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 EMBRACING CYSTERHOOD: Awareness of Polycystic Ovarian Syndrome

Polycystic ovary syndrome (PCOS, is a common health problem caused by an imbalance of reproductive hormones leading to infertility, irregular menstrual cycles and other long term health problems such as diabetes and heart disease

It is important to understand the symptoms and treatment for PCOS as it affects 1 out of 10 women in the childbearing age. A staggering 50% women with PCOS will develop type 2 diabetes or pre-diabetes before the age of 40 and there is 3 times the risk of women suffering PCOS of developing endometrial cancer. Furthermore, it’s shocking that 50% of the women go undiagnosed. Hence it is the need of the hour to create awareness of this syndrome that can easily be kept in control by lifestyle changes.

 Before getting into the details of PCOS it is necessary to understand the basic anatomy and physiology of the female reproductive system.

Anatomy

In girls there is a third opening –called the vagina or vaginal passage. This is where babies come from. The vaginal passage leads to the uterus or womb inside the body. This is where a baby grows in its mother’s body.

On either side of the uterus is an ovary. These are two small almond-shaped structures. The ovaries contain thousands of little eggs from the time a girl is born. The ovaries are then connected to the uterus by a tube like structure known as the Fallopian Tube. This is where Fertilisation (fusion of the egg and sperm) occur.

MENSTRUATION

Between 10 and 15 years old, the ovaries begin to release one egg every month. Just before the ovary releases one egg every month, the uterus begins to thicken its lining and collect blood in case a baby is to be made. If the female egg has not met the sperm then this blood and lining comes out little by little through the vagina for 2-8 days.

Menstruation stops totally when a woman is around 45-55 years old, this is known as Menopause.

What is PCOS ?

PCOS is a serious genetic, hormonal, metabolic, reproductive disorder that affects women. Hormones are substances your body makes to help different processes happen. Women with PCOS produce higher-than-normal amounts of male hormones and this hormone imbalance causes them to skip menstrual periods and makes it harder for them to get pregnant.

Those that are involved in PCOS include:

1. Androgens:

2. Insulin

3. Progesterone

CAUSE AND COMPLICATIONS

The exact cause of PCOS isn't known. Factors that might play a role include:

1. Excess insulin: Insulin is the hormone produced in the pancreas that allows cells to use sugar, your body's primary energy supply. If your cells become resistant to the action of insulin, then your blood sugar levels can rise and your body might produce more insulin

 2. Low-grade inflammation: This term is used to describe white blood cells' production of substances to fight infection. Research has shown that women with PCOS have a type of low-grade inflammation can lead to heart and blood vessel problems.

3. Heredity: Research suggests that certain genes might be linked to PCOS.

4. Excess androgen: The ovaries produce abnormally high levels of androgen, resulting in hirsutism and acne.

 Complications of PCOS can include:

1. Infertility

2. Liver disease

3. Heart disease

4. Diabetes

5. Depression, anxiety and eating disorders Obesity is associated with PCOS and can worsen complications of the disorder

SYMPTOMS OF PCOS

Signs and symptoms of PCOS often develop around the time of the first menstrual period during puberty.

A diagnosis of PCOS is made by an experienced doctor when you experience at least two of these signs:

1. Irregular periods: Infrequent, irregular or prolonged menstrual cycles are the most common sign of PCOS. For example, you might have fewer than nine periods a year, more than 35 days between periods and abnormally heavy periods.

2. Excess androgen: Elevated levels of male hormones may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness.

3. Polycystic ovaries: Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly. These polycystic ovaries can be seen on an ultrasound.

DIAGNOSIS

There's no test to definitively diagnose PCOS. Your doctor is likely to start with a discussion of your medical history, including your menstrual periods and weight changes. A physical exam will include checking for signs of excess hair growth, insulin resistance and acne. Your doctor might then recommend:

1. A pelvic exam

2. Blood tests. Your blood may be analyzed to measure hormone levels along with sugar and fat levels

3. An ultrasound. Your doctor checks the appearance of your ovaries and the thickness of the lining of your uterus.

Treatment

Unfortunately, PCOS doesn’t ever go away for good. The good news though is that with a healthy diet, regular physical activity, medications, supplements, and other lifestyle changes, PCOS and its symptoms can become manageable.

Treatment focuses on managing your individual concerns, such as infertility, excess facial and body hair, acne or obesity.

1.       Lifestyle changes: Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight — for example, losing 5 percent of your body weight — might improve your condition.

2.       Medications: To regulate your menstrual cycle, your doctor might recommend: Combination birth control pills: Pills that contain estrogen and progesterone decrease androgen production. Regulating your hormones can lower your risk of complications.

PCOS STIGMA

Often, when girls or young women are first diagnosed with PCOS, they often feel Confused, frustrated and/or sad if you are having a hard time losing weight, dealing with acne, excess body hair, and menstrual irregularities.

It is important to remember that these symptoms are nothing to be embarrassed about and that you’re not alone either. It’s completely normal to seek help from a mental counsellor to help you come to terms with your diagnosis. Understanding and learning more about PCOS might also help you understand your emotional needs.

For those of you who knows someone that has PCOS, it is important to not pass insensitive comments about their body hair/acne/weight.  On the contrary, make yourself aware and be empathetic to their condition.

Let us all rise together and embrace the Cysterhood!

References:

1. https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443
2. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
3. https://www.webmd.com/women/what-is-pcos
4. https://www.researchgate.net/publication/288103898_Body_image_and_quality_of_life_of_women_with_polycystic_ovary_syndrome
5. https://pcoswellness.com/pcos-treatment-blog/psychology-positive-body-image/
6. https://www.healthline.com/health/polycystic-ovary-disease#the-bottom-line
7. MSAI Feel The Deal Domestic Activity Brochure

       This content is written by Sanchita Iyer ( M.B.B.S, 3rd Year, Govt. Medical college Miraj)