Symptoms of Polycystic Ovarian Syndrome, its impact on fertility, and how to manage it

Symptoms of PCOS: One prominent characteristic of PCOS is insulin resistance, which aggravates hormonal imbalances and can result in diabetes, obesity, and hypertension, among other disorders (Image: Canva)

PCOS, or polycystic ovarian syndrome, is a common disorder that affects approximately 10 percent of women who are fertile. Hormonal imbalances causing irregular periods, metabolic problems such as insulin resistance, and changes in appearance like acne and abundant facial hair are just a few of the symptoms that women with PCOS face.

Many women find it difficult to become pregnant because of this illness, which has a major impact on fertility. Elevated levels of insulin and androgens, or male hormones, interfere with ovulation, or the release of eggs from the ovaries, in PCOS. Consequently, irregular or non-existent menstrual periods are common in women with PCOS, which makes conception more difficult. Despite being one of the leading causes of female infertility, PCOS is a treatable condition.

Effective management through lifestyle modifications can enhance fertility and overall health, reducing associated risks during pregnancy and in the long term, says Dr Astha Dayal, Director- Obstetrics & Gynaecology, CK Birla Hospital Gurugram.

How PCOS affects fertility

An imbalance of hormones: Ovulation is hampered by the hormonal imbalance associated with PCOS, including the high levels of insulin and androgens. Menstrual periods become irregular or non-existent as a result of this disruption, which stops the ovaries' normal process of producing and releasing eggs, says Dayal.

Problems with ovulation: Dayal says that the chances of conception are reduced for women with PCOS who do not have regular ovulation. These ovulation abnormalities cause difficulty getting pregnant in about 30 percent of women with PCOS.

Resistance to insulin: One prominent characteristic of PCOS is insulin resistance, which aggravates hormonal imbalances and can result in diabetes, obesity, and hypertension, among other disorders that complicate fertility and general health.

Managing PCOS to improve fertility

Eat healthy: Eating a nutritious diet is essential. Prioritise a diet low in carbohydrates like fruits, vegetables, whole grains, lean meats, and healthy fats. This enhances overall hormonal balance by assisting in the management of weight and insulin levels.

Exercise regularly: Engaging in regular exercise, such as brisk walking or swimming, can help manage weight, reduce insulin resistance, and regulate hormone levels. Aim for at least 30 minutes of moderate exercise three to five times a week.

Reduce stress: Reducing stress with yoga or meditation can have a beneficial effect on fertility. Lowering stress contributes to general wellbeing and hormone balance.

Control weight: Keeping a healthy weight is essential for PCOS management. Even a small weight loss of 5 percent to 10 percent can increase the likelihood of getting pregnant and return ovulation cycles to normal. Reducing pregnancy issues also means reaching a healthy weight prior to conception.

Medical interventions

Medication:

Metformin: Promotes better ovulation, regular menstrual periods, and helps control insulin resistance. It increases the efficiency of modifying one's lifestyle, says Dayal.

Drugs for ovulation induction: Medication such as letrozole or clomiphene citrate promotes the development and release of eggs. Due to hazards such ovarian hyperstimulation syndrome and multifetal gestation, they should be taken with caution.

Assisted Reproductive Techniques

Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF): These techniques have high success rates for women with PCOS, especially when lifestyle changes and medications are insufficient.