Polycystic Ovarian Syndrome (PCOS) is a common women’s health problem. A look at how it can disrupt your life and ways to handle it.
Prakruthi Keshavamurthy*, 19 years old, quiet, shy and pleasantly plump, is a first-year engineering student. Sandeepa Shankar*, 38, is an aggressive, always-on-the-run marketing professional and the mother of two little boys. Deeptha Khanna*, 27, is a reserved, withdrawn accounting professional desperately trying to start a family; three women from diverse backgrounds, completely different from each other. So what do they have in common? All of them have been diagnosed with PolyCystic Ovarian Syndrome (PCOS).
They each have a story to tell. Prakruthi had always had irregular periods from the very beginning. Her mother Savithri Keshavamurthy* had convinced herself that “things would settle down” as she grew older. Only they didn’t. Instead, she started having pimples that couldn’t be controlled by tried and tested methods. But when she started to gain a lot of weight – the women in their family are invariably petite – Savithri decided it was time to see the doctor. After initial treatment and some tests, Prakruthi was diagnosed with PCOS.
Prakruthi doesn’t completely get what the disease is about. But she is very troubled by the acne and weight gain. They have both made her very conscious of her looks and given her a poor body image and low self-esteem. Her mother on the other hand, is devastated. Even the name of the disease terrifies her. She has read that PCOS can cause lifelong problems, especially infertility.
The story was different with Deeptha. She had been perfectly normal until the age of 24 when she got married. When she first started having irregular periods, she attributed it to the stresses of marriage, relocation and a new job. In fact, the doctor she consulted actually tested her for pregnancy and then told her not to worry, that things would improve over time. But when things continued in a similar vein for more than a year, she was tested and found to have PCOS. She had always been quiet and reserved but weight gain, medications and the battle against infertility have all made her very depressed.
Sandeepa never knew anything by way of ill health, ever. The robust entrepreneur had always been busy living life to the fullest. Since she already had children, she didn’t have to worry about infertility when her monthly cycles became irregular and remembers wondering if it was very early menopause. When she first started noticing facial hair growth, she quickly attended to the problem and even joked about it. But the problem soon grew to unmanageable proportions and she went to a doctor where, over time, she was detected to have PCOS.
With an incidence of 5 to 10% worldwide, PCOS is a common endocrine disorder where there is an imbalance in the hormones produced in a woman’s body.
With an incidence of 5 to 10% worldwide, PCOS is a common endocrine disorder where there is an imbalance in the hormones produced in a woman’s body. The condition causes a wide range of problems ranging from acne to infertility. In India, the incidence is estimated to be on the rise and is becoming a cause of concern especially in fertility-related issues.
While the exact cause of the condition is not known, the problem largely affects the ovaries, the organs responsible for the production of eggs and female hormones. The condition sometimes runs in families, but whether it is a genetic condition or governed by environmental factors is not really known. PCOS can occur in any woman in the reproductive age group and often affects younger women.
PCOS can cause a diverse range of symptoms. It is characterized by multiple cysts in the ovaries, affecting hormone production. As a result, it mainly causes menstrual irregularities and anovulation, the condition where menstrual cycles occur without ‘ovulation’ or the release of an egg from the ovary. This step in the reproductive cycle is an important prerequisite for conception and anovulatory cycles directly contribute to infertility.
PCOS is also characterized by abnormally high levels of androgens or male hormones. The result – acne or pimples, hirsutism or excessive hair growth and sometimes even male pattern hair loss. It also causes the body’s blood sugar control to malfunction resulting in high levels of insulin and insulin resistance. This makes PCOS sufferers prone to diabetes. Another potentially dangerous long term effect of PCOS is the possibility of developing endometrial cancer and cardiovascular disease.
Weight gain is noticed in many women with PCOS but it is not known whether it is a cause or effect of the condition. Some may also develop acanthosis nigricans, a condition that causes large dark patches to appear on the skin. Changes like these often lead to depression, psychological stress and a poor body image.
Most patients with PCOS are, ironically, first treated with oral contraceptive drugs. The reason for this is that these medications actually contain female hormones and are used to regulate menstrual cycles. So using these drugs initiates regular bleeding. Other treatment depends on the symptoms manifested by the patient. Women trying to conceive are given medications like clomiphene and metformin that stimulate ovulation and are usually effective.
Women with PCOS are often intensely focused on a single aspect of their problem… at the risk of losing the big picture, that this is a disease with potentially serious long term adverse effects.
Weight management appears to be very important in people with PCOS. Losing weight can help reduce male hormone levels in the body and lessen symptoms like unwanted hair growth caused by excess androgen. Women with PCOS may also find their monthly cycles becoming regular with weight loss. Diet and exercise are also very important in reducing the risk of developing diabetes. Diets rich in fibre and omega fatty acids have been shown to be beneficial.
Women with PCOS are often intensely focused on a single aspect of their problem – like trying to conceive – at the risk of losing the big picture, that this is a disease with potentially serious, long term adverse effects on women’s health. Early diagnosis has the advantage of being able to take greater control over symptoms and treatment ensures help while reducing the risk of complications.
*Names changed to protect privacy.
*Photo credit: wolak
Dr. Lakshmi Ananth is a doctor and a writer who wields both scalpel and pen
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