POLYCYSTIC ovary syndrome (PCOS) affects approximately 15 to 20% of women and thanks to the Internet, more and more young women are coming forward to get diagnosed – after relating to the symptoms they’ve read online.
What is PCOS?
A woman’s menstruation cycle is normally about 28 days. During ovulation, an egg is released from one of the ovarie – ready to be fertilised by sperm.
So, as the cycle progresses towards ovulation – the lining in the uterus starts to thicken – preparing for a fertilised egg to attach to the lining to start developing. Progesterone levels are also high at this point as it helps the uterus grow during pregnancy and prevents it from having contractions (contractions can lead to a miscarriage).
In the event there is no fertilised egg, the lining then breaks down and bleeds – leading to menstruation.
In the case of women with PCOS, there is an imbalance of hormones in their body – specifically, very high levels of androgen (male hormones). This disrupts and blocks the ovulation process – translating into the following symptoms:
- Irregular periods or no periods at all
- Excessive hair – usually on the face, back, or chest
- Acne that persists even past the age of 30
- Hyperpigmentation on the neck, underarms, or groin area
- Infertility
- Obesity
Do note that some women may not be obese but still have PCOS.
Who is at risk of PCOS?
While there is no definite answer at this moment, recent discovery has linked it to genetics. About 5 to 10% of women with PCOS have a family history of it.
Besides, women with PCOS have insulin resistance as well –which means they have a higher risk of developing diabetes.
To receive an official diagnosis, an ultrasound and blood test are needed. During the ultrasound scan, if a woman has PCOS, the doctor may notice a lot of immature eggs around the ovaries – resembling a “string of pearls”. Her blood test will also reveal high levels of androgen.
How does it affect women?
The most pressing issue that most women face is infertility – as the condition hinders ovulation. This does not mean that pregnancy is impossible as there are medications to stimulate and regulate ovulation as well as Assisted Reproductive Techniques (ART) – and success rates are high.
It is important to note, though, that pregnant women with PCOS have a slightly higher risk of miscarriage and developing gestational diabetes (high blood sugar levels during pregnancy that return to normal after birth).
But, this condition does not directly affect the health of the baby or cause any birth defects.
Nonetheless, PCOS is a condition that requires life-long monitoring as there are long-term consequences. Due to the imbalance of hormones, the endometrial cells (the innermost lining of the uterus) can turn abnormal and if not monitored and treated in time, could turn cancerous.
Not to mention, due to the symptoms such as excessive hair and acne, women with PCOS may experience low self-esteem and depression.
What are the best treatment options?
The most effective and important treatment is lifestyle modification:
- Eat less carbohydrates with a high glycemic index (white bread, potatoes, and white rice)
- Minimise intake of processed foods and drinks high in sugar
- Up intake of fibre and protein
- Exercise regularly to lose weight and maintain it.
Losing weight and maintaining it are extremely crucial. I never ask my patients to lose 20kg or even 10kg. Just a 3 to 5% reduction of weight can help correct their period cycle naturally.
All it takes is brisk walking for 30–45 minutes three to four times a week. Do bear in mind though that the cycle can be disrupted once more if the weight is regained.
If a woman is looking to regulate her menstruation cycle – there are many combinations of hormone medication to help with this. If it is fertility that they are struggling with – there are medications to help with ovulation.
Once she starts her medication and incorporates lifestyle modification – her menstruation cycle is monitored. When it is well-regulated, doctors will start trying to wean the patient off medication.
Surgery is usually not involved, but it is worth mentioning that in the past, “ovarian drilling” was the main go-to treatment. It involves inserting a laparoscope to stimulate the ovaries – this procedure will lower the formation of androgen. But, it is not widely practised today.
The take-home message
At the end of the day, PCOS is a condition that can be treated, and women should not despair even if they experience fertility issues as pregnancy success rates are high with treatment.
The most important thing to remember is that it is crucial to lead a healthy lifestyle and to go for annual checkups to ensure there are no abnormalities. Women with PCOS can lead happy, normal lives. Help is out there – so, don’t suffer in silence. – The Vibes, August 10, 2022
