Polycystic ovary syndrome is a chronic endocrine disorder, metabolic syndrome and fertility, according to AIIMS, 25% of women in India suffer from PCOS and it is currently estimated to affect 30% to 35% more of women in India, says the medication report issued by ministry of health and wellness recently.

In addition to reproductive and skin factors, PCOS is also associated with a significant increase in the risk of various cardio metabolic variables, low quality of life, emotional disorders, sexual dysfunction, body image problems and poor diet. However, PCOS awareness remains low, in part because of its misleading name; polycystic ovaries do not need to be diagnosed with an unknown etiology or a complex condition that affects many organ systems in different ways, depending on the phenotype.

Polycystic ovary syndrome (PCOS) is a widespread reproductive disease that covers a wide range of related health conditions and contributes to various metabolic processes. PCOS is characterized by hyper androgenise, polycystic ovaries, and anovulation. It increases the risk of insulin resistance (IR), type 2 diabetes, obesity, and heart disease. The etiology of the disease remains unclear, and the automatic phenotype makes the combined diagnosis difficult among physicians.

It appears to be a family genetic disorder caused by a combination of environmental and genetic factors. It can be linked to metabolic disorders in primary family members. PCOS is responsible for up to 30% infertility in couples seeking treatment. Currently, there is no PCOS solution. In addition to the growing nature of the disease, limited studies have been conducted covering all PCOS detection.

What is PCOD?

People with Polycystic Ovarian Disease (PCOD) have many small cysts in their ovaries that are mostly asymptomatic (showing no symptoms as such) and are diagnosed with regular clinical tests. This condition is usually harmless and does not affect fertility, as women with polycystic ovaries may still have hormonal imbalances and open more often. PCOD is not a disease but a variation of common, non-existent eggs. It can cause abnormal menstruation sometimes, but that can be controlled by a gynaecologist’s visit.

What is PCOS?

Polycystic Ovarian Syndrome (PCOS) is related to your entire body. It is because of the combined effect of excess hormone that causes ovulation, and something called insulin resistance, which leads to an increase in the level of insulin in your body. Elevated levels trigger the excess levels of the male hormone i.e. testosterone, which is usually only produced in small amounts in women. This disrupts the normal growth of follicles in the ovaries.

They do not grow fully and therefore cause problems with ovulation which leads to periods of delay and reduced fertility. Polycystic ovary syndrome (PCOS) usually occurs during adolescence and is characterized by insulin resistance, hyperinsulinemia, and hyperandrogenism.

The goal is that the diagnosis of PCOS should be based on the presence of at least two of the following three processes: chronic anovulation, hyperandrogenism (clinical or biological), and polycystic ovaries. Diagnosis of PCOS in adolescence is very difficult due to developmental problems in this group.

Many symptoms of PCOS, including acne, menstrual irregularities, and hyperinsulinemia, are common in puberty. Adolescents with PCOS are at increased risk of developing health problems later in life, such as diabetes, heart disease, and infertility. One has to deal with the recurrence of PCOS in type 1 diabetes, in which the ovaries and adrenals are exposed to excess insulin concentration. Ovarian hyperandrogenism is common in adolescent girls with type 1 diabetes. Treatment options for teens with PCOS include diet and exercise. Metformin is commonly used in young girls and adolescents with PCOS as a first line immunotherapy or in combination with androgen-resistant drugs.

In-fecundity

Polycystic ovary syndrome is the most common cause of menstrual irregularities leading to childbirth. Of all couples seeking reproductive treatment, 30% of cases are due to abortion. It is estimated that 90% of anovulation cases are actually caused by PCOS.

The oogenesis process in PCOS patients is different from that of a fertile cycling woman. The activation of the individual from the first to the next during the genesis period is independent. Disruption of the PI3K and FOXO3 pathways results in the functioning of all follicles in the uterus, resulting in liver failure and premature ovarian failure. These two substances, LH and insulin, are very important in PCOS patients as 60-80% of patients show insulin resistance (IR), which may contribute to hyperinsulinemia. Insulin secretion in the ovaries can increase the LH granulose response, producing residual androgens at the site. In healthy women, LH stimulation continues with cord development from stage one to stage two. Increased LH can also cause premature maturation of granulose cells and accelerate infertility.

PCOS patients often use assisted reproductive technology (ART) methods of pregnancy. The first procedure commonly used for ovulation is to promote the formation of more follicles that will eventually be ready for pregnancy. The most common drug treatment used for ovulation is clomiphene citrate. Clomiphene Citrate (CC) has been shown to lead to pregnancy 50% of the time after three treatment cycles.
 

Areas of uncertainty and the way forward

Recently, there has been an increase in interest of the PCOS research field. Over the past five years, there have been thousands of published resources on various aspects and relationships with regard to PCOS. Aside from the high and growing state of PCOS among people, there are a number of factors that remain still unclear. Few studies are conducted that can understand the disease in all its complexity.

Although much attention has been given to PCOS, one of the most important issues in this disease is still widely debated i.e. its diagnosis. The etiology of this disease is not well understood. There is a basic need for further research regarding the pathogenesis of PCOS in order to determine the causes.

A growing number of publications have proven that ‘genetics’ are the primary culprit in this disease, and it has taken different approaches to understanding this genotypic-to-phenotypic association. Genetic abnormalities have been shown to play a major role in metabolic disorders (including IR), and they occur in the first male and female relatives with PCOS. However, genetic research in the field of PCOS is still relatively new, and previously published findings need to be re-evaluated. There exist several contradictions between genetic studies, in the area of PCOS and the lacklustre in the officials’ continues. Genetic testing for PCOS is also the gateway to many other research areas.

As researchers are baffled by the rapid onset of the disease, genomic loci diagnoses can provide great insight. These two areas require a basic set of ideas to expand our knowledge of the etiology of the disease. These findings may also help to create a new treatment for the same. Randomized testing methods in addition to its high complexity make PCOS a challenging research in the prevailing environment.

In conclusion, PCOS with time is becoming the most common disease among women of childbearing age with lifelong problems. One of the most challenging aspects of the disease is its complex diagnosis and severity of symptoms. In the future, further research into the genetics and pathophysiology of PCOS is needed to determine the risk factors for prevention and effective treatment of this disease.

Award Winning Article Is Written By: Mr.Ashish Dash - 1st year law student at Institute of law, Nirma University, Ahmedabad

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