PCOS - A Brief Overview
Nearly one in five Indian women suffer from Polycystic Ovarian Syndrome, a slightly alarming statistic especially considering the low levels of awareness of the same.
PCOS, as the condition is referred to, is a hormonal disorder that is common among women of reproductive age. PCOS commonly develops around the time of the first menstrual period, or at puberty. However, it is known to develop later in a woman’s life especially as a result of weight gain, stress or other lifestyle factors.
The signs of PCOS outwardly are usually weight gain; development of hair on the chest, face and armpits and an inability to conceive. PCOS diagnosis is made if the sufferer has at least two of the following three signs:
- POLYCYSTIC OVARIES: This is a condition in which the ovaries become enlarged and contain a large number of harmless follicles. Follicles are essentially fluid-filled sacs in which eggs develop. During ovulation in a healthy woman, follicles release eggs to be fertilised. Polycystic Ovarian Syndrome, however, causes the sacs to be unable to release an egg resulting in no ovulation.
- IRREGULAR PERIODS: One of the most common PCOS symptoms is irregular periods. Those suffering from Polycystic Ovarian Syndrome may have only six to eight periods a year, or over 35 days between periods.
- EXCESS ANDROGEN: Chief PCOS symptoms also include excess androgen, that is excess testosterone. This results in excess body and facial hair, male-pattern balding and severe acne.
Unfortunately, the exact PCOS causes remain unknown. However, failing diagnosis and treatment, PCOS causes long-term complications such as type-2 diabetes and heart disease. PCOS causes can include:
- INFLAMMATION: Research has shown that women suffering from PCOS may have an issue of low-grade inflammation that causes the ovaries to produce more androgens which lead to heart blood vessel issues.
- EXCESS INSULIN: Insulin is a hormone produced by the pancreas that regulates the way sugar is used by the body. In simpler terms, it’s like the traffic policeman that guides insulin in the bloodstream to organs that use it for energy. If cells become insulin resistant, the body produces more insulin despite elevated blood sugar levels. This also prompts the production of androgens, delaying/hampering ovulation.
- EXCESS ANDROGENS: Some women may witness the production of excess androgens such as testosterone in their body due to genetic, stress or other lifestyle-related issues. This may also be caused by excessive exercise or certain supplements.
- HEREDITY: Studies have shown that certain genes may be linked to higher levels of androgens or PCOS.
Myth #1 - You Have to Have Polycystic Ovaries to Have PCOS
As you read this a movement to rename PCOS to ‘reproductive metabolic disorder’ is churning the medical fraternity. This is because polycystic ovaries are not always signs of PCOS! In many cases, a PCOS diagnosis may be possible in a woman with no cysts on her ovaries. Thus, the name is actually a misnomer.
PCOS symptoms can include irregular periods, high testosterone and weight gain and absolutely normal ovaries: this is important to remember. What's important with PCOS are the metabolic and reproductive abnormalities that come with it.
Myth #2 - You Can’t Get Pregnant if You Have PCOS
PCOS is a hormonal problem that affects the ovary’s ability to release an egg, but this, in no way means, the woman can never get pregnant. Sadly, too many women are told that PCOS treatments do not exist and all, and they can never get pregnant post a diagnosis.
But this is not true. Fertility specialists can help with a number of medications that can stimulate ovulation or assisted reproductive treatments such as in vitro fertilisation.
Myth #3 - If Your Menstrual Cycle is Irregular, You Have PCOS
PCOS is not the only cause of irregular periods. While irregular periods may be one of the chief signs of PCOS it is important to remember that they may also be caused by breastfeeding, extreme dieting or exercising, stress, lifestyle changes, excess smoking, thyroid disorders, uterine fibroids, etc.
Further women must observe how often and for how long their cycles are irregular. If the irregularity lasts just a few cycles, then it is probably a short term issue and not PCOS.
Myth #4 - Everyone With PCOS is Overweight
The bearded, fat woman--that is the usual image people have of a woman suffering from PCOS. This is partly true as PCOS is directly related to the body’s inability to manage insulin, which leads to weight gain. Similarly, obesity has been found to worsen PCOS.
However, the fact is that several lean women suffer from PCOS, as well. As a matter of fact, it is worse for them--since they are thin people simply overlook PCOS as a probable condition that could be causing other symptoms in them.
Thus, it is important to note that PCOS does not discriminate and can happen to women of all shapes and sizes. The PCOS treatment is thus eating healthy and avoiding a sedentary life.
Myth #5 - You Will Know for Sure If You Have PCOS
There is no way to know for sure, without tests or USGs, if one has PCOS for sure.
Especially because with symptoms such as mood swings, irregular periods, acne and weight gain--PCOS is easy to confuse for something else. Besides for some women with polycystic ovaries, the symptoms are almost entirely invisible. As a result, nearly 50% of women's PCOS can go undiagnosed.
Conclusion - All The Myths Debunked
While there is no cure for PCOS, it is possible to manage the condition with a healthy lifestyle through eating well and exercising. In our time it is especially important to have adequate knowledge of PCOS symptoms and treatment. Having adequate knowledge of PCOS symptoms and treatment saves one from falling for inaccurate myths that mislead them, and take them down the wrong path. This is also an important reminder to stay wary of ‘alternative treatments’ that promise to cure PCOS.
If you suspect you have PCOS--don’t panic. Take a deep breath and consult your doctor. They will prescribe a few tests and USGs and recommend a treatment plan accordingly.
Dr. Kriti Sharma,
MS (Obstetrics & Gynecology)