Welcome back to the Polycystic Ovary Syndrome (PCOS) special topic. Today, we will discuss the following issues:
- 6. The causes of PCOS are not clear.
- 7. What tests are required for diagnosing PCOS at the hospital?
- 8. PCOS patients may experience insulin resistance.
- 9. Both patients and doctors find PCOS frustrating.
- 10. How do PCOS patients prepare for pregnancy?
The causes of PCOS are not clear
Firstly, the exact causes of PCOS are currently unclear. Some suggest that it may be due to refined diets and lifestyle habits in recent years. However, this viewpoint has a flaw, as PCOS has been present in the past, but the limited number of people seeking medical attention and available diagnostic samples made it less noticeable.
Many mothers of adolescent girls nowadays get anxious if their daughters miss their periods for a few months, leading to an easy diagnosis of PCOS when consulting a doctor. However, this may be an exaggeration, as menstrual irregularities are common during adolescence due to academic stress and emotional influences.
Some girls, now grown, were diagnosed with ovarian cystic changes due to irregular periods during adolescence. Years later, they still believe they have PCOS. If asked about their current menstrual regularity, they may claim it’s regular. However, informing them that they were never PCOS patients can be hard for them to accept.
What tests are required for diagnosing PCOS at the hospital?
Now, let’s discuss the tests required for diagnosing PCOS. In addition to the ultrasound mentioned in the first article, to assess hormone levels, blood tests for six sex hormones are necessary. These include progesterone, estradiol, luteinizing hormone, testosterone, prolactin, and follicle-stimulating hormone. This examination primarily assesses the endocrine status of the ovaries to determine if there is an imbalance and if the ovarian function in females is normal.
- Progesterone: Helps protect the uterine lining and maintain a normal pregnancy. This test helps identify issues such as ovulation abnormalities and luteal phase dysfunction.
- Estradiol: Promotes the development of female secondary sexual characteristics and changes in the uterine lining during the proliferative phase. Through estradiol testing, abnormalities in ovarian function can be identified.
- Luteinizing hormone: Promotes ovulation and maintains the function of the corpus luteum. It helps to understand whether there are abnormalities in ovarian function and ovulation disorders.
- Testosterone: Promotes the closure of non-dominant follicles and increases libido. This test helps identify conditions such as PCOS and tumors that secrete male hormones.
- Prolactin: Plays a role in female breast development and lactation, also participating in the regulation of reproductive function. This test helps identify the causes of amenorrhea and diseases associated with high prolactin levels.
- Follicle-stimulating hormone: An important hormone in the development of ovarian follicles. Testing this hormone helps doctors understand issues related to menstrual irregularities and abnormal ovarian function.
Hormone levels exhibit characteristic changes during different ovarian cycles, so it’s essential to know the specific phase when assessing them. It is recommended to undergo these tests on days 2-5 of the menstrual cycle when hormone levels are at a baseline. The timing of these tests may vary for different diagnostic purposes.
PCOS patients may experience insulin resistance
Generally, we recommend seeing a gynecologist for these tests. Some might suggest an endocrinologist for the sex hormone panel, but a portion of PCOS patients may also have insulin resistance.
Speaking of insulin resistance, let’s briefly discuss diabetes. The food we consume is like packages delivered to a station, insulin acts as the delivery person. Insulin carries the sugar from the food we eat, reaching every cell and tissue, knocking on their doors and saying, “Your sugar is here, please take it.” Sugar is the energy source for cells and organs.
Insulin resistance occurs when, after insulin carries the sugar to the cells, they refuse to open the door, saying, “We still have sugar from the last delivery, don’t give us more; we can’t use it anyway.” When the body experiences insulin resistance and impaired metabolic function, it becomes necessary to consult an endocrinologist.
Insulin resistance typically leads to weight gain, increased body mass index (BMI), and improper fat distribution. Normally, insulin transports sugar to cells and organs for utilization. In cases where this is not possible, sugar remains in the bloodstream, accumulating in certain areas as it flows through the body. This can lead to irregular fat distribution and an increase in BMI, resulting in obesity.
Both patients and doctors find PCOS frustrating
Many patients want to understand the causes of PCOS, but the current medical knowledge cannot provide definitive answers. Both doctors and patients find this condition frustrating because PCOS cannot be cured. If someone is diagnosed with PCOS, it can be disheartening. However, many diseases are incurable in humans, and PCOS is just one of them. We face numerous challenges, such as the common cold, for which doctors can’t predict the frequency. Similarly, urinary tract infections and vaginal infections aren’t diseases that can be permanently solved.
Are there cured patients? Yes, for instance, some patients have had their uterus removed, eliminating the possibility of uterine fibroids. However, does an incurable disease necessarily mean the patient suffers significant pain? Does the inability to cure PCOS imply a diminished quality of life? These are not equivalent statements.
How do PCOS patients prepare for pregnancy?
Some patients are diagnosed with PCOS while trying to conceive. How should PCOS patients prepare for pregnancy? If, at the time of PCOS diagnosis, the menstrual cycle is regular, it is not advisable to intervene. Management of diet, weight control, and exercise are recommended at this stage. With a regular menstrual cycle, it is assumed that ovulation is normal, though there are rare cases where the cycle is regular but ovulation does not occur.
In clinical practice, if the menstrual cycle is regular, doctors do not recommend aggressive drug treatments. In summary, the more weight is lost in cases of obesity, the higher the chances of pregnancy. However, the ultimate result varies from person to person.
