Gynecological Conditions & Treatments

Polycystic Ovary Syndrome (PCOS) Symptoms and Treatment

PCOS or Polycystic Ovary Syndrome is a disorder of the ovaries that manifests as a group of symptoms

resulting from hormonal imbalances in the affected women. Your doctor may also refer to PCOS as

hyperandrogenic anovulation or Stein–Leventhal syndrome. This condition is actually a consequence of

both environmental and genetic factors. Today, PCOS is the commonest endocrine malady likely to

affect women between 18 to 44 years of age. So much so that, nearly 5-10% of the women in this age

bracket are affected by PCOS at some point in their lifetime.

What Causes PCOS?

The precise cause of PCOS is still uncertain. However, this disorder also has a strong genetic tendency

and is inclined to run in families. It is also believed that several environmental factors like obesity and a

lack of physical exercise may increase a woman’s chances of developing PCOS, especially when she has a

family history or a close family member suffering from this disorder.

What Happens in PCOS?

PCOS is actually a set of symptoms affecting multiple organs. There are nearly 28 symptoms that are

attributed to PCOS due to its associated underlying hormonal imbalances. Different women are likely to

suffer from different sets of symptoms. Around 15% of the women affected by PCOS show multiple fluid

filled cysts on their ovaries that are visualized with a pelvic ultrasound. Menstrual symptoms may vary

from heavy or irregular periods to no periods at all. PCOS also produces symptoms like excessive body

and facial hair growth, oily skin, and acne that are a result of increased levels of the male hormones or

androgens. Some women also develop dark, velvety, and thick patches on their skin or brownish skin

tags known as acanthosis nigricans. These patches are commonly seen in the armpits, around skin folds,

and below the breasts. Central obesity and insulin resistance are some other symptoms of PCOS.

Unfortunately, PCOS is also one of the foremost causes of infertility in women today. This is mainly due

to the irregular or complete lack of ovulation and increased male hormones in the blood stream.

How is PCOS Treated?

PCOS is incurable. However, its symptoms may be controlled with certain medications. The most

important factor in treating PCOS is weight loss, especially in obese or over-weight patients. Even a loss

of 5 kg of a woman’s overall weight is likely to result in a considerable reduction in her symptoms.

Menstrual irregularities may be treated with the help of oral contraceptive pills to regularize the

periods. Metformin is also likely to help with the insulin resistance in such patients. Anti-androgenic

medications may help with certain symptoms and infertility by improving ovulation. Other symptoms

like acne and skin eruptions are treated with the usual acne and hair removal treatments.

PCOS has a wide variety of treatments to keep up with the wide variety of symptoms it produces. Hence,

no two women may be given the same treatment for PCOS. It’s best to speak to your doctor about the

most suitable treatment for your PCOS symptoms.

Sexual function is very important in everyday life. The female sexual function depends from the age and is closely related to menopause. Sexual dysfunctions have a high prevalence also in premenopausal woman, making their life very stressful. Female sexual disorders have often been associated with pelvic floor disorders.

What Is the Pelvic Floor?

The pelvic floor normally consists of muscles, ligaments and connective tissue. The main role of the pelvic floor is to support the organs located in the pelvis, like the bladder, uterus and rectum. Pelvic floor not only prevents these organs from prolapsing, but also plays a big role in maintaining their normal function by keeping them in their anatomical positions. Any problem or disorders of the pelvic floor components will lead to female sexual disorders. These conditions are not life threatening. However, pelvic floor disorders affect the quality of life.

Risk Factors for Pelvic Floor Disorders

There are different possible risk factors and conditions that affect the integrity of the pelvic floor. Some of these risk factors include:

• Pregnancy
• Childbirth
• Aging
• Menopause
• Genetic factors
• Trauma
• Race
• Smoking
• Pelvic surgeries
• Obesity
• Chronic coughing, etc.

Disorders with the Pelvic Floor Lead To:

• Pelvic Organ Prolapse – occurs in cases when the pelvic floor fails to support the pelvic organs. This leads to pelvic organ prolapse, including the bladder, urethra, vagina, cervix, uterus and bowls. The above mentioned organs can drop out through the vaginal opening and may be even seen. Vaginal childbirth is often determined as the risk factor for pelvic organ prolapse. Pelvic organ prolapse is classified according to the wall or compartment that is prolapsed. According to this we do have anterior wall prolapse, defined as cystocele, posterior wall prolapse, defined as rectocele. Cases when there is a bowel herniation at the vaginal apex are known as enterocele. There is also a possible prolapse of the cervix and the uterus after a hysterectomy. In these cases it is called apical prolapse.
• Urinary Incontinence – is the involuntary loss of urine. There are three main types of urinary incontinence:
• Stress urinary incontinence
• Urge urinary incontinence
• Mixed incontinence – where both of the above mentioned types of urine incontinence are present
• Abdominal Pain
• Rectal bleeding

The cause of the incontinence is different for each subtype and involves difficulties with the innervation and musculature of the pelvic floor. Pregnancy and childbirth are strongly associated with stress urinary incontinence and the urge to urinate.

• Anal incontinence – results in flatulus incontinence and loss of formed or loose stool. It usually occurs due to pelvic floor problems after pregnancy and childbirth.

The Goals of Pelvic Floor Reconstruction

It has been estimated that about 35% of women will develop some form of pelvic floor disorders during their life. Pelvic floor disorders lead to discomfort and pelvic pain, difficulties urinating, frequent need to urinate, urge to urinate, difficulties holding a full bladder, difficulties with bowel movements, etc.

The goal of pelvic floor reconstruction surgeries is to restore the normal structure and function of the female pelvic organs. By restoring the pelvic floor, the sexual function is also restored.