Polycystic Ovarian Syndrome (PCOS) currently affects two out of 10 women of reproductive age with a global prevalence of 8-13%. Polycystic Ovary Syndrome is a disorder of the endocrine system that causes excessive hair growth, baldness, infertility and weight gain in women.

There are many women who are not even aware that they are suffering from it and what exactly it is. It is the most common hormonal imbalance problem among females and one of the biggest causes of female infertility, as well as the cause of numerous small cysts (fluid-filled sacs) that form in the ovaries. If this condition is left unchecked or undiagnosed, it can lead to long-term health concerns.

**What is PCOS and why does it happen?, **

Stein-Leventhal syndrome broadly known as Polycystic ovary syndrome (PCOS) is a hormonal imbalance that occurs when your ovaries (the organ that produces and releases eggs) create excess hormones. If you have PCOS, your ovaries produce unusually high levels of hormones called androgens. This causes your reproductive hormones to become imbalanced.

All women produce male hormones in their bodies. But if you have PCOS, your body produces a little bit more than the normal amount of testosterone. High LH (Luteinizing Hormone) and insulin levels cause the ovaries to produce more testosterone.

Testosterone is produced normally in both the ovaries and the adrenal gland (a small gland sitting on top of the kidneys). In addition to androgens, the adrenal gland also produces other hormones, including cortisol, adrenalin, and aldosterone. Specifically, it is the theca cells within the ovary that are responsible for the overproduction of hormones.

In the normal situation, the ovaries and adrenal glands contribute equally to testosterone production. But women with PCOS the ovary is the key source of excessive testosterone production. PCOS usually have elevated levels of total testosterone. Even a slight increase in testosterone can affect a woman’s menstrual cycle and ovulation.

How serious is PCOS for women?,

Studies show that cardiovascular disease, hypertension, lipid metabolic problems, and endometrial cancer are all two to six times more common in PCOS patients than in the general population. Globally, prevalence estimates of PCOS range from 2.2% to 26%, affecting 6%–18% of adolescent girls.

Women are more prone to these conditions due to their anatomy and hormonal makeup. Women with PCOS have a higher risk of developing other health complications such as hypertension, high cholesterol, anxiety and depression, sleep apnea, heart attack, diabetes and endometrial, ovarian and breast cancer. Women who have PCOS have a higher rate of miscarriage, gestational diabetes, and premature delivery.

Because the female urethra is shorter than the male urethra, making it easier for bacteria to enter the bladder and cause PCOS. There is currently no cure for PCOS. However, several drugs are used to manage the condition’s symptoms and the menstrual cycle.

Although the cause of the abnormalities of PCOS is not so well established, accumulating evidence suggests that it is a multi-gene condition with substantial epigenetic and environmental impacts, including nutrition and lifestyle variables.

This means if your biological parent has PCOS, you may be more likely to have it, too. Menstrual abnormalities and reproductive dysfunction are the most commonly reported signs of PCOS, leading to female infertility.

Symptoms of PCOS,

The symptoms and experiences of PCOS vary between patients. If a woman has PCOS, she may have a combination of the following:
An imbalance of sex hormones.
Polycystic ovaries- Your ovaries might be bigger. Many follicles containing immature eggs may develop around the edge of the ovary. The ovaries might not work the way they should.
Ovaries that are large or have many cysts.
Irregular periods, missed periods or very light periods
Acne
Too much androgen- High levels of the hormone androgen may result in excess facial and body hair. This is called ‘Hirsutism’. Sometimes, severe acne and male-pattern baldness can happen, too.
Metabolism problems
Insulin resistance and diabetes/high levels of insulin and androgens, can contribute to the development of PCOS/PCOD.
Weight gain, especially around the belly (abdomen)
Pimples
Hair loss
Fertility issues

Is there any cure of PCOS?,

There is no set cure as such for PCOS, but one of the best ways to manage it is by introducing changes in your lifestyle (after having consulted professionals, of course: your gynecologist, an endocrinologist and a dietician, preferably).
Its symptoms can be controlled with the help of dietary changes, exercises and some medicines. You can follow these tips to bring positive changes in your life.
Walk and exercise for 30 minutes daily.
Pay attention to weight, avoid obesity.
Eliminate fast food from the diet and eat fruits and vegetables.
Consult a doctor if you notice any unusual symptoms, so that serious health problems can be avoided in future.

PCOS prevalence in India,

Only a few researchers participated and studied the prevalence of Polycystic Ovarian Syndrome in different regions of India. The prevalence of PCOS in India ranges from 3.7% to 22.5% with very limited data. Due to which it is very difficult to define the prevalence of PCOS in our country.

An estimated one in five (20%) Indian women suffer from PCOS 25% of the Indian female population didn’t know about PCOS or PCOD while 65% women were not aware of PCOS symptoms.

A study conducted by the department of endocrinology and metabolism, AIIMS (All India Institute of Medical Sciences) demonstrated that around 20-25 percent of Indian women of reproductive age are experiencing PCOS. While 60 percent of women with PCOS are dealing with obesity, 35-50 percent have a fatty liver. Around 70 percent have built up insulin resistance leading to diabetic conditions, also around 60-70 percent have an abnormal state of androgen and 40-60 percent have glucose intolerance which is affecting their hormonal balance.

Similar studies in South India and Maharashtra showed the predominance of PCOS, as 9.13% and 22.5% respectively.

In a developing country like India, poor access to health care, resources and medicines, and limited paying ability may contribute to poor adherence, contributing to the national morbidity burden. Poor adherence reflects the falling health of individuals. To design culturally appropriate care for women with PCOS, documenting the barriers can identify gaps in actual practices and enable planning specific recommendations for future implementations.
PCOS does not find any place in government health programs, though it is a significant endocrine disorder affecting women of the reproductive age group. With a meagre budget allocation of funds, the PCOS affected women have far less possibility of seeking early diagnosis and treatment services.