It is a question asked by most of the women suffering from PCOS. Before I get to ‘can PCOS be cured completely?’ I will give you an insight into what is PCOS.
What is PCOS?
PCOS is condition in women where there is hormonal imbalance. There is excessive levels of androgens in women with pcos. Androgens are male sex hormones which are usually present in small quantities in women. Apart from elevated levels of androgen, women with pcos also have increased production of LH which is hormone released from pituitary gland. LH is responsible for stimulating the growth of follicles in the ovaries. The excessive levels of LH leads to excessive stimulation of the ovaries which inturn lead to development of multiple small follicles in one or both ovaries ,none of which mature enough to result in ovulation. Another problem in women with pcos is decreased sensitivity to insulin which is termed as insulin resistance.Insulin resistance causes the body to produce more insulin as a compensatory mechanism. The excessive circulating insulin further stimulates the pituitary gland to produce more LH and thus further adding to the problem.
It is reasonable for one to wonder why pcos occurs and can pcos be cured completely. This article will now take you through those aspects. Though the exact reason is not yet known there may be few contributing factors in development of the condition.
Why PCOS Occurs?
Obesity may be one of the reasons for pcos problem to manifest. Obesity results in insulin resistance thereby causing increase in insulin production. Elevated levels of insulin result in development of other hormonal imbalances in the woman.
Ovarian dysfunction may be a reason for the disruption of the fine balance between production and metabolism of the male and female sex hormones, testosterone and estrogen respectively.
Now that we know the basic science behind the development of pcos, let us see what are the signs that may point towards the possibility of you having pcos.
Signs of PCOS
You may have pcos if you are facing the following problems:
- Excess facial and body hair also called as hirsuitism
- Dark or hyperpigmented areas of skin over areas as the nape of the neck ,armpits
- Menstrual irregularities in the form of longer cycles or absent menstruation
Obesity in pcos generally is in the form of fat deposition around the upper body and abdomen. It is male pattern of fat distribution as a result of excess testosterone hormone. Hirsuitism is also explained by the excess testosterone levels.
Menstrual irregularities and infertility are a result of anovulation. Anovulation is because despite the presence of multiple developing small follicles in the ovaries,none of them mature enough to release an ovum.
Some women may have decreased glucose tolerance which means decreased utilization of dietary glucose by tissues due to insulin resistance. This leads to elevated blood sugar levels.
If you are experiencing the above, you may need to get advice from an expert. The doctor may ask for some tests before concluding on a diagnosis of pcos.
- Thyroid function tests
- Serum prolactin level
- Testosterone level
- Serum HCG level
- Cortisol level
- Insulin level
- LH and FSH levels
- GnRH levels
Other blood tests
- Blood sugar levels
- Lipid profile
- Oral glucose tolerance test
- Ultrasound abdomen and pelvis – Pelvic ultrasound may reveal multiple (12 or more) small follicles in one or both ovaries. The ovaries may be enlarged.
- CT or MRI may help in detailed evaluation of the pelvic be
On the basis of your symptoms and the reports of the above tests, your doctor will be able to tell if you have pcos. If you are diagnosed with pcos, you doctor will then plan the best treatment for you based on the severity of your symptoms. Treatment for pcos is individualized after considering factors such as age, symptoms and body mass index of the woman.
But can PCOS be Cured Completely?
The effects of pcos an be brought under control with prompt treatment in the right way. Though the condition may not be reversible and may not regress completely, the symptoms can be minimized to a great extent with the right kind of advice and treatment by doctors experienced in treating pcos.
Treatment of PCOS
The corner stone of pcos treatment is weight loss. As obesity worsens insulin resistance, losing weight may lead to improved insulin sensitivity, thereby decreasing the insulin levels in the body. Decreased insulin levels will then reduce many of the symptoms of pcos which are caused by insulin excess. Woman with pcos may find it a tedious task to loose weight but it is surely possible with healthy dietary habits and regular exercising.
The medicines prescribed for pcos women are based on the symptoms and their severity.
- If the woman is experiencing problems associated with excess androgens such as excess facial and body hair, they will be prescribed medicines to counteract the male hormone testosterone.
- Menstruation can be regulated using oral contraceptive pills which are hormonal preparations, so as to bring about balance in the hormone levels.
- If infertility is a problem despite all measures to bring pcos effects under control and all other causes of infertility have been ruled out, such women may need drugs to induce ovulation.
- If impaired glucose tolerance is the problem ,insulin sensitizing drugs like metformin can be used. Metformin is also known to improve fertility in women with pcos.
In case medical therapy fails to improve fertility in women surgery is a choice.
Can PCOS be cured Completely by Surgery?
PCOS surgery comprises of laparoscopic drilling or puncturing of not more than 4 cysts in each ovary. Though it may not cure the condition completely, it helps in restoring hormonal balance and thereby improving fertility. It may avoid the need for IVF in women with pcos having difficulty in conceiving.
Benefits of laparoscopy in PCOS
- Other causes for infertility like tubal block can be looked for
- Endometriosis can be looked for and treated by cauterization which involves electrically burning the uterine lining tissue lying outside the uterine cavity.
It is as well good to understand the long term health problems which may be associated with pcos and how they can be avoided.
Long term complications of PCOS
- About 10 percent of women with pcos are prone develop diabetes in the long run. The insulin resistance and impaired glucose tolerance seen in women with pcos are contributory to the development of diabetes. Some women with pcos may also develop diabetes during pregnancy as pregnancy worsens the already existent insulin resistance.
- The hormonal imbalances present in pcos alters the lipid profile in women. It increases the levels of LDL which is commonly known as the bad cholesterol and decreases the levels of HDL which is the good cholesterol. There is also increase in the levels of triglycerides or fats in the blood. All these changes make the women more prone to heart disease and stroke etc.
- Long standing obesity associated with pcos leads to obstructive sleep apnoea due to increased neck circumference and fall back of the comparatively large tongue. It further leads to sleep problems and chronic lung problems due to inadequate ventilation of the lungs and exchange of gases.
Considering all the above side effects associated with PCOS and the fact that reducing weight itsel helps a great deal towards reducing the symptoms of pcos, healthy lifestyle modifications are very important for women with pcos.
What is meant by Healthy Lifestyle Modifications?
By healthy lifestyle modifications we mean switching over to a healthy diet and adopting regular exercise routines if in case you were not following it previously.
A healthy diet will be a one is low in saturated fats, rich in proteins, minerals and vitamins. Avoiding sugary foods is very important so as to keep your blood glucose levels under control. Avoid refined carbohydrates such as refined flour which has high glycemic index, which means that after a meal containing foods with high glycemic index, your blood sugars rise rapidly. Your food should include plenty of green leafy vegetables and coloured vegetables.Including whole nuts will provide your body with adequate amounts of unsaturated fats which is essential for maintaining good health.
Adopting a regular routine of exercising is important to keep your body weight undercheck and for maintaining overall health. Moderate amount of exercise on a regular basis will be good. Exercise may be in any form.
If you are a beginner to exercising you may start by walking briskly for about 30-45 minutes daily.
Can PCOS be cured completely by Yoga?
Yoga if done with adequate training is also a good form of exercise. It will help in weight reduction and improving fertility. Though claims of curing pcos through yoga may not be true, it surely is a very good form of exercise. If you are a beginner you may start with simples yoga poses under the guidance of a trained person.
Inspite of having exhausted all the modalities of pcos management, some women with pcos have difficulty in getting pregnant. Such women present to the clinic with doubts like getting pregnant with pcos-is it possible?
Getting pregnant with PCOS
First of all, not all women with pcos have to resort to IVF treatment ,surrogacy or adoption for a baby. Most women with pcos conceive naturally with simple things like just losing a few pounds of body weight, if they have no other factors contributing to infertility.
Why women with PCOS have difficulty in getting pregnant?
The reason behind infertility issues among women with pcos are their anovulatory cycles. Such women fail to produce a mature ovum and release them during a menstrual cycle. Anovulation is mainly due to ovaries containing multiple small follicles none of which are mature enough, as a consequence of overstimulation by the LH hormone excess.
So now that means, if the woman succeeds in ovulating after achieving balance of hormone levels either by lifestyle modifications or by medications, it is possible to get pregnant.
Mostly when women succeed in losing weight, they become more insulin sensitive, hence restoring the hormonal balance. Once the hormonal balance is achieved, mature follicles develop in the ovary during a menstrual cycle and it leads to successful ovulation. So all that most women with pcos need to get pregnant are losing few pounds of body weight.
If insulin resistance is profound and manifests as impaired glucose tolerance, metformin is given. The drug metformin improves insulin sensitivity. It is also known to improve fertility. Sometimes metformin therapy alone results in relief of hormonal imbalance seen in pcos and helps in women getting pregnant provided causes of infertility other than pcos are ruled out.
If women with pcos fail to conceive despite weight loss, they may need medicines to assist with ovulation. The medicines modify hormone levels in the woman so as to get them to ovulate successfully.
If multiple cycles of therapy with ovulation stimulation drugs have failed and all other causes of infertility have been ruled out,laparoscopic surgery for drilling or puncturing of the cysts in the polycystic ovary may be attempted.About 3-4 cysts in each ovary are punctured. The cystic fluid released brings about improvement in hormone levels. Women mostly get pregnant within one year of the treatment and it is much more cost effective when compared to in-vitro fertilization (IVF ) treatment.
In case all the above treatment options have been exhausted, In-vitro fertilization commonly known as IVF is an option.In IVF an ovum is directly retrieved from the womans ovary after giving her hormones to ovulate and it is fertilised in the laboratory with sperms collected from her spouse. The embryo is then transferred into the womans uterus. Pregnancy tests are done to confirm successful implantation of the embryo in the uterus.
So, in this era of advanced medical facilities getting pregnant with pcos is not impossible provided you are in expert hands with extensive experience in the field of pcos and infertility.
To conclude pcos symptoms can be brought under perfect control so as to lead a very normal life with pcos. PCOS is no reason to worry if you get prompt treatment and advice from experts in the field.