What you need to know about PCOS
“DOCTOR, my periods have been very irregular and I find myself missing months at a time. Then when it comes, it’s so heavy that I have to wear two pads at a time and it lasts for over a week. Also, I’ve been trying to get pregnant for over two years and nothing is happening, even though we are having sex all the time. Can you tell me what’s wrong?”
As gynaecologists we often hear these complaints, which many times may be due to a condition known as polycystic ovarian syndrome (PCOS). In fact, it is quite likely that you, dear reader, may know someone affected by PCOS. So, what is it really?
PCOS is a disorder linked to the body’s inability to process insulin properly, which eventually leads to a hormonal imbalance, with excess male hormone levels around the ovaries and in the bloodstream. This leads to an interruption of the normal menstrual cycle and ovulation, which is necessary for pregnancy. Common symptoms associated with PCOS include irregular periods, excess acne and facial/body hair, and difficulty getting pregnant. Women with the disorder tend to be overweight (although it is possible to have PCOS at a normal weight) and may have the abnormal findings of many small or immature follicles on their ovaries on ultrasound.
The symptoms caused by PCOS can be due to other conditions, so in order to make the diagnosis, the doctor has to take a detailed history and do a proper examination of the patient. On examination, we may see features confirming PCOS, but we may also see signs of other illnesses such as thyroid disease or glucose intolerance (metabolic syndrome). Routinely we also order blood tests and ultrasounds to help confirm PCOS and rule out other causes of irregular periods or infertility.
Once the diagnosis is made, we move on to treatment, which will depend on the patient’s desire to get pregnant (or not), and any problems she may be having with her periods. In addition to the problematic symptoms that patients experience, PCOS also increases the risk of abnormal changes in the lining of the uterus (which if left untreated can become cancerous over time), and is also associated with increased risk of diabetes, things which we also target in our therapy. Treatment generally includes weight loss and anti-diabetes medication to help control insulin and improve hormonal levels. Many times, these measures are enough to regularise the menstrual cycle and allow ovulation (and pregnancy). However, as weight loss is not an easy endeavour for many patients, we may also give hormonal medication to regularise the periods. If pregnancy is desired, we may opt to use medication to assist with ovulation to help decrease the time it takes to achieve pregnancy.
If you are experiencing any of the described abnormal symptoms, don’t wait or continue to suffer. Make an appointment to see a gynaecologist or the doctor at your health centre in order to get relief much sooner.
Dr Anna-Kay Taylor Christmas is a consultant obstetrician and gynaecologist at the Obs and Gynae Centre, Winchester Business Centre. She can be contacted at drtaylorchristmas@gmail.com or 908-3263, 906-2265, 325-7362.
