Dr. Nainy Saluja

Symptoms, causes, and medications for PCOS

Hi! I’m Dr. Ravi from Kukatpally, Endocrinologist. Today we are going to learn about PCOS, it is Polycystic Ovarian Syndrome. In Polycystic Ovarian Syndrome, a woman will have irregular periods and acne, unwanted facial hair and also hair loss from the head. There will be difficulty in conceiving. And usually there will be overweight and obesity with this Polycystic Ovarian Syndrome. So what causes this Polycystic Ovarian syndrome? In PCOS patients, their ovaries won’t work normally. Every month one follicle will enlarge and mature and it will rupture releasing an egg. In PCOS multiple follicles will enlarge and they won’t rupture. And over a period of time, these follicles will accumulate. Now if you do a scan, a number of follicles will be there.

So what are the symptoms of this Polycystic Ovarian Syndrome? It contains as I told you, irregular menstruation periods, acne and androgen features just like facial hair and hair fall and the third one is irregular menses in the background of insulin resistance. These PCOS patients will have health related issues-hormonal and other problems. So they need to be evaluated, if they have high cholesterol, high blood sugar, high BP, other things, they need to get monitored and get treated accordingly.
Now we learn about what lab tests they need, okay, they need hormonal tests, blood sugars, cholesterol and they need to undergo some ultrasound scans, abdomen with the ovaries. Okay, these are the lab tests they need, and what is the treatment for PCOS? First thing is weight loss, if you lose weight around 5%, around 4-5 kgs, 50% of people, this Polycystic Syndrome will resolve. So, weight loss with diet and exercise is an important thing along with lifestyle modification and weight loss, some medications like birth control pills, they won’t acute the PCOS but the thing is they will ameliorate all problems with the…..so if you use birth control pills, your cycles will be regular, your unwanted facial hair will reduce. So these birth control pills are good, and they will protect the uterus from cancer if you use those birth control pills. Another drug is Anti-Androgens so they will block hormonal action

Side effects of these Anti-androgens like aldosterone, the thing is you will need to monitor the lever enzymes and also there is weight gain. That means water retention in the body. Okay, these are the two side effects for anti-androgens. Another drug we use is Metformin. Usually, we use that for controlling high blood sugar. But the thing is those who use this Metformin their insulin resistance will get controlled reduced and leading to normal…..cycles and other things in PCOS patients. So this can also be useful. Another one is individualizing problems; the thing is if an elderly person will come with this PCOS if their concern is they don’t want excess facial hair, so the best thing is anti-androgens. If a married person comes with PCOS, their main problem is to get a reproduction, to conceive, to get children. For them, we will use ovulation-inducing drugs. And if another married woman comes with PCOS and her complaint is hair fall and unwanted facial hair, we use another drug or local ointment to reduce facial hair or laser, these things. So, individualizing treatment depending on their problem is an issue in the treatment of PCOS.

Now, lastly, can a PCOS woman lead a normal life? Yes. The thing is whatever problem they are having there are good medicines and everything. They can lead a normal life with regular medication and regular doctor visit. So, don’t worry about PCOS.