10 myths & facts about PCOS

PCOS causes hormonal imbalance and metabolism problems that may affect the overall health and appearance of women. Dr Nirmala Chandrashekar suggests ways to mitigate its effects

Polycystic ovary syndrome (PCOS) is an issue that affects 1 in 10 women of childbearing age. Women with PCOS have hormonal imbalance and metabolism problems that may affect their overall health and appearance. Here are some facts that bust the myths around PCOS.

1Myth: All PCOS patients are obese.
Fact: Only around 50% of PCOS patients are obese. Thin PCOS patients do have other features of PCOS like excess facial hair, irregular menstrual cycles, anovulation. On ultrasound, there will be a polycystic pattern (multiple cysts) in the ovaries.

2Myth: With PCOS, women will not be able to conceive.
Fact: Anovulatory (absence of egg release from the ovary) infertility occurs in almost 75% of PCOS patients. Most PCOS patients conceive either spontaneously or with treatment for egg release with either oral medications or injections.

3Myth: PCOS patients need to have multiple cysts in the ovaries for diagnosis.
Fact: The following are the criteria for the diagnosis of PCOS:

Anovulatory infertility decreased flow during menses; excess facial hair; Polycystic ovaries on ultrasound.

The presence of any two of the above three criteria is necessary for the diagnosis of PCOS. Even if polycystic ovaries are not there, with the presence of the other two criteria, it is still diagnosed as PCOS.

4Myth: All PCOS patients have irregular menstruation.
Fact: Menstrual disturbance in PCOS could range from absent menstrual cycles, decreased flow during menses, delayed menarche or heavy and irregular periods

5Myth: All PCOS patients have hirsutism.
Fact: There are various causes of excess facial hair growth like the adrenal, pituitary and thyroid causes.

6Myth: If a woman is not planning for pregnancy, then there is no concern and needs no lifestyle modification.
Fact: There are long-term consequences.

A three-time increased risk of Impaired Glucose Tolerance and a seven-fold increase in Diabetes mellitus. Increased risk of Lipid abnormalities.

Increased risk of hypertension and cardiovascular disease.

Increased risk of endometrial carcinoma.

7Myth: All PCOS patients need to be treated.
Fact: Young PCOS patients with regular menstruation need no hormonal treatment. Irregular menstruation and patients anxious to conceive need to be treated accordingly.

8Myth: PCOS is not linked to diabetes.
Fact: PCOS patients have insulin resistance and are at increased risk of developing Diabetes mellitus. However, the actual cause and the effect is still not known.

9Myth: PCOS is a condition with no cure.
Fact: PCOS patients can be treated and effectively managed. Weight reduction by diet, exercise and lifestyle modification plays a key role. Weight loss of around 2-5% decreases testosterone (male hormone) by 21% and women may resume regular ovulation. Lifestyle modification like avoiding alcohol, smoking, psychosocial stressors add to the disease modification.

10Myth: Weight loss has not many roles in PCOS. Treatment with drugs is sufficient.
Fact: Weight loss reduces the symptoms and the long-term complications. Thus, it plays a major role in the treatment of PCOS.

(The author is a consultant in obstetrics,
gynaecology & gynaec oncology.)