Polycystic ovary syndrome (PCOS): understanding it for a better life

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects around 1 in 10 women. It is the most common hormonal disorder in women of childbearing age. Among other things, PCOS is characterised by an increase in androgenic hormone levels (the ovaries produce too much testosterone), with consequences that have a direct impact on the body as a whole.

What symptoms are needed to diagnose polycystic ovary syndrome?

Often misdiagnosed, PCOS is a common endocrinological disease affecting women of childbearing age. Its diagnosis is generally based on diagnostic criteria that are not always met. Symptoms vary widely from one woman to another.

  • The presence of cysts on the ovaries. They are functional (they come and go depending on the cycle), which means that they are not always present at the time of imaging; ovarian cysts are not the main reason for diagnosing PCOS.
  • On pelvic ultrasound, there is a high number of follicles in the ovaries (more than 10 in each ovary) and/or large ovaries (more than 10 ml).
  • A large ovarian cyst is at risk of torsion and rupture, leading to pain and haemorrhage, which may constitute a gynaecological emergency (laparoscopic surgery for cystectomy and peritoneal cleansing).
  • Menstrual irregularities, long cycles or even absence of periods, known as secondary amenorrhoea
  • Dysovulatory or anovulatory cycles that can lead to difficulties in procreation and infertility
  • Acne
  • Hirsutism and/or hyperpilosity
  • Alopecia
  • Overweight or obesity
  • android adiposity (= abdominal fat).
  • Metabolic syndrome: PCOS is often associated with cardiovascular risk factors such as insulin resistance or pre-diabetes, arterial hypertension and poor regulation of blood lipids.
  • PCOS increases the risk of endometrial cancer
  • PCOS increases the risk of depression

Origin of PCOS

The ovarian origin of PCOS and the cause of PCOS are still unknown and at the research stage. It is genetic and multifactorial. It has been described that women with a family history of diabetes or a personal history of type 2 diabetes are at greater risk of developing PCOS.

Treatment of PCOS

PCOS is a chronic hormonal disease whose symptoms alone can currently be treated by lifestyle, appropriate medication and phytotherapy:

Lifestyle

A balanced Mediterranean-style diet with plenty of healthy fats, vegetables, fruit and little refined sugar or processed food,

Sleeping well is essential,

Regular physical activity such as daily walking and sport are essential to reduce the symptoms of PCOS. These lifestyle changes can contribute significantly to :

  • Reducing insulin resistance and therefore improving its sensitivity and effectiveness
  • Promote weight loss and loss of abdominal fat mass (android).

For some women with PCOS, these measures may be enough to normalise their menstrual cycles and ovulation.

Medicinal treatments

In addition to lifestyle changes, a personalised drug treatment is proposed.

The most commonly prescribed treatment protocols for PCOS include :

  • Oral contraceptives to regulate menstrual cycles and reduce androgen levels
  • Spironolactone (an anti-androgen) to treat symptoms such as hirsutism, acne and alopecia.
  • Metformin, a drug prescribed for diabetes, can improve insulin resistance and encourage ovulation in some women with PCOS.
  • In cases of overweight and/or obesity, treatment with liraglutide may be indicated
  • In the case of anovulatory cycles and dysmenorrhoea, hormonal protocols are prescribed to produce menstrual cycles and ovulatory cycles for fertility.
  • Laser hair removal and electrolysis are effective in destroying hair follicles
  • Phytotherapy: chasteberry, inositol, alchemilla, yam

To date, there is no single medical treatment for PCOS, but rather a comprehensive medical and paramedical approach that should be implemented as soon as symptoms appear, and should be considered from puberty onwards.