How to Cure PCOS?

Polycystic ovary syndrome (PCOS) has no complete cure yet, but its symptoms can be managed by adopting specific lifestyle changes and using different treatment options.

Lifestyle Changes

Maintaining a healthy weight is an important step in the management of PCOS symptoms. Weight gain and obesity further escalate insulin resistance which exacerbates the symptoms of PCOS. Reducing weight helps the body to use insulin efficiently and reduces the production of androgens in the body. Sometimes even losing a small amount of weight can kick-start your ovulation and make your periods regular.

Weight loss is difficult with PCOS because your body is at storing mood, it can only be achieved by making some lifestyle changes including

●      Eating Healthy Food

Try to add healthy, low-calorie, and high-fiber food to your diet whereas limiting the intake of trans fat and processed food. It will not only assist you to maintain a healthy weight but a healthy diet is also a secret to a healthy life.

●      Physical Activity and Exercise

Try to have an active lifestyle with moderate amounts of exercise daily. Exercise helps you to maintain your healthy weight and according to research it also improves ovulation frequency by increasing insulin sensitivity.

Medicines

Your physician will prescribe you medication depending on your desire to get pregnant or not. If you want to conceive then the focus of the treatment will be to improve your fertility otherwise the treatment will focus on the management of other symptoms to avoid future complications.

Fertility Medications

Following medications may help to make your ovulation more regular and improve your chances to conceive.

Clomiphene citrate: It is mostly chosen on a priority basis because it is best for inducing ovulation in women with PCOS. It works by stimulating the hormones that support ovulation.

Letrozole: It is an aromatase inhibitor that also helps in inducing ovulation. Research shows that it is more effective in inducing ovulation than clomiphene citrate; it should be used as a first-line agent to treat anovulation in women with PCOS. However, the use of letrozole for infertility is still off-label and has not been approved by FDA.

Metformin: Metformin is used in diabetes for treating insulin resistance. Since insulin resistance also plays a major role in PCOS, that's why using metformin is also beneficial in reducing the symptoms of PCOS, Research shows that metformin helps in reducing the resistance of the body cells towards insulin and decreases its level in the blood, of both obese and non-obese patients. Low levels of insulin help in reducing the level of androgens in the body, restore the normal menstruation cycle, and increase the ovulation rate in women with PCOS.

Medications to Control the Symptoms of PCOS

If you are not wanted to conceive then your physician may prescribe you the following medications for improving PCOS symptoms

Contraceptives: Birth control pills or contraceptives are the first choices for women with PCOS who don't want to conceive right now. They help in regulating the periods to minimize the risk of uterus lining overgrowth which can become cancerous in the future. They are also helpful in reducing the symptoms of PCOS such as excessive hair growth by reducing the level of Male hormones. A combination of birth control pills that contain two hormones estrogen and progestin (synthetic form progesterone) is the preferred choice by the physician, if it does not suit you due to the possible side effects then your physician may be switched you to the mini pill that contains only progestin and has less side effect as compared to combination birth control pill.

Spironolactone: it is mainly developed as a diuretic, but it also acts as an androgen blocker. It helps in the treatment of excessive hair growth and acne in PCOS by reducing the effects of androgens hormones on the skin. You should not have to take this medicine if you are pregnant or want to be pregnant as it can cause feminization in male fetuses because of its antiandrogenic effect.

Eflornithine:  it is topically applied to reduce unwanted hair growth. It produces its action by inhibiting the enzyme required for hair production.

Electrolysis and laser therapy: These methods can also be used to reduce unwanted hair. Laser therapy destroys the hair follicles whereas in electrolysis individual hairs are removed by the application of an electrical current.

Surgery

Sometimes surgical intervention is required if medications do not work to improve fertility. A minor surgical procedure known as laparoscopic ovarian drilling is performed. In this procedure, some tissues of the ovaries that are producing androgens are destroyed by the use of heat or laser. It results in decreased production of androgens which restart ovulation.

Summary

PCOS is a common hormonal disorder among women which can affect your fertility and can cause a range of symptoms. If it is left untreated it can start to affect your daily life and can cause multiple long-term complications. If you are diagnosed with this condition, it is important to fight it by taking appropriate medical intervention and by adopting healthy changes in your lifestyle so that you can enjoy a happy and healthy life.

About the Author:

Dr. Dur e Sameen is a Pharm-D graduate from Jinnah University for Women and working as a freelancer, creative writer.

BASIC RECALL:

If you have irregular periods along with other symptoms such as acne, hair fall, and excessive hair growth on your body, there is a high chance you have PCOS. It is one of the most common health issues among women of childbearing age and one of the leading causes of female infertility. It is not completely curable, but the good thing is that it can be managed by adopting certain changes in your lifestyle and diet. Many medications are also available for reducing the impact of PCOS on your body. If you want to know more about PCOS, its effects on your body, and how you can manage a normal life with PCOS then please read on.

What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome (PCOS) is a common hormonal problem among women during their fertile years. It disturbs the normal functionality of the ovaries, which leads to different complications in the body. This condition may

 ●     Reduce the capability of the ovaries to produce mature eggs.

●     Increase the production of androgens (male hormones) by the ovaries.

●     Develop multiple small cysts in the ovaries.

 Usually, our ovaries perform two functions. They regulate the menstrual cycle by producing hormones like estrogen, progesterone, and small quantities of male hormones called androgens. Secondly, they release a mature egg every month for fertilization. This phase of the menstrual cycle is called ovulation. If the egg is not fertilized, then your body throws it out with the help of menstruation.

 Gonadotropin-releasing hormone (GnRH), which is released from the hypothalamus, has a major influence on the function of the ovaries. It sends signals to the pituitary gland to produce two hormones: follicle-stimulating hormone (FSH), which helps the ovaries in the production of follicles (a sac that contains an egg) and luteinizing hormone (LH), which prompts the ovaries to release a mature egg by rupturing the ovarian follicles.

 In polycystic ovary syndrome, due to abnormalities in the secretion pattern of GnRH hormone from the hypothalamus, the LH to FSH ratio is raised. The lower FSH level halts the growth of ovarian follicles and makes them unable to release mature eggs. These immature follicles start to accumulate in the ovaries and appear as a cyst under medical imaging. Because of the presence of large numbers of cysts, it is called polycystic ovary syndrome. Women with PCOS may have 12 or more of these immature follicles, and the ovaries may be a bit larger. However, multiple cysts and enlarged ovaries are not present in all cases.

 whereas the increased LH level becomes the reason for the increased production of androgens. Increased levels of androgens cause additional complications in the menstruation cycle as they cause desensitisation of the hypothalamus to progesterone/estrogen-negative feedback. It further increases gonadotropin secretion and hence ovarian androgen production. It ultimately results in a self-starting vicious cycle.

 What are the Causes of PCOS?

We are still unaware of the exact cause of PCOS. Though certain factors can lead to PCOS, including;

Insulin Resistance.

Insulin resistance is considered a major risk factor leading to PCOS. It is estimated that 65 to 70% of women who have PCOS also have insulin resistance.  Insulin is a hormone that helps your body to regulate blood sugar. It is secreted from the gland pancreas. It helps our body cells to utilize sugar as a source of energy. Sometimes our body develops resistance to the action of insulin which leads to increased levels of glucose in our blood. As a counter-response, our body starts to make more insulin. In PCOS, despite peripheral insulin resistance, our ovaries don't develop this resistance, and even become more sensitive to the effect of insulin. Too much insulin becomes the reason for excessive androgen production in the body by different methods such as:

● Insulin increases the response of luteinizing hormone on ovarian theca cells and leads to increased production of androgens.

● Insulin also inhibits the release of sex hormone-binding globulin (SHBG) from the liver. SHBG is a circulating protein that binds with the androgens and helps in their transport through the blood. Decreases SHBG levels increase free testosterone in the blood which increases androgenic activity.

● Insulin also triggers GnRH-mediated gonadotropin release from the anterior pituitary which also results in increased androgen biosynthesis by the ovaries.

Obesity.

Obesity is not the primary cause of PCOS and many women have PCOS at a normal weight or underweight. However, PCOS is more likely to happen in women who are overweight. The reason may be the linkage between obesity and insulin resistance. Being overweight further exacerbates insulin resistance and results in the production of more insulin by the pancreas.  High insulin level increases androgens production and leads to further weight gain. This is the reason why weight loss is difficult with PCOS. However, losing weight can help to improve insulin resistance and PCOS symptoms.

Genetics.

Genetics also plays an important role in PCOS. About 50% of women with PCOS also have some female blood relative with PCOS. According to research, instead of a single gene, multiple gene mutations may be associated with different phenotypes of PCOS. The Genes that are under study for their role in the implication of PCOS are those that are involved in

●     Steroid hormone metabolism

●     Gonadotropin action and regulation

●     Insulin action and secretion

●     Obesity and energy regulation.

Inflammation.

The role of chronic low-grade inflammation has also been identified in PCOS. Several studies showed elevated levels of CRP (C reactive protein) in women with PCOS compared to those without this condition. It is also observed that other markers of inflammation such as inflammatory cytokines, oxidative stress, and White blood cells are also higher than normal in most cases of PCOS. Since Chronic low-grade inflammation is associated with androgen excess and insulin resistance, it is also considered a key contributor to the development of PCOS.

For more information about Polycystic Ovary Syndrome, Please stay connected.

About the Author:

Dr. Dur e Sameen is a Pharm-D graduate from Jinnah University for Women and working as a freelancer, creative writer.

The first thing we should know about depression is that it is not the state of sadness or grief but it is a common and serious disorder that negatively affects the way of feeling, thinking and acting in affected individual. It is also called major depressive disorder. Depression is a common illness which can lead to different problems like melancholy, loss of interest in preferred activities, decrease in ability to work properly. A person suffering from depression lives in a persistent state of sadness, guiltiness, and being worthlessness.

Signs and Symptoms- That we need to identify-

There may be all or some of symptoms like hopelessness, tearfulness, frustration, loss of libido, loss of interest in enjoyable activities, sleeping disturbances, loss or gain of weight, fatigue, restlessness, anxiety, abnormal changes in the way of thinking, speaking and movement, suicidal thoughts, and suicide attempts.

Depression may affect differently; some patients face noticeable changes in their behavior while some patients feel miserable without knowing the cause.

What actually leads to Depression-

Depression may occur in every stage of life. It is more common in teen ages. It is most commonly occurs in women than men. It may also occur in children. Most symptoms of depression are similar in every population but there can be some differences in children and adults.

Depression occurs due to various reasons. It may be running genetically in some individuals. Biological differences in brain also causes depression. Neurotransmitters play a vital role in the maintenance of brain activity, and when they are disturbed from their normality it also leads to depression. Irregularity of hormones also affect the state of mind, so when hormonal changes occur in an individual, it may also causes depression.

What we can do about it-

Depression is a serious illness but fortunately it is treatable. If you are feeling depressed, you should visit to a health professional for a thorough diagnostic evaluation. It may be done through an interview and physical examination. It may also be find through blood test in some rare cases, that whether it is caused due to hormonal changes or vitamins deficiency. If you are diagnosed with depression, you can be treated through varies range of therapies. The first option is psychotherapy or talk therapy. It will help you to give up on negative thinking, and to improve yourself through a positive change. If your depression is moderate to severe, you will pass through both psychotherapy, and antidepressants. Antidepressants are used to regulate the chemistry of brain. They are used for long term. They are used according to the advice of the prescriber. There are some painful side effects of antidepressants which you should know before starting the treatment. It is necessary to keep track of side effects and discuss it with the therapist. In severe major depression, Electroconvulsive therapy is used. When a patient does not respond to other treatment, then this option is used. It is done through electrical stimulation of the brain of patient.  Self-coping is also a best strategy to fight depression. Taking exercise, getting enough sleep, eating healthy diet, avoiding unhealthy consumption, and working in healthy environment may help a person to reduce the symptoms of depression.

A Quick Reminder:

Depression is real and denying it, is not the solution of problem. It is treatable. For a healthy individual, a healthy state of mind is mandatory. Perfect peace and health of mind is achieved through proper evaluation, diagnosis and treatment.