THEME: ‘CREATING CHANGE TOGETHER’
Dr. Tariq Jagnarine
Family Medicine, Endocrinology/ Diabetes
September is Polycystic Ovarian Syndrome Awareness Month.
Polycystic Ovarian Syndrome (PCOS) is a condition that affects a woman’s hormone levels. Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes their bodies to skip menstrual periods and makes it harder for them to get pregnant.
PCOS also causes hair growth on the face and body, and also causes baldness; and it can contribute to long-term health problems, like diabetes and heart disease.
Birth control pills and diabetes drugs (which combat insulin resistance, a PCOS symptom) can help fix the hormone imbalance and improve symptoms.
PCOS is a problem with hormones that affect women during their childbearing years (ages 15 to 44). Between 2.2 and 26.7 percent of women in this age group have PCOS. Many women have PCOS, but don’t know it. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed.
PCOS affects a woman’s ovaries, the reproductive organs that produce estrogen and progesterone — hormones that regulate the menstrual cycle. The ovaries also produce small amounts of male hormones called androgens.
PCOS is a “syndrome,” or group of symptoms that affects the ovaries and ovulation. Its three main features are:
• Cysts in the ovaries
• High levels of male hormones
• Irregular or skipped periods
In PCOS, many small, fluid-filled sacs grow inside the ovaries. The word “polycystic” means “many cysts.” These sacs are actually follicles, each one containing an immature egg. The eggs never mature enough to trigger ovulation.
The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Progesterone levels are lower than usual, while androgen levels are higher than usual. Extra male hormones disrupt the menstrual cycle, so women with PCOS get fewer periods than usual.
CAUSES
Doctors don’t know exactly what causes PCOS. They believe that high levels of male hormones prevent the ovaries from producing hormones and making eggs normally.
Genes, insulin resistance, and inflammation have all been linked to excess androgen production.
COMMON SYMPTOMS OF PCOS
Some women start seeing symptoms around the time of their first period. Others discover they have PCOS only after they’ve gained a lot of weight or they’ve had trouble getting pregnant.
The most common PCOS symptoms are:
• Irregular periods. A lack of ovulation prevents the uterine lining from shedding every month. Some women with PCOS get fewer than eight periods a year, or none at all (10 Trusted Source).
• Heavy bleeding. The uterine lining builds up for a longer period of time, so the periods such women do get can be heavier than normal.
• Hair growth. More than 70 percent of women with this condition grow hair on their faces and bodies — including on their backs, bellies, and chests. Excess hair growth is called hirsutism.
• Acne. Male hormones can make the skin oilier than usual, and cause breakouts in areas like the face, chest, and upper back.
• Weight gain. Up to 80 percent of women with PCOS are overweight, or have obesity.
• Male pattern baldness. Hair on the scalp gets thinner, and may fall out.
• Darkening of the skin. Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breasts.
• Headaches. Hormone changes can trigger headaches in some women.
BODY CHANGES
Having higher-than-normal androgen levels can affect fertility and other aspects of health.
• Infertility
To get pregnant, you have to ovulate. Women who don’t ovulate regularly don’t release as many eggs to be fertilised. PCOS is one of the leading causes of infertility in women.
• Metabolic syndrome
Up to 80 percent of women with PCOS are overweight, or have obesity. Both obesity and PCOS increase the risk for:
• High blood sugar
• High blood pressure
• Low HDL “good” cholesterol
• High LDL “bad” cholesterol
Together, these factors are called metabolic syndrome, and they increase the risk for:
• Heart disease
• Diabetes
• Stroke
• Sleep apnea
• Endometrial cancer
• Depression
“PCOS is not an absolute barrier to conceiving naturally. According to a 2009 study, the features indicating the presence of PCOS (the polycystic ovary part) actually diminished throughout the lifespan of participants…The rate of miscarriage among those with PCOS was also not higher than those without it. The bottom line? Everyone is different.” – Dr. Emma Gray, The British CBT & Counselling Service.
“No matter how big or small your pain is, it matters. Give it attention and give it care, because even if it is always there, it should not get in the way of the life you want to live.” – Jennifer Nelson, writer and artist.
