Mrs. Riya was a 21 year old IT professional and was all excited to start her newly married life. But here is the problem- she has always had irregular periods. And adding to her low self esteem, she had been having issues with pimples and excessive facial hair growth that have not responded to treatments. And now her biggest fear is that she may not conceive as she gets her periods only once in 4 months. She does not know what to do.

You might have frequently come across someone like Riya who is battling with this problem of “Poly Cystic Ovarian Syndrome” or PCOS.

But there is a solution!! Talk to your gynaecologist now.

What are the symptoms of PCOS?

  • Irregular periods- PCOS is typically earmarked by irregular periods, either infrequently or too frequently, sometimes no periods at all.
  • Infertility- Polycystic ovaries fail to regularly release eggs leading to infertility
  • Obesity- Incidence of obesity is as high as 80% in PCOS women.
  • Acne- Acne associated with PCOS usually do not respond to treatment
  • Excessive unwanted hair-  This condition called hirsutism, is caused by increased androgen levels leading to unwanted hair in face, chest and upper thighs.
  • Acanthosis nigricans- Thickened, velvety, darkened skin is commonly seen around the neck region and is due to insulin resistance
  • Male pattern baldness- Women may typically experience thinning of hair in the frontal region due to androgen excess
  • USG- shows multiple small collections follicles which have failed to ovulate, giving the appearance of polycystic ovaries.

Lifestyle to be blamed!!

Though the disorder is not new, it is increasing at a dizzying rate. Obesity is one of the main reasons why PCOS is on the rise. Most youngsters eat processed and junk food which lead to quick weight gain. Add to that strenuous academic and working hours, and they are left with no time to exercise.

What is insulin resistance?

Insulin is a hormone produced in pancreas that allows cells to use sugar, which is the body’s primary energy supply.  If cells become resistant to action of insulin, then the blood sugar levels can rise and the body might produce more insulin. Excess insulin might increase androgen production, causing difficulty with ovulation.

Does a USG showing polycystic ovaries mean I have this disease?

No. Only a USG finding of polycystic ovaries without other symptoms cannot be labelled as PCOS. A woman with PCOS should have two or more of the following criteria

  • Irregular or infrequent periods. But still 20% of PCOS women might have regular cycles.
  • Signs of increased androgen in the form of acne, hirsutism or blood tests revealing increased androgen levels
  • Scan showing polycystic ovaries

Are treatment options available?

And the good news is YES!! Treatment is tailored to each woman according to her symptoms and whether she wants to become pregnant. Because of the chronic nature of the condition, lifelong management is necessary. Certain drugs aid in weight loss, restore androgen levels and improve sensitivity to fertility drugs.

How does oral contraceptive pills help?

Contraceptive pills are a combination of estrogen and progesterone and possess anti-androgenic properties. They are used to regulate the periods and reduce hirsutism and acne by reducing androgen levels.

And it should be borne in mind that cycles are regulated for the patient’s sense of well being and there is no necessity to treat for “30 days cycle” as long as the periods occur sufficiently often. 

Is weight loss the answer?

YES. For overweight women, weight loss is the most effective method of restoring ovulation and menstruation. Even small amount of weight loss around 5% can be helpful in making your periods more regular.

Eat the right food. Don’t starve!!

Healthy eating plays a big role in PCOS. Stop radical eating. Include plenty of fruits and vegetables. Cut down on sugar, white bread, maida, potatoes, oily and junk food. Replace them with high fibre carbs and protein rich foods.

What if PCOS is not treated?

PCOS can produce long time consequences which include increased risk of developing Type II diabetes mellitus, cardiovascular disease and high cholesterol levels. PCOS woman tend to have endometrial hyperplasia, a condition in which the inner lining of the uterus is thickened. This can predispose to development of endometrial cancer.

Consult your gynaecologist now if you have any of the above symptoms. They will help you to identify and treat the problem and lead a healthy and happy life.

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