Chat with us, powered by LiveChat What Causes Polycystic ovarian syndrom (PCOS)?

What Causes Polycystic ovarian syndrom (PCOS)?

By MomMed | 02 August 2022 | 0 Comments


 

Overview

For centuries, physicians have searched for the root causes of PCOS. Yet, even in these modern times, this is still somewhat undefined.

However, a number of important causes have been implicated. These range from genetic to hormonal derangements, all combined to produce the features of PCOS such as hirsutism, acne, infertility, menstrual irregularities, obesity, etc.
Regardless, the solution to the problem of PCOS lies in understanding these causes.
 

What is PCOS?

It is a disorder of the female reproductive system, affecting the sexual cycle hormones including progesterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and even insulin which controls blood sugar metabolism.

The overall effect of these derangements is the increase in the secretion of male sex hormone (androgen), which then counters the development and maturation of follicles (egg cells) in the ovaries and their subsequent release via ovulation. This leaves the ovaries with immature and unreleased eggs which later become fluid-filled cavities.

The surge in androgen also creates insulin resistance which causes the release of more androgen in addition to problems of metabolism like diabetes.
 

What are the causes of PCOS?

The following are some of the known causes of PCOS:
 

Genetics:

It is believed that in addition to other factors, a genetic predisposition may be responsible for the development of PCOS.

It is possible that genes kick-start the cycle of hormonal derangements that ultimately lead to failure of ovulation and the development of multiple cysts in the ovaries.

Some studies have noted that a good percentage of women who have polycystic ovary syndrome have first-degree relatives (mothers or sisters) who have had the condition.

In the same vein, family members of women who have PCOS also show a tendency to come down with the other metabolic conditions that are associated with the condition such as diabetes, obesity, and insulin resistance.

Although obesity is common in PCOS, it is not always the case for every woman with the condition, suggesting that there are other factors at play. It would seem that there is no single gene responsible for PCOS but rather an interplay between a combination of genes. The fact that people with PCOS often have variations in their range of symptoms and in the age at which they develop these symptoms also lends credence to this.

 

Insulin resistance:

Insulin is made by the pancreas. It is the hormone that regulates blood glucose, ensuring that its concentration is kept within the range required for normal glucose metabolism.

Women with PCOS tend to have insulin resistance. The excessive androgen secretion following the loss of its control occasioned by reduced progesterone levels causes insulin resistance. This means that your body cells are no longer responsive to the function of insulin.

The resulting surge in blood sugar induces the pancreas to make more and more insulin in a futile bid to counter the resistance. This leads to excessive amounts of insulin in the circulation (hyperinsulinemia).

Insulin, which is a known stimulator of the male sex hormones, further increases the production of these androgens, leading to a positive feedback cycle that perpetuates the disorder.

Furthermore, these androgens which now exceed the small amounts required in the female body, ultimately shuts down the activities of the ovaries, leading to infertility, menstrual irregularities, and multiple cysts in the ovaries, in addition to hirsutism and acne.

 

Hormonal imbalance:

Sex hormones control the woman’s sexual cycle - menstruation, development and maturation of the eggs, and subsequently, ovulation. When there is an imbalance in these hormones, disorders like polycystic ovarian syndrome could result.

The follicle-stimulating hormone (FSH), controls the maturation of eggs in the ovary. The luteinizing hormone controls ovulation and also increases the secretion of the male sex hormone, androgens. Both hormones are produced by the pituitary gland in the brain.

When ovulation has occurred, progesterone is produced from the shells of the released eggs. This in turn controls the release of both the luteinizing hormone and the follicle-stimulating hormone.

In people with PCOS, ovulation fails to occur and progesterone is not produced, leading to a loss of control of the release of the pituitary hormone. This results in the excessive production of the luteinizing hormone which is the major instigator of the production of androgen.

Excessive androgen secretion opposes egg development and ovulation and also causes insulin resistance. It is known that insulin resistance further enables the release of even more androgens as the body secretes more insulin which has a positive effect on androgen secretion. The ultimate effect is a positive feedback loop that perpetuates the hormonal derangement and thus, the features of PCOS.
 

What options are available to you if you have PCOS?

If you are a woman of childbearing age and you have any of the features of PCOS, you need not despair because there are treatment modalities to help you conceive.

These are centered on countering the causative mechanisms of the disorder and the most prominent modalities include:

Weight loss: this has been proven to significantly improve the chances of conception in women who have PCOS

Drugs: drugs like clonidine stimulate ovulation and have been found to help women conceive.

Metformin: this anti-diabetic drug has been seen to help control blood sugar and thus, the excessive secretion of insulin.
 

The overall effect is that the stimulatory action of insulin on the production of excessive androgen in women is significantly reduced.

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