hand, is a grouping of metabolic illnesses that mostly affects the abdomen and includes abdominal obesity, insulin resistance, poor glucose metabolism, hypertension, and dyslipidemia. The risk of endometrial cancer, Type 2 diabetes mellitus, coronary heart disease, and cardiovascular diseases is directly impacted by these related conditions. Visceral obesity, hyperinsulinemia, and insulin resistance are common characteristics of the metabolic syndrome in PCOS patients. These increase the incidence of gynaecological cancer, especially endometrial cancer, cardiovascular disease, as well as Type 2 diabetes. Infertile women with PCOS are also more likely to develop metabolic syndrome.
There is currently no medication to cure this syndrome, but it can be managed with a healthy lifestyle that includes a balanced diet and regular exercise (Jayasena and Franks, 2014).
Conclusion
Polycystic ovarian syndrome (PCOS) is a condition characterized by hormonal imbalances and excessive hair on the body. In some cases, it might affect metabolism as well. People with metabolic syndrome might have type 2 diabetes or various other diseases that are connected to obesity.
References
El Hayek S, Bitar L, Hamdar LH, Mirza FG and Daoud G (2016) Polycystic Ovarian Syndrome: An Updated Overview. Front. Physiol. 7:124. doi:10.3389/fphys.2016.00124
Ali AT. Polycystic ovary syndrome and metabolic syndrome. Ceska Gynekol. 2015 Aug;80(4):279-89. PMID: 26265416.
Sanchez-Garrido, M. A., & Tena-Sempere, M. (2020). Metabolic dysfunction in polycystic ovary syndrome: Pathogenic role of androgen excess and potential therapeutic strategies. Molecular metabolism, 35, 100937. https://doi.org/10.1016/j.molmet.2020.01.001