A Guide to PCOS: Effects of PCOS on Reproduction.

PCOS(Polycystic Ovarian Syndrome) is more common that than a lot of people think, and oftentimes, it goes undiagnosed. It might be wreaking havoc, but a good number of people might not take any steps to find out what is the issue until it has done a great deal of damage been done. This is why it is important to regularly have check-ups and report any unusual symptoms. This guide to PCOS will give you a basic understanding of the condition and the effects of PCOS on reproduction.

Polycystic Ovarian Syndrome(PCOS) is one of the leading causes of fertility problems. It affects 25-30% of all women of reproductive age, and that is about a fourth to a third of reproductive women. Also, it accounts for 30% of all infertility cases. To further appreciate how detrimental the effects of PCOS on reproduction are, note that it has been found that 73% of women with PCOS have infertility due to anovulation(i.e. they do not produce eggs at all).

How to know that you have PCOS.

Aside that it causes infertility, this condition also comes with myriads of other symptoms and complications. As a guide to PCOS, here are some symptoms that can help you identify PCOS if you observe them in yourself or someone else around you:

• Irregular menstruation, with longer cycles(oligomenorrhoea).
• PCOS can cause hirsutism: Hirsutism is an excessive growth of hair in a woman. This hair grows in a pattern and in places where it would usually grow on men, like on the face, chest, etc.
• Numerous immature follicles in the ovary that appear like a string of beads. It is because of this appearance that they are also referred to as ovarian cysts.
• Abnormal ratio of hormones that regulate ovulation.
• Acne;
• Insulin resistance, diabetes and obesity.

These are only some of the symptoms. As this guide to PCOS progresses, you will get better perspective on what to expect.

Modern Understanding of PCOS.

PCOS is also known as hyperandrogenicanovulation(that is to say, non-production of eggs due to excessive androgen levels), and Stein-Levental syndrome(after the American gynaecologists that discovered it). The condition is a set of symptoms that arise due to hormone imbalances in women.

What causes this condition?

While there is no exact cause known, this guide to PCOS explores evidence that these might have a part to play in aggravating the risk for PCOS:

• Genetics: A woman is likely to develop PCOS if she is related to a person who also has the condition. Daughters are at an increased risk if their mother has the condition.
• Environment: Some chemicals in the environment can predispose one to PCOS. Some of them include xenoestrogens. These are found in plastics that we use everyday, like water bottles for example. They can disrupt the endocrine system and cause hormone imbalances. Also, bisphenol A (BPA) can cause insulin resistance, increasing the risk of PCOS. A study carried out in animals has also revealed that exposing babies to androgen, even in the womb, brings with it an increased risk of PCOS.
• Obesity, stress, etc, are also risk factors for PCOS.

The Pathogenesis of PCOS.

The pathogenesis is not understood clearly. However, as this is a guide to PCOS, the pathogenesis has been simplified somewhat. The following are worthy of note concerning PCOS:

1. Hypothalamic-Pituitary-Ovarian axis abnormality:

We can say this is a pathway, or a network of communication between the hypothalamus and the pituitary gland in the brain, including the ovaries. They exchange information that help to regulate the hormones that govern the reproductive cycles. If there is a disturbance in a communication, then there will be hormonal/chemical imbalances.

Consequently, there will be an increase in the ratio of the Leutenizing Hormone(LH) to Follicle Stimulating Hormones(FSH). So, the LH:FSH ratio will now become 3:1 or higher. This is not favorable for ovulation, and it is one reason why the effects of PCOS on reproduction can be so serious.

2. Abnormal Androgen Levels:

Androgens are “male hormones”, like testosterone for example. This does not mean that these so-called male hormones are not present in females at all. Rather, they are only present in little quantities.

The problem only arises when the androgen levels rise higher than they should go. This can happen because the enzyme regulating the formation of androgen is not well regulated itself.

When the levels of male hormone get too high, it disturbs the regular female processes, like ovulation and reproduction.

3. Anovulation due to Low FSH:

FSH is the follicle stimulating hormone. It was stated earlier that the ratio of LH relative to FSH becomes too high. FSH, being the follicle stimulating hormone, is supposed to take care of maturation of follicles for matured eggs to be produced. But because it the levels are too low, it is unable to do this. As a result, the eggs remain immature.

With no mature eggs, the process of ovulation cannot be completed.

4. Insulin resistance, obesity and diabetes:

Time and again, correlation has been discovered between obesity and PCOS, and how they are both linked together by insulin resistance. It is actually proven that about 50% of women with PCOS are obese. In fact, obesity sets you up for lots of health problems and hormonal imbalances.

It is known that insulin resistance leads to type-II diabetes. With diabetes, there’s excess sugar(glucose) in the blood. The excess glucose is due to the fact that the body resists the action of insulin to convert the glucose into a format where it can be stored in the cells, that is, glycogen. Excess sugar leads to weight gain/obesity.

Furthermore, since the action of insulin is resisted, the insulin becomes of no use, and therefore accumulates in the blood. Thus, blood insulin levels increase.

The chain reaction goes on. With excess insulin running around in the blood stream, androgen(male hormones) production is stimulated. The increase in androgen is coupled with a reduction in the sex hormone-binding globulin(SHBG). So, with more hormones running around and less SHBG to catch them, androgen levels also shoot up. The consequence is that, with higher testosterone, ovulation is suppressed, causing anovulation.

5. Complications and other long-term consequences of PCOS:

PCOS has to be addressed as soon as it is detected. This guide to PCOS seeks to aid you in doing this. Delay is dangerous, and early detection is key, so that the effects of PCOS on reproduction and overall quality of life can be cut down.

If untended, PCOS can progress to cause:

• Endometrial hyperplasia: The cells of the enodmetrial layer of the uterus start multiplying abnormally.
• Endometrial carcinoma: this overgrowth of cells in the endometrial layer can become cancerous.
• Diabetes mellitus: Due to the insulin resistance, diabetes can arise.
• Cardiovascular disease: For one, the obesity that results from PCOS can cause cardiovascular complications.
• Hypertension.

How is PCOS Diagnosed?

Diagnosis of PCOS can be made judging from the symptoms. However, it requires an expert to really see what’s going on. To diagnose PCOS, the following would have been observed:

• Hyperandrogenism;
• Oligomenorrhoea(long cycles).
• Polycystic ovaries: this can be revealed through medical imaging. The immature eggs are seen as a string of beads on the follicles.

Also, weight history, family history, medical/diet supplements, results of previous tests, are all taken into consideration.

An Ayurvedic perspective of Polycystic Ovarian Syndrome.

In Ayurveda, PCOS (or Artavakshaya) is classified as a Kapha disorder. However, the three doshas have a part to play in the reproduction. This is to say that, the effects of PCOS on reproduction is traceable to all doshas.

• Vata: Vata is responsible for movement. In reproduction, it is in charge of getting the egg to move from the ovary through the Fallopian tubes. This movement is stimulated by a force called apana vayu, the force behind downward movemnt from the navel down. It is also responsible for the flow of blood in menstruation and the movement of a baby during childbirth.
• Pitta: Pitta dosha is responsible for transformation. The complex interplay of hormones throughout the menstrual cycle is under the control of the Pitta dosha.
• Kapha: This is for structures. It is responsible for building up the reproductive system for reproduction. For example, the thickening of the endometrial layer is traceable to kapha. It is also responsible for lubricating the reproductive systemm, and prevents drying out, desptie the presence of vata.

Recall that PCOS is chiefly due to a problem with the kapha dosha. The imbalanced kapha then blocks vata and pitta, causing an obstruction of movement and suppression of the transformation processes that should normally occur.

The kapha problem also affects the jathara agni(digestive fire), so that eventually, there is an accumulation of ama(waste).

The main clinical feature of artavakshaya is granthi(cysts). This is a swelling or protuberance that is caused by a combination of mamsa, rakta, and madu, all assisted by the vitiated Kapha dosha.

Treating Polycystic Ovarian Syndrome.

In modern medicine, medications might me recommended. Most commonly, oral contraceptives or other synthetic hormones are taken to even out the hormone imbalance. However, this only masks the symptoms.

If eventually, the patient has to get off the hormone therapy, then the symptoms will return, and this time in a more advanced stage. Worse, the patient might have become infertile completely.

Tips for addressing PCOS.

1. If you are tending to obesity or you have a high body mass index(BMI), then you need to shed some weight.
2. Eating healthy can also help. Follow a PCOS diet.
3. Explore other natural Ayurvedic remedies to treating PCOS.