Understanding ‘Lean Polycystic Ovarian Syndrome’ and its diagnosis
Polycystic Ovarian Syndrome (PCOS) is an endocrinal disorder that affects many women of reproductive age group and is also one of the causes of infertility among women. As per World Health Organisation (WHO) it is estimated that approximately 5% of women in the reproductive age group suffer from PCOS, making it one of the most common hormonal disorders. In India, incidence of PCOS is higher than the world average and ranges from 6 to 10%.
Common features include menstrual irregularities, excessive hair growth, hirsutism, hyperandrogenism and polycystic ovarian morphology on ultrasonography although the presentation can be heterogeneous. Insulin resistance is thought to be responsible for the hormonal and metabolic derangements observed in PCOS. Lean PCOS is a unique subtype of Polycystic Ovarian Syndrome which usually affects a smaller percentage of young girls.
Lean PCOS is a term used to describe a specific type of PCOS that affects women primarily young girls who have a healthy body mass index (BMI). In simpler words, the women who suffer from lean PCOS are not overweight or obese, which is otherwise a common characteristic feature of PCOS. Women with lean PCOS usually experiences many of the same symptoms as those with the conventional form of PCOS.
One of the most common symptoms of lean PCOS is irregular menstrual cycles. Women with this condition may have menstrual cycles that are shorter or longer than average, or they may skip periods altogether. This is due to the hormonal imbalances that are common with PCOS. Women with lean PCOS may also experience acne, excessive hair growth, and fertility issues.
The exact causes of lean PCOS are not entirely clear, but researchers believe that it may be related to insulin resistance. Insulin is a hormone that helps the body use glucose for energy. When the body becomes resistant to insulin, it can lead to high levels of insulin in the blood, which can cause hormonal imbalances and other health problems. Some studies have suggested that women with lean PCOS may have insulin resistance, even if they do not have obesity or diabetes perse.
Different criteria have been used to diagnose Polycystic Ovarian diseases but agreement has been made that PCOS is a diagnosis of exclusion. The commonly used criterion to diagnose PCOS have been devised by
Rotterdam European Society for Human Reproduction and Embryology and the National Institutes of Health/National Institute of Child Health and Human Disease (NIH/NICHD). As per
Rotterdam criterio, diagnosis requires two of following crietrion, 1. Hyperandrogenism 2. Polycystic ovaries on USG 3. Anovulation/oligo-ovulation. While as as per NIH/NICHD, diagnose requires hyperandrogenism and menstrual disturbances.
There is currently no specific treatment available for lean PCOS, but there are several treatments that can help manage the symptoms. One of the most common treatments is hormonal therapy, which can help regulate menstrual cycles and reduce the risk of ovarian cancer. Other treatments may include metformin, a medication that helps the body use insulin more effectively. Lifestyle changes such as a healthy diet and regular exercises is also equally important.
Women who suspect they may have lean PCOS or PCOS as such should speak with their doctor for a proper diagnosis, treatment and diet plan.
The writer is Consultant Radiologist at GMC Anantnag.
