So many young girls come to my clinic and inform me that they have PCOS; but what actually is it?
Well, it is Poly Cystic Ovarian Syndrome (PCOS), a condition of hormonal imbalance that impairs the normal functioning of ovaries(female organ that produces eggs). The clinical effects of this imbalance are seen on several systems of the body and hence it is called a syndrome. The hormonal imbalance is the one where male pattern hormones predominate. This leads to oily skin, pimples, increased hair growth in unwanted body areas (upper lips, chin, chest, etc) and hair loss from the scalp.
The disturbed hormonal milieu in the ovaries prevents proper egg formation and hence periods get irregular, usually prolonged. And if one is trying to get pregnant that can take a while or even some medical assistance to help form proper eggs. However, all symptoms might not present in any single patient and so one should be watchful even if any one of the above symptoms comes up.
It is very important to know that to diagnose somebody as PCOS we need to fulfil at least two out the three criteria:
1) clinical features of PCOS (as described above)
2) abnormal hormone levels in blood test
3) polycystic ovaries on ultrasound.
So don’t be worried if your ultrasound report mentions poly cystic ovaries. If you don’t have abnormal blood tests or clinical features, you still can’t be labeled as having PCOS.
The next question that comes is, what can we do about it?
PCOS is essentially a life style disorder and probably that’s why it is so rampant in modern times. If you are overweight or genetically predisposed to develop ‘Insulin Resistance’ (a condition where the body cannot lower blood glucose levels for a given amount of Insulin), you are more prone to develop the hormonal imbalances that lead to PCOS. This would mean that the first step in managing PCOS is to optimize body weight.
One should use a combination of diet and exercise to achieve a healthy body weight. The importance of this cannot be over emphasized. Having PCOS also puts you at a higher risk of developing high blood pressure, diabetes, heart disease, high cholesterol and sleep disorder in future. Maintaining a healthy body weight goes a long way in keeping these monsters at bay.
Symptomatic treatment can usually take care of other problems. You would usually be prescribed combined hormonal pills (birth control pills) if your cycles are irregular. In fact, losing even 5-10% of body weight can also help in getting the menstrual cycle back on track. Specific combination pills can take care of excessive hair growth over body. Cosmetic treatments like waxing, bleach or lasers can help in dealing with that as well. If you have insulin resistance, the doctor would most commonly prescribe a drug called Metformin. It helps to utilize blood sugar more efficiently and so it helps to lose weight as well. If you have PCOS and you are having difficulty in getting pregnant you should meet your gynaecologist sooner than later.
It is important to remember, the only way to beat PCOS is to adopt and follow a healthy lifestyle and always consult your gynaecologist for the right advice !