Polycystic Ovary Syndrome: Hormonal Imbalance and Treatment Options

Polycystic Ovary Syndrome (PCOS)

Hello, Doctor: Since I started menstruating, my cycle has always been irregular.
Later, after some tests, I was diagnosed with polycystic ovary syndrome (PCOS).
I found some related information online, but my body shape has always been quite normal, and I haven't experienced sudden weight gain.
The symptoms of hirsutism are also mild, but my skin condition has not been very good.
I am currently seeing a traditional Chinese medicine practitioner for treatment.
I would like to ask why PCOS causes an excess of androgens? If my menstrual cycle becomes regular, will the hormone levels also normalize? Can the skin and hirsutism issues improve? Is PCOS curable? If I need to go back to the hospital for further examination, will it involve blood tests? I have quite a few questions.
Thank you, Doctor.

Alice, 20~29 year old female. Ask Date: 2016/01/20

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Women with polycystic ovary syndrome (PCOS) face two main issues: irregular ovulation and increased androgen activity in their bodies.
In addition to these two problems, these women often experience metabolic abnormalities.
For a long time, the medical community has lacked clarity regarding the causes, consequences, and manifestations of this condition, and there has been no consensus on its diagnosis.
It wasn't until 2003 that experts in Europe and the United States reached a consensus on polycystic ovary syndrome, defining the latest diagnostic criteria to include three conditions: infrequent menstrual cycles or prolonged cycles, elevated androgen levels, and the presence of polycystic ovaries.
PCOS has a genetic predisposition.
Issues such as acne, hirsutism, and hair loss due to elevated androgens can be managed with anti-androgen medications or oral contraceptives that have anti-androgen properties.

Polycystic ovary syndrome is the most common endocrine disorder among women and is one of the most overlooked women's health issues.
Historically, there has been no consensus in the medical community regarding the causes and management of this condition.
Although current medicine cannot cure this endocrine disorder, similar to diabetes and hypertension, it is hoped that by understanding this condition, patients can better manage their physiological issues and seek treatment for their symptoms, thereby rebuilding their confidence and achieving a normal physiological and psychological life.

Currently, PCOS is considered a metabolic disorder that requires long-term observation and attention, with a genetic predisposition.
The primary focus of treatment is lifestyle modification.
Therefore, follow-up visits to the hospital should include blood tests, ultrasounds, and medical history assessments, as well as education and counseling related to diet, exercise, weight management, metabolism, emotional health, and fertility.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2016/01/20

More Info

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that affects many women of reproductive age. It is characterized by a combination of symptoms, including irregular menstrual cycles, elevated levels of androgens (male hormones), and polycystic ovaries. Understanding the hormonal imbalances associated with PCOS and the available treatment options is crucial for managing the condition effectively.

Hormonal Imbalance in PCOS
The hormonal imbalance in PCOS primarily involves an overproduction of androgens, which can lead to various symptoms such as acne, hirsutism (excessive hair growth), and alopecia (hair loss). The exact cause of this imbalance is not fully understood, but it is believed to be linked to insulin resistance, which is common in women with PCOS. Insulin resistance can lead to higher insulin levels, which in turn can stimulate the ovaries to produce more androgens.

In your case, even though you do not exhibit significant weight gain or hirsutism, it is possible to have elevated androgen levels and still maintain a normal body weight. This is because PCOS can manifest differently in each individual, and symptoms can vary widely.

Menstrual Cycle Regulation and Hormonal Balance
Regarding your question about whether normalizing your menstrual cycle can help restore hormonal balance, the answer is yes. Regular menstrual cycles often indicate that ovulation is occurring, which can help regulate hormone levels. Treatments such as hormonal contraceptives (birth control pills) are commonly used to help regulate menstrual cycles and reduce androgen levels. These medications can also improve skin conditions related to excess androgens, such as acne and oily skin.

Improvement of Skin and Hair Symptoms
As for the skin and hair issues, many women with PCOS find that their symptoms improve with appropriate treatment. Hormonal contraceptives can help reduce androgen levels, leading to improvements in acne and hirsutism. Additionally, anti-androgen medications, such as spironolactone, can be effective in managing these symptoms by blocking the effects of androgens on the skin and hair follicles.

Can PCOS Be Cured?
Currently, there is no definitive cure for PCOS, but it can be effectively managed. The focus of treatment is on alleviating symptoms and reducing the risk of long-term complications, such as type 2 diabetes and cardiovascular disease. Lifestyle modifications, including weight management, regular exercise, and a balanced diet, are essential components of managing PCOS. These changes can improve insulin sensitivity and help regulate menstrual cycles.

Follow-Up and Testing
If you are considering further evaluation, blood tests are typically conducted to assess hormone levels, including androgens, insulin, and glucose levels. An ultrasound may also be performed to check for the presence of cysts on the ovaries. Regular follow-up with a healthcare provider is important to monitor your condition and adjust treatment as necessary.

In summary, while PCOS is a chronic condition, it can be managed effectively through a combination of lifestyle changes and medical treatments. Regular monitoring and a tailored treatment plan can help you achieve better hormonal balance and improve your overall quality of life. If you have any further questions or concerns, it is advisable to consult with a healthcare professional who specializes in reproductive health or endocrinology.

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