Polycystic Ovarian Syndrome: A troubling disease for women 

Dr IMTIAZ AHMED  | Thursday, 26 May 2022

Polycystic Ovarian Syndrome, popularly known as PCOS, is one of the hormonal diseases affecting women worldwide. This is often characterised by increased male hormones (i.e. androgens) in women, development of menstrual problems, and small-sized cysts in the ovaries.  

How common is this? WHO estimates that approximately 3-4 per cent of the world’s female population is suffering from this condition. Projections put the number at 116 million, but this is definitely increasing. 

PCOS can develop any time once a woman hits puberty. Usually, it is diagnosed early, i.e. between 20-30 years of age. It is not uncommon to find PCOS when women come to the physician seeking help for conception.   

The exact cause of PCOS is still unknown, but we do know the risk factors. It has a strong genetic component. If a member of the family, like the mother or a sister, has PCOS then the risk is quite high.   

Obesity is also a risk factor since it can lead to insulin resistance. Studies revealed that 33-83 per cent of women with PCOS are afflicted with weight issues.  

In PCOS, there is an intricate interaction among three factors which give rise to the symptoms. One is elevated male hormones in the blood, leading to some masculine features.  

The male hormones/androgens may also impair the ovary's function, blocking the release of eggs which is critical for conception. This negatively impacts menstruation as well.   

In PCOS, this high level of androgen is coupled with insulin resistance and inflammation to create sufferings for the patients.  

There are many symptoms of PCOS. An irregular menstrual cycle is often seen. Due to male hormones, there may grow hair in unexpected places/hirsutism (e.g. facial hair), excessive acne as well as loss of scalp hair and development of male type baldness. Even though the name suggests it, enlarged ovaries with cysts are not universal. 

PCOS often lead to other health issues. Two of the most important are diabetes and infertility. In addition, liver disease, hypertension, high cholesterol, anxiety, and depression are not uncommon.  

If someone has symptoms suggestive of PCOS or has a family history of it, it is imperative to consult a physician. Physicians use clinical criteria to diagnose PCOS, which is usually based on menstrual abnormalities, features of excess male hormone and ovarian cysts. However, not everyone will fit all criteria.  

As the cause of PCOS is unknown, we cannot adopt any intervention for prevention. But modern medicine offers treatment to manage the symptoms. Goals for treating PCOS include correcting ovarian function (ovulation), alleviating the effect of male hormones and reducing insulin resistance. 

Common drugs used in PCOS include birth control pills, anti-diabetic medications, anti-androgens, and ovulation inducing agents. Surgery may be needed sometimes. 

Adopting lifestyle modification also helps in PCOS. Research showed that changes in diet, exercise and other aspects of life can help to reduce the burden of symptoms. Switching to a nutritious and balanced diet is advisable.  

High fiber vegetables, e.g. broccoli, cauliflower, lettuce etc. are useful to combat the insulin resistance. They should be an integral part of the diet, along with lean proteins like fish and chicken and inflammation preventing foods (turmeric, tomatoes, olive oil, walnuts, and strawberries).  

At the same time, we should either eliminate or restrict certain food items, especially refined carbohydrates like white bread and foods made with white flour, sugary drinks, juices, beverages, red meat and processed foods.   

People with PCOS will also be benefited by regular exercise. At least 150 minutes weekly exercise should be the target. Maintaining a healthy weight is always recommended, but it must be remembered that weight reduction and maintenance should be done gradually following expert advice, nothing drastic is good. If the patient is a smoker, it might be a good time to stop.   

[email protected]