PolyCystic Ovarian Syndrome(PCOS) in Adolescent GirlsView in: Tamil
– Dr. Vidhya Selvam, MBBS, MS, DNB, MRCOG(UK)
Covid pandemic has led to the epidemic outburst of many lifestyle disorders. One among them affecting our kids in adolescent age group is polycystic ovarian syndrome. In this article, we are going to see about PolyCystic Ovarian Syndrome(PCOS) in detail.
When do you suspect polycystic ovarian syndrome?
When a woman presents with irregular cycles, male pattern hair growth over face, ultrasound showing enlarged ovaries with small follicles studded around the ovaries.
Associated features are weight gain, black pigmentation around neck.
What is the cause of polycystic ovarian syndrome?
In a woman with regular menstrual cycles, female hormone, estrogen is present in the first half of the cycle. Rise and fall in estrogen is so well organised that a woman has this cyclical increase and fall in estrogen from her menarche (first cycle) to menopause (last cycle). Fat cells in our body do not just contain fat. They are active glands secreting many hormones. One of them is estrone, weak for of female hormone estrogen.
So, the estrogenic action that should be present only for 15 days is present throughout the month.
The increased fat content in blood makes our body resistant to insulin action. To overcome the resistance our pancreas produces more insulin. Insulin keeps more amount of testosterone in the active form.
Because of these various abnormal changes in the hormonal mileu, the ovary loses its cyclical function. Growth of the follicles from which eggs are released is arrested at earlier stage. There will be no release of egg from ovaries. And hence no menstruation.
Because of high active testosterone, abnormal male pattern hair growth will be present. So, poly cystic ovaries are the triad of irregular cycles, features of excess testosterone and ultrasound image showing enlarged ovaries with immature follicles around the ovaries.
What are the long-term sequelae of having polycystic ovaries syndrome?
As I said, there is no release of eggs from ovaries. So, when the girl attempts for pregnancy later in life, the chances of spontaneous conception is less.
There is insulin resistance. So, the girls are at risk of developing diabetes in the future.
The uterus is exposed to high estrogen for a long time. This will make them at risk of developing cancer of uterus in future.
So excess fat is the root cause of all the problem?
Yes, in most of the time.
How to treat?
Lose the excess fat. Take healthy diet. Do regular exercises. Reduce 5%of your present weight. That would help to regain the normal ovarian function.
What is healthy diet?
Food rich in fibres- greens and vegetables.
Food low in refined sugars
Food low in fat content
Food devoid of broiler chicken and it’s eggs
Foods taken in small amount at regular intervals.
Can I have PCOS with normal weight?
Yes. sometimes the girl may have genetic variations that make their body resistant to insulin. At these times, PCOS may be present with normal weight.
I have regular cycles. But ultrasound shows polycystic ovaries. Should I be worried?
No. You need not worry if the ultrasound shows polycystic ovaries in a regularly menstruating woman with no features of excessive testosterone action.