Endocrine and metabolic disorders include PCOS. Any woman who has acne, hirsutism, irregular menstruation, or obesity is taken into consideration.
Patients with PCOS, have anovulation, i.e. they may not produce a follicle cyclically. Thus, it is possible that they will exhibit primary amenorrhea (i.e. no periods at all), too few periods (oligomenorrhea) or secondary amenorrhea i.e. absence of periods for six months or more. Some people may also experience dysfunctional uterine bleeding, which is excessive, frequent, and irregular bleeding.
An important contributor to PCOS is insulin resistance and an increase in insulin levels. About 50% of PCOS patients have obesity. The ratio of waist to hips may be higher than 0.85.
Although the exact cause of PCOS is unknown, there is a chance that it is a complex genetic disorder in which the genetic component interacts with various environmental factors to lead to an imbalance in the hormones.
The diagnosis of PCOS is based upon clinical and biochemical criteria. Teenagers with hirsutism, acne, irregular menstrual cycles, or obesity may have it. If laboratory testing reveals excess androgen, the diagnosis is further supported. An androgen panel includes other androgens like DHEA sulfate as well as free testosterone and total testosterone in plasma. The most accurate test for identifying androgen excess is the plasma-free testosterone test. The most important indicator of androgens derived from adrenals is DHEA sulfate. To rule out other causes of obesity, obese patients should undergo cortisol and thyroid function tests.
A polycystic ovary can be seen on a pelvic ultrasound. i.e. multiple(more than 10) small follicles with increased stroma.
As PCOS is linked to insulin resistance, a baseline lipid panel and glucose tolerance test are crucial. The two-hour level in PCOS is poorly predicted by the fasting glucose concentration. It is significant from a treatment standpoint if your two-hour blood sugar is greater than 140 mg/dL because this indicates insulin resistance.
The symptoms of PCOS are used to guide treatment. Depending on the symptoms and objectives of each patient, the treatment will be chosen.
The first step is to reduce weight through diet and exercise.
Patients with PCOS should be treated for menstrual irregularities as chronic anovulation is linked to an increased risk of endometrial hyperplasia and carcinoma.
For women with irregular menstruation, combined oral contraceptive pill therapy (COCP) is typically the first line of treatment. They effectively normalize androgen levels while regulating the cycles.
Patients can choose from a variety of cosmetic treatments for abnormal or excessive hair growth. Although it is secure and efficient, it does not address the underlying issues. So, each one only provides transient solace. Depilation (e.g. shaving, hair removing creams), epilation (eg, plucking, waxing), destruction of the dermal papilla (eg, electrolysis or laser therapy.
Treatment with COCP significantly reduces acne and halts the development of hirsutism.
In cases of severe hirsutism, COCP may also be prescribed in addition to antiandrogens. The treatment for insulin resistance involves using insulin-lowering medications like metformin, thiazolidinediones, and D-chiro-inositol. This helps PCOS patients’ ovulation and hormonal profiles.
Patients with PCOS who want to have children but are unable to conceive naturally may need ovulation medications and assisted reproductive techniques.
Patients with PCOS in particular need to build up their confidence because these conditions—hair growth, acne, and obesity—can cause them to experience serious emotional problems. In addition to her medical care, Dr. Sangeeta gives her patients sound advice and inspiration to achieve their objectives.