What Is PCOS?
More than one in ten women around the world suffer from polycystic ovary syndrome (PCOS). It is a sort of hormonal imbalance in the body leading to a spectrum of abnormalities including but not limited to absent or decreased menstruation, acne, growth of unwanted hair on the body, hair loss, multiple cysts in the ovaries, and infertility. Women with PCOS produce excessive male sex hormones and too much insulin because the insulin they produce does not work as it should. The exact cause of the disease is unknown.
PCOS can happen at any age, beginning from puberty even up to menopause. Women often come to clinics with an ultrasound report suggestive of multiple cysts in the ovaries. They are anxious about self-diagnosis made after obtaining half-baked knowledge from the internet. Diagnosing PCOS is the job of the gynecologist, and she must let him or her do it. The woman may have to undergo a battery of tests before finally getting diagnosed as PCOS and for guiding the further treatment plan. The diagnosis involves the presence of at least two out of the three what are known as ‘Rotterdam Criteria.’
1. Increased male hormones in the body.
2. No ovulation from the ovaries.
3. Polycystic ovaries on ultrasound.
It must be understood that young girls who have just started menstruating have irregular cycles for the first one or two years and should not be tagged as PCOS based on these menstrual irregularities alone.
When Should a Woman Seek Help?
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Very little flow of blood in periods or months of altogether absent periods.
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Acne, hair loss, excessive facial, or body hair.
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Having problems conceiving.
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Family history of PCOS.
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Ultrasound ever show a polycystic ovarian pattern.
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Darkening of the skin at the nape of the neck, below the breasts, or in the armpits.
What Are the manifestations of PCOS?
Other than the evident cosmetic issues, menstrual irregularities, and infertility, there are many other long-term consequences associated with PCOS. It, in fact, is a ticking bomb waiting to blast unexpectedly. Regrettably, many doctors also do not see beyond treating the immediate symptoms of infertility in these women. The potential future complications of this disease also need to be taken equally seriously and discussed with the patient.
When ignored, these women may develop metabolic syndrome, which is a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increases one’s risk of heart disease in the future. There are also chances of steatohepatitis caused by fat accumulation in the liver. Women who conceive with PCOS are at high risk of abortions, pregnancy-induced high blood pressure, gestational diabetes, and premature birth.
The condition is often complicated with obesity, though lean patients with PCOS are also not uncommon. The obese PCOS patients also suffer from sleep apnoea, which manifests as snoring, fatigue, and excessive daytime sleepiness. Most of the obese PCOS girls have body image issues, and some are in frank depression. Many girls develop eating disorders resulting in a cycle of eating and further weight gain.
Unfortunately, the risk does not end here. Women with PCOS also have a twofold rise in the risk of cancer of the uterine lining known as endometrial cancer. This happens because of less frequent menses. The inner lining of the uterus is shed normally in every cycle, but in the absence of periods, the lining keeps growing without being shed.
What Are the Common Myths About PCOS?
1. PCOS is diagnosed on ultrasound only.
No. Polycystic ovary syndrome is a misnomer. It is a systemic disease and not just a disease of the ovaries. Even without having polycystic ovaries on ultrasound, one may be diagnosed as PCOS based on clinical evidence and blood tests.
2. one cannot get pregnant if they have PCOS.
Though PCOS is a common cause of infertility, one can still get pregnant either naturally or with fertility treatments. Always seek early advice from the gynecologist when planning for a baby. Most of the time, simple ovulation-induction drugs help the patients in achieving pregnancy through IUI (intrauterine insemination) or IVF (in vitro fertilization) may be required too.
3. If one do not want to conceive, they do not need to treat PCOS.
As discussed, PCOS has a long-term impact on the health of women. Getting diagnosed and treated is critical for a healthy life. One must seek medical help not only for treatment but also for preventive check-ups to diagnose other associated ailments like diabetes, lipid abnormalities, and even malignancy as early as possible.
4. Everyone with PCOS is overweight.
Not everyone! Though most women with PCOS are overweight or frankly obese, thinner women may also have PCOS and should not be overlooked.
5. Women with PCOS cannot lose weight easily.
There is no concrete scientific evidence suggesting that PCOS women cannot lose weight. Healthy living and losing just 5 % of one’s body weight can have immeasurable long-term benefits.
6. PCOS is a hopeless disease.
While it is true that there is no magic cure for PCOS, it indeed is treatable. Acne, hair loss, menstrual irregularities, and infertility all can be treated. Long-term complications like diabetes, heart diseases, blood pressure, lipid abnormalities, and cancer too can be prevented or controlled.
Does Being Obese Cause PCOS or Does PCOS Result in Obesity?
The association between obesity and polycystic ovary syndrome is complicated. It works either way. Obese women have a higher risk for PCOS, and women with PCOS have a higher risk of obesity. one need to break the cycle.
Can Bariatric Surgery Be Done for Weight Loss?
Bariatric surgery or weight loss may be considered as an extremely necessary step in morbidly obese women with a BMI of over 40 or in those with a BMI of 35 with other chronic diseases like diabetes or hypertension. This should be done after all other means of weight loss have been tried and have failed to achieve results.
What Are the Lifestyle Changes That Can Help in PCOS?
- Maintain a healthy lifestyle.
- Try to lose weight, even if it is as low as 5 % of the total body weight.
- Maintain an ideal weight.
- Eat healthily and eat on time. Watch out for ‘emotional eating.’
- Do not consume foods with very high sugar and/or fat content.
- Sleep at least 8 hours a day.
- Avoid smoking and reduce alcohol consumption.
- Do some kind of physical activity for a minimum of 2.5 hours or 150 minutes a week is needed for maintaining an ideal weight. Physical activity may include walking, cycling, swimming, household chores, sports, or planned exercise.
Between the myths and the realities lies the critical step of scrutiny and assessment by qualified personnel. So, if one suspect they have any symptoms of PCOS, go for a check-up, and if one is living with PCOS, do not ignore regular follow-ups.
