PCOS

PCOS – ARGUABLY THE MOST PREVALENT MORBIDITY IN 21ST CENTURY

With India being the most populous country, it is also the PCOS capital of the world. It is a lifestyle disorder which can be managed by taking timely preventive measures. It mostly affects urban girls. So its empirical to educate and enlighten the young generation, to prevent them from falling prey to this disease.

How many females are affected by PCOS?

1 in 10 females in India suffers from PCOS, with the majority of them being of the adolescent age group.

What are the causes of PCOS?

There is no pinpoint cause of PCOS. It is mainly caused by unhealthy dietary habits, sedentary lifestyles and unhealthy lifestyle choices. With the modernization of society, outdoor playing habits and increased physical activity are no more practised. The increase in alcohol intake, and smoking habits in females has also precipitated the prevalence of PCOS. It also runs genetically in families. A female with a mother or sister suffering from PCOS is more likely to develop it. Excess insulin (due to insulin resistance)  causes improper ovulation due to hormonal imbalance that leads to male hormones (androgens) in excess.

How do you know if you have PCOS?

The most common presenting complaints are menstrual irregularities and cosmetic complaints of acne, increased facial hair growth (hirsutism). Females in their 20s and 30s come with the inability to conceive. Later if they have conceived, report high-risk pregnancies with diabetes or high blood pressure. Ideally, a diagnosis is made by a doctor after a detailed history, clinical examination, lifestyle and dietary assessment, hormonal blood workup and ultrasound correlation.

Signs and Symptoms of PCOS

  • Menstrual irregularities
  • Acne
  • Excessive hair growth (hirsutism)
  • Abnormal flow of menses
  • Infertility
  • Black discolouration of the neck (Acanthosis Nigricans)
  • Polycystic appearance of ovaries

Is it possible to lose weight with PCOS?

One of the biggest myths that revolves around PCOS is that “PCOS has caused weight gain”. However, it’s the other way around. Weight gain leads to PCOS onset and its aftermath. It is definitely difficult to lose weight with PCOS due to an increase in insulin resistance but with proper guidance, appropriate diet modification, and an appropriate cardio-workout routine.

Adding high fibre in the diet (like millets, bran), decreasing gluten intake (avoiding wheat and including millets as an alternative), decreasing intake of simple sugars (sugar, honey) or high glycaemic index foods (white rice, white bread, cakes, cookies, breakfast cereals, chips, mango, watermelon, grapes, pineapple, sweetened dairy products).

Are all PCOS patients overweight or obese?

No, all patients are not obese or overweight. An entity called “Lean PCOS” also exists. So if there are symptoms matching the PCOS profile, you should visit your gynaecologist.

Can you conceive with PCOS?

It is difficult for females suffering from PCOS to conceive spontaneously due to erratic menstrual cycles. So the ovulatory days cannot be predicted easily. But with medical help, conception is possible. Some may need mild assistance, few may need IVF depending on the severity of the disease. Moreover, with improvement in lifestyle, dietary habits and weight loss, females conceive spontaneously.

Is PCOS curable?

Currently, there is no cure for this. But its symptoms can be controlled and eliminated. With the correct approach and treatment, acne, hirsutism and menstrual irregularities can be managed.

Are hormonal pills the only way to regulate periods?

Traditionally, short-term use of OC pills can be used to regulate the cycles but long-term use of it carries its own side-effects.

Can acne and facial hair be treated?

Acne can be managed with topical and oral therapies. The facial hair can become thin but the density does not change. For complete removal, laser treatment is the option.

Why infertility treatment is more tricky in cases of PCOS?

Females with PCOS have the chance of production of excessive eggs with ovulation stimulation (OHSS – ovarian hyperstimulation syndrome). So the dose and drug for ovarian stimulation have to be decided very meticulously and judiciously.

How does PCOS affect pregnancy?

Pregnancy in PCOS females are prone to developing Diabetes in pregnancy, hypertension in pregnancy or preterm delivery. They also have higher rates of Abortions.

Overdiagnosis or underdiagnosis of PCOS?

Symptoms of PCOS may match with thyroid disorders, diabetes and other hormonal imbalances. So over and under–diagnosis of PCOS is common. There are specific clinical, hormonal and radiological criteria for diagnosis and management.

What are the long-term adverse effects of PCOS?

  • High risk of developing Diabetes before 40 years of age.
  • High risk of Heart disease by 4-5 times.
  • High risk of developing hypertension.
  • Sleep apnea 
  • High levels of cholesterol, triglycerides and low levels of good cholesterol
  • Depression and anxiety
  • Increased risk of endometrial cancer (uterus cancer)

PCOS patients can be managed well by creating awareness, modifying lifestyles and adequate medical help.

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