Don't fret over it

Don't fret over it

Polycystic ovarian syndrome (PCOS) is one of the most common hormonal problems faced by women today. It affects about 5-10 per cent of the members of the fairer sex. As a result of sedentary lifestyles, rising obesity, stress and unhealthy eating habits, the prevalence of the disorder is increasing by a great margin.

Though the name suggests that it is an ovarian disorder, PCOS is not exactly so. It is a multi-system disorder that affects  many organs and ovaries are just one target. It even causes hormonal imbalance and insulin resistance. In the long term, PCOS patients are more prone to endometrial cancer, type 2 diabetes, hypertension, dyslipidemia and stroke.

PCOS causes infrequent menses, prolonged bleeding, difficulty in conceiving, weight gain, scalp hair loss, acne and increased growth of facial hair. Since most of the symptoms are cosmetic in nature, women also suffer from depression. PCOS also increases the risk of diabetes, hypercholesterolaemia, stroke, endometrial cancer and heart disorders at a later age.

Dealing with it
The exact cause of the disorder is not known, although studies shows that it could be genetic in origin as there are familiar clustering of cases. But its severity could be compounded by obesity, stress and sedentary lifestyles. If the patient has polycystic ovaries (diagnosed on ultrasound) or oligo ovulation (infrequent release of the eggs from the ovaries) or=increased male hormones, they are diagnosed to have PCOS. About five per cent women have polycystic ovaries, but not the syndrome.

PCOS is a chronic disease which has no definite cure, but can only be kept under control. The goals of the treatment are:

To reduce the insulin resistance
Restoration of the menses
Restoration of fertility
Treatment of excess hair growth
On a general scale, the corner stone of the treatment is a drastic change in lifestyle. These patients need to have regular exercise and a low-calorie diet to keep their weight under control, as they gain weight easily. Weight loss, even in moderate amount, will restore spontaneous ovulation and regularity of cycle. 

Apart from the lifestyle changes, there are certain drugs that could help:
Oral contraceptive pills are used to regularise the menses.

Medications like metformin to reduce the insulin resistance can be also used.
Anti-androgen medications to treat androgen excess and acne could be used.
If child-bearing is the main concern, the patient can be treated with appropriate fertility medications.

PCOS is usually diagnosed with the help of ultrasound and blood tests. Keeping the long-term health risk of this condition in mind, it is better to get examined as early as possible. It always pays off to maintain a healthy lifestyle as it will go a long way in treating the condition and reducing the long-term health hazards posed by it.

(The author is consultant gynaecologist, Narayana Multispecialty Hospital, Bengaluru)

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