Polycystic Ovary Syndrome (PCOS) is the most common gynaecological endocrine disorder in women of reproductive age. Research by Doctors G. O. Ugwu, C. A. Iyoke, H. E. Onah, and S. G. Mba of the Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu concluded that “PCOS is fairly common, occurring in approximately one in 6 infertile Nigerian women.” Despite the fact that this disorder is prevalent, not much is known about it. To shed more light on it, City People’s Contributing Editor, IYABO OYAWALE spoke to a senior medical doctor, Onwualu Anthony.
What is PCOS?
Polycystic Ovarian Syndrome is a hormonal disorder that causes the ovaries to develop fluid-filled sacs called cysts. To put it simply, it is an imbalance of your hormones that can lead to certain issues.
What causes PCOS?
Unfortunately, the exact cause of PCOS is unknown. However, studies have shown that hormones, genetics, lifestyle, and insulin sensitivity, amongst others, can cause it.
What are the symptoms of PCOS?
Symptoms can vary in women, and also things like stress, environment can also aggravate or reduce symptoms, the most common symptoms are missed, irregular, infrequent, or prolonged periods, heavy bleeding during periods, facial hair growth (Hirsutism), sometimes a deep voice, darkened skin, skin tags on the neck or in the armpits, mood changes, pelvic pain, abdominal weight gain, and thinning hair.
Who can get PCOS? What age group is most affected?
Any woman can get PCOS. The thing is once you hit puberty (13yrs), you can develop PCOS at any time. It’s just that PCOS can be very silent and sometimes can show no symptoms. So, it tends to go undiagnosed. When most people are diagnosed when they are trying to conceive.
For Instance, the constant stereotype of Igbo women having excess facial hair, while this may be true to an extent, it is also a symptom of PCOS called Hirsutism. This is not to say that any woman that has facial hair has PCOS.
Do you have the statistics on PCOS in Nigeria?
Not exactly but according to a study in Enugu, southeast Nigeria, PCOS affects one in six infertile women in Nigeria.
How is PCOS diagnosed?
When you go in for a consultation, there are certain questions your fertility doctor would ask you. Questions like your sexual and reproductive history, as well as a complete medical history. Your doctor will also check your weight, Blood Sugar, Blood pressure, and BMI. He/She will perform an ultrasound to check your uterus (womb), they will also check your ovaries for multiple cysts.
Please note that you can have cysts on your ovaries and not have the polycystic ovarian syndrome. In fact, 33% of women worldwide have been misdiagnosed as having PCOS, when they had just ovarian cysts.
Ovarian cysts can sometimes resolve on their own or become enlarged and painful and have to be removed via surgery.
For a definitive diagnosis of PCOS, you have to find a higher-than-normal amount of androgens in the blood of the patient. Androgens are hormones responsible for male characteristics in both men and women. You will also do a full hormonal panel to check the levels of all the hormones responsible for ovulation and conception.
How does PCOS affect fertility? Can PCOS affect the chances of getting pregnant?
Yes, it can definitely affect fertility. PCOS can cause irregular periods and heavy periods. PCOS can also affect ovulation, if as a woman, you are not ovulating, then there is no release of eggs to mate with the male sperm.
Having PCOS can cause a reduction in the secretion of progesterone, which can cause vaginal dryness and also make the vagina hostile to sperm.
Yes, it can affect your chances of getting pregnant as I just explained.
If you have PCOS, what medical problems are you at risk for?
Women who have PCOS are at risk of developing multiple health-related conditions. They include diabetes, gestational diabetes (diabetes when pregnant), heart disease, high blood pressure, sleep apnea (a disorder that causes breathing to stop during sleep), stroke—plaque (cholesterol and white blood cells), clogging blood vessels can lead to blood clots that in turn can cause a stroke, depression and anxiety, etc.
Can patients do anything to decrease their PCOS symptoms?
Yes, according to recent treatment guidelines, physicians now recommend lifestyle change as the first part of treatment. They are resistance training in your workout routine (lifting weights). This is because the trinity of PCOS is insulin resistance, abdominal obesity, and chronic inflammation. Weight training takes care of all 3. Diet Change, daily walks, taking care of your mental health, and taking your supplements daily, can also help.
What diet is best for women with PCOS?
Women with PCOS should have a protein-focused diet, e.g., chicken, turkey, fish, eggs, etc. The diet should also be high in fibre and contain nuts, seeds, berries, etc. Legumes, sweet potatoes, and good sources of good carbs and fats should also be included in the diet.
They should avoid dairy-based products. Diary products contain compounds called an insulin-like growth factor. This causes increased androgen production in the body.
Is there a cure for PCOS?
Unfortunately, there is no cure. You can live a healthy life by intentionally taking care of yourself and following health advice.
Should women who have PCOS see a fertility doctor before trying to conceive?
Yes, they should definitely see a doctor. You have to remember that PCOS is not the only cause of infertility. Your doctor would have to run a number of tests from a hormonal panel to a pelvic scan to probably a hysterosalpingogram (HSG).
So, to avoid stories that touch the heart, please visit your fertility specialist, if you and your partner have been trying to conceive after a year of having unprotected sex.
Is it true that pregnancy cures PCOS?
AAhhh, this is a big lie, please. There is no cure for PCOS, only management. I have also heard of instances where a woman was diagnosed with PCOS, got pregnant, and delivered and after a scan, no cysts were seen.
Now I am not doubting miracles but there is a possibility that she had ovarian cysts and was misdiagnosed as PCOS. Ovarian cysts can sometimes resolve on their own. Any woman trying to get pregnant should be taking prenatal Vitamins with Folate, Vitamin D supplements, and Omega 3 Fatty acids.
Any woman with a confirmed diagnosis of PCOS trying to conceive should be taking Myo-Inositol, Prenatal Vitamins with Folate, Vitamin D, Omega 3 fatty acids, N-acetylcysteine, Berberine, Maca, Turmeric, and Blackseed.