PCOS MORE COMMON THAN YOU THINK
If you happen to see someone who is overweight, has bald patches on her scalp, or has excessive facial hair, try not be judgemental. Or conclude that she is lazy, unhealthy and eats a lot. For all you know that may not be the case at all.
She could be a victim of Polycystic Ovary Syndrome, also known as PCOS. What it means is she could have cysts on her ovaries.
She Is Not Alone
It is estimated that 1 in 5 women of reproductive age suffer from PCOS, i.e. around 200 million women worldwide. Annually, there are over a million reported cases of PCOS in India. This is a significant health concern.
The main problems associated with PCOS are menstrual cycle disturbances, including irregular or absent periods, weight gain, excess facial hair growth and skin conditions. Even women who regularly exercise and eat moderately suffer from PCOS.
Myths & Reality
While myths persist that women with PCOS cannot get pregnant, the reality is that it is highly treatable and every woman with PCOS should be able to get pregnant. Consulting a fertility specialist will be of great help.
In fact, many will find success with basic fertility treatments and medications. As for those who may need help conceiving, there is in vitro fertilization (IVF) — a highly effective form of treatment for women with PCOS.
PCOS And The Mind
PCOS can make young women who may have been trying to conceive feel frustrated and isolated. Leading to irritability and depression, all signs of high levels of stress. This affects the release of an egg. While feelings of anguish and anxiety may delay ovulation.
But stress can be managed easily once you understand it. There are two kinds of stress. Stress that we cannot avoid and stress of our own making. The latter is the stress that can be reduced. This is also the most damaging kind of stress.
Remember, stress can also make you lose appetite and lead to skipping meals, increase intake of juices and perhaps even lead to consuming alcohol. Don’t give in to these, because they can disrupt the hormonal system and will only add to the problem.
Instead, seek help of a counsellor. It is very important to support yourself emotionally and reduce any stress or anxiety. Learn to manage it.
What Causes PCOS?
Although the specific cause of PCOS is still unknown, the condition results in hormonal imbalances that prevents ovulation — a natural process by which the body produces and releases eggs from the ovary.
What is common in women with PCOS is to have an inappropriate production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). As a result, they experience limited follicular development (follicles are small sac-like structures within the ovaries, and each follicle contains an egg).
With limited follicular development, egg development will not occur. Also as a result, women with PCOS have an increase in testosterone levels and other typically male hormones (androgens).
Clinically, the limited egg development will result in irregular ovulation or a complete lack of ovulation (anovulation), which can persist for months and sometimes for years. This ovulatory dysfunction is what actually causes infertility in women.
Also, when anovulation is prolonged, the endometrial tissue in the uterus can get very thick, resulting in heavy or irregular periods.
It is common for women with PCOS to develop an insensitivity to insulin. This can trigger weight gain leading to obesity. Which means exposing the patient to the risk to diabetes and cardiovascular disease.
Tests For PCOS
There are no specific tests for PCOS, but the condition can be clinically diagnosed. Your doctor will determine if there are any physical signs of excess androgens present, as well as evidence of ovulation problems by evaluating the length and regularity of your menstrual cycles.
Some testing may also reveal common features of the condition. Doctors might recommend basic fertility testing including blood testing and ultrasound.
Ultrasound can determine if the ovaries are enlarged and contain immature follicles,
a sure sign of PCOS. Blood testing can also confirm elevated levels of androgen (male hormones).
When making a diagnosis of PCOS, it is important to rule-out other causes of ovulatory disorders, including thyroid dysfunction.
Once your doctor has a complete picture and can make the diagnosis, he or she will work with you to create an individualized treatment plan.
Diet & Exercise Can Help
For overweight women with PCOS, weight loss is the first step to increasing the chances of pregnancy. The direct benefits of weight reduction include improved ovulatory function, better response to fertility medications, improved chances of conception,
and a safer pregnancy for both the mother and baby.
Studies have shown that by losing just 5 percent of body weight, you could actually restore your menstrual cycle and ovulate naturally. Weight loss has also shown to reduce other symptoms such as hair growth, acne, and balding.
Treatment For PCOS?
Depending on the initial testing, a fertility specialist may recommend a patient to start ovulation induction medications with timed intercourse or intrauterine insemination (IUI) that can be scheduled around the time of ovulation.
For these treatments, it is important that the fallopian tubes are open and your partner’s sperm counts are normal. The typical success rates with IUI is about 15 to 25 percent per cycle; a woman’s individual success rate with IUI is largely dependent upon her age.
If ovulation induction with timed intercourse or IUI fail, the doctor might recommend in vitro fertilization (IVF).
Women with PCOS have a very good chance of conceiving. However, patience and dedication will be necessary. Allow an adequate amount of time for lifestyle modifications to enhance fertility naturally followed by a successful pregnancy.
Experience indicates that PCOS can be managed for the long-term and patients can live a relatively symptom-free life.
We hope this gives you a clearer picture of Polycystic Ovary Syndrome. If you have any concerns or want to get yourself checked, then please click on the following link which will show you the nearest Milann Fertility Clinic. Or call 7097299470 to reach a Milann specialist.
Dr Mekhala Dwarakanath,
MS OBG, DGO, FRM
Reproductive Medicine Specialist at Milann.
Let us know how we can help.