PCO – Polycystic Ovary Syndrome: Symptoms and Treatment
PCO (Polycystic Ovary Syndrome) is a common hormonal disorder in women causing irregular periods, elevated androgen levels, and cystic changes in the ovaries.
Things worth knowing about "PCO"
PCO (Polycystic Ovary Syndrome) is a common hormonal disorder in women causing irregular periods, elevated androgen levels, and cystic changes in the ovaries.
What is PCO?
PCO stands for Polycystic Ovary Syndrome (also known as PCOS) and is one of the most common hormonal disorders affecting women of reproductive age. It is characterized by a combination of hormonal imbalances, structural changes in the ovaries, and often metabolic disturbances. Globally, an estimated 5–15% of women of childbearing age are affected.
Causes
The exact cause of PCO syndrome has not yet been fully determined. It is believed to result from a combination of several factors:
- Hormonal dysregulation: Elevated levels of male sex hormones (androgens) disrupt the normal maturation of eggs in the ovaries.
- Insulin resistance: Many women with PCOS have reduced sensitivity to insulin, which can further stimulate androgen production.
- Genetic factors: The syndrome frequently occurs within families, suggesting a hereditary component.
- Chronic inflammation: Low-grade inflammatory processes in the body may also contribute to its development.
Symptoms
The symptoms of PCO syndrome are diverse and vary from woman to woman. Common complaints include:
- Irregular or absent menstrual periods (oligomenorrhoea or amenorrhoea)
- Signs of excess androgens: excessive hair growth on the face and body (hirsutism), acne, or oily skin
- Hair thinning or loss (androgenetic alopecia)
- Weight gain and difficulty losing weight
- Ovarian cysts visible on ultrasound
- Difficulty conceiving due to absent or infrequent ovulation
- Mood swings and psychological distress
Diagnosis
The diagnosis of PCO syndrome is based on the Rotterdam Criteria. At least two of the following three criteria must be met:
- Irregular or absent ovulation
- Clinical or laboratory evidence of elevated androgens
- Polycystic ovaries on ultrasound (at least 12 follicles per ovary or increased ovarian volume)
Additional investigations include blood tests (hormone levels, blood glucose, insulin levels) and the exclusion of other conditions such as thyroid disorders or adrenal gland diseases.
Treatment
A definitive cure for PCO syndrome is currently not available. Treatment is tailored to the individual symptoms and whether pregnancy is desired:
Lifestyle Modifications
Weight loss through a balanced diet and regular physical activity is often the most effective measure to normalize hormone levels and improve insulin sensitivity.
Medical Treatment
- Hormonal contraceptives (the pill): Regulation of the menstrual cycle and reduction of androgen levels
- Metformin: Improvement of insulin sensitivity, particularly when insulin resistance is present
- Anti-androgens: Treatment of acne and hirsutism
- Clomiphene or letrozole: To stimulate ovulation in women trying to conceive
Additional Measures
Psychological support may be beneficial for women experiencing emotional distress. Cosmetic treatments such as laser hair removal can be used to manage hirsutism.
Long-Term Risks
Untreated PCO syndrome may increase the risk of developing the following conditions:
- Type 2 diabetes
- Cardiovascular disease
- Endometrial cancer
- Sleep apnoea
- Depression and anxiety disorders
References
- Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004): Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Human Reproduction, 19(1), 41–47.
- Teede HJ et al. (2018): Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction, 33(9), 1602–1618.
- World Health Organization (WHO): Polycystic ovary syndrome. Available at: https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome
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