POLY CYSTIC OVARY SYNDROME (PCOS)
- PCOS is a set of symptoms due to elevated male hormone in women. These symptoms include irregular or no menstrual periods, excess body and facial hair, acne, difficulty getting pregnant, etc. PCOS also gives rise to other diseases such as type-2 diabetes, obesity, heart disease, mood disorders, etc.
- Causes of PCOS: It is believed that abnormal levels of the pituitary luteinizing hormone (LH) and high levels of male hormones (androgens) interfere with normal function of the ovaries.Due to this, multiple small follicles (small cysts 4 to 9 mm in diameter) accumulate in the ovaries.
- Diagnosis: PCOS can be diagnosed from its symptoms and it can be confirmed by ultrasound, hormonal test or by using Rotterdam criteria. All these parameters confirm the presence of cysts in the ovaries of a woman.
- Treatment: PCOS can be treated by targeting its symptoms. The mode of treatment includes oral contraceptives to maintain regularity in menstrual cycle, progestin consumption, hair treatment to stop excess facial growth or on other parts of the body, weight loss to cure irregular menstrual cycle and diabetes, metformin to treat diabetes originate from PCOS and consumption of phyto-extracts (plants-based treatment) to cure infertility.
- Goals for treating PCOS: Goals for treatment may be considered under four categories:
- Lowering of insulin resistance levels
- Restoration of fertility
- Treatment of hirsutism (hair growth) or acne
- Restoration of regular menstruation
DO I have PCOS?
Young women with PCOS usually have certain symptoms. The following questionnaire may help you in to figure out you have PCOS or not
- Do you have irregular periods?
- Do you have acne or other skin problems?
- Acne is severe.
- Darker patches of skin on the back of my neck.
- Darker patches of skin in the area under my arms.
- Darker patches of skin in my groin area.
- Have you had any hair changes or extra hair growth?
- Dark hair above my lip – like a mustache.
- Extra dark hair in other places – chin, neck, or chest area.
- The hair on head feels like it’s getting thin.
- Do you have trouble maintaining a healthy weight?
- Do you have a family history of PCOS or diabetes?
CONSULT YOUR DOCTOR
- Metformin has shown to be effective to treat polycystic ovary syndrome. Metformin is generally used in type-2 diabetes to reduce insulin resistance. The similar effect has been seen in PCOS patients also.
- Mechanism of action: Metformin in PCOS works by reducing the circulating insulin levels. There is, however, some conflicting evidence as to whether metformin can directly affect ovarian steroidogenesis. Mansfield R et al. demonstrated a direct effect of metformin on ovarian steroidogenesis by culturing ovarian cells and concluded that metformin reduced the androgen levels. But, Arlt W et al. had proved that metformin has no direct effect on PCOS. Metformin has no effect on the enzymes responsible for androgen biosynthesis. They said that metformin probably prevents PCOS by lowering circulating insulin concentrations.
- In many cases, it supports ovarian function and returns the situation to normal ovulation. Metformin also shown to reduce the circulating androgen levels in the body.
- Metformin may help with weight loss. Although metformin is not a weight-loss drug, some studies have shown that women with PCOS who are on a low-calorie diet lose more weight when metformin is added. If metformin is used, it is essential that diet and exercise are also part of the recommended regimen because the weight that is lost in the early phase of metformin treatment may be regained over time.
Precautions while taking metformin
Following precautions should be kept in mind while the patient is on metformin:
- Kidney function should be tested regularly and verified normal while consuming metformin. If any evidence of abnormal kidney function comes then, metformin should be discontinued immediately.
- If there are any signs of lactic acidosis such as diarrhea, muscle pain, numbness in arms and legs, sleep disorderness, vitamin B12 deficiency, nausea, vomiting etc, then metformin should be discontinued.
- If the patient has heart problem, breathing problem, kidney disease or liver disease then, metformin should not be prescribed to him/her.
- If the patient on metformin is going to have any surgical procedure then, metformin should be stopped for some time prior to the surgery.
- Alcohol is known to potentiate the effect of metformin on lactate metabolism. Patients, therefore, should be warned against excessive alcohol intake.
- Metformin may interact with the dye used for X-ray or CT scan. Thus, the doctor may advice the patient to stop taking it before any medical exam.
- Fenugreek is a natural remedy for polycystic ovary syndrome. Being an herb, it has very less side effects as compared to metformin treatment. In many clinical studies, it has also shown decrease in blood glucose levels.
- Furocyst® is a cinically evaluated and patented product for safe and effective management of PCOS. Furocyst is an innovative product involving separations of active ingredients from the natural plant (fenugreek seeds) without affecting chemical properties of the active fractions. No chemicals are used. It is a natural and promising dietary supplement for the management of Polycystic Ovary Syndrome (PCOS). Furocyst shows 94% efficacy in PCOS patients.
- Consuming fenugreek leaves or seeds will help in maintaining normal insulin levels. Mallika Quereshi, a gynaecologist, said that methi improves glucose tolerance in the body, which helps in weight loss.
- Mechanism of action: Furocyst help to increase insulin sensitizing activity & peripheral utilization of insulin thus correcting increased androgen hormones which are responsible for PCOS & bring down the Hypercholesterolemia.
- It has been proved by a clinical study that fenugreek seeds extract reduced the ovarian volume, reduced the number of cysts and reduced body weight also. Females also shown improvement in menstrual cycle and pregnancy. The extract was also proved to be safe in those PCOS patients.
- Fenugreek also helps to cure the state of hirsutism which is caused due to the raised levels of androgens in the ovaries. As the androgen levels are normalized, hirsutism is also managed. Thus, fenugreek is a natural therapy which targets all the goals for the treatment of PCOS.
- Lashen H: Role of metformin in the management of polycystic ovary syndrome. Ther Adv Endocrinol Metab. 2010; 1(3): 117–128
- Bagchi D et al.: Efficacy of a Novel Fenugreek Seed Extract (Furocyst) in Polycystic Ovary Syndrome in Female Subjects. The FASEB Journal 2015; 29(1)
- Lord JM, Flight IH and Norman RJ: Insulin sensitizing drugs (metformin, troglitazone, rosiglitazone, pioglitazone, D-chiro-inositol) for polycystic ovary syndrome. Cochrane Database Syst Rev. 2003; 3:CD003053
- Mansfield R et al.: Metformin has direct effects on human ovarian steroidogenesis. Fertil Steril. 2003; 79(4):956-62
- Jaipuriar AS et al.: Clinical evaluation of standardized fenugreek seed extract as furostenolic saponins (Furocyst) in polycystic ovary syndrome patients. World Journal of Pharmaceutical Research 2015; 4(12):942-952.