POLYCYSTIC OVARIAN DISEASE (PCOS)
One in ten women suffer from Polycystic ovarian syndrome (PCOS)
Q. What is PCOS?
It’s actually a misnomer. The cysts in the ovaries actually represent mid-follicular arrest of the growth and hence cannot reach mature stage and eventually there is no ovulation in a timely manner.
Therefore, some prefer to call it as polyfollicular ovarian syndrome. But, PCOS is widely used term all over the world.
Q. How common is PCOS?
In the reproductive age group women (15-45years), on ultrasound scan, PCOS features in the ovaries can be seen as high as one in three. But, not all these women with PCO features on scan suffer from PCOS. Only one in ten women suffer from PCOS.
Q. I am concerned about whether I have PCOS, how do I know, whether I have or not?
Women with PCOS can have following symptoms either alone or in combination
Very irregular periods. In some women, interval between the two menstrual cycles can be up to 60 days.
Absent menstrual cycle more than 60 days
Scanty periods (periods lasting less than two days)
Obesity, (body mass index more than 30)
Difficulty to fall pregnant because of failure to ovulate on time
Hair loss or excessive hair on the face or chin
Q. What are the other consequences of PCOS?
Few women with PCOS can have problems with regular menstruation. Because of this, the lining of the uterus doesnot get shed off in a timely manner. If this goes on for a long duration (many years), there is a small chance that, this thickened lining of the uterus can turn out to develop precancerous changes. In a minority of such women cancer of the lining of the womb may happen if no actions were taken to cause regular menstrual bleeds.
Q. I have PCOS, what precautions I should take?
If you have been diagnosed with PCOS, the most important thing you can do which is in your hands is to regulate the body weight, i.e., optimise the weight. Even a 10% weight loss, dropping weight from 90 kilograms to 80 Kilograms can have lots of potential positive effects.
The other things you need to ensure is that, you have at least four menstrual cycles a year. If this is not happening, you need to consult your GP or a Gynaecologist. They may consider for you to have artificial menstruation with medications
Q. Is there a cure for PCOS?
There is no cure for PCOS. But, one can keep the symptoms of PCOS under control with different therapeutic strategies. Usually PCOS resolves once a woman nears to her menopause.
Q. Will PCOS affect my chances of getting pregnant?
As PCOS women suffer from not having ovulation on time, this may be the sole reason, for few women with PCOS can’t fall pregnant without medical help (ovulation induction)
Q. I have no periods or too scanty periods and am worried about sinister pathology in the lining of the womb in the long term. Is there anything that can be done to prevent such things happening?
This anxiety and clinical situation can be handled by several different ways.
The most important thing is to optimise body weight (keeping BMI to < or equal to 25)
Make sure you have at least 4 menstrual cycles per year (either natural or artificial)
If your family is completed, and if there are no contraindications, then there is an option to consider a medicated Progestogenic intrauterine system insertion . This is shown to cause thinning of the lining of the womb. By doing this, it negates the effects of overgrowth of lining of the womb.
Q. What other additional problems I may suffer from if my PCOS is not controlled?
Studies have shown that women with uncontrolled PCOS may develop following problems
Cardiovascular problems such as high blood pressure
High cholesterol levels and its attendant risks