Polycystic Ovarian Syndrome/Disease, also know as PCOS or PCOD, is a hormonal disorder. If you were recently diagnosed with PCOS, know that you are not alone. In urban India, approximately one in four women suffer from this condition, yet there are a lot of misconceptions about it.
Let’s answer some of the more common questions about PCOS.
Answers to common questions about PCOS
1. What causes PCOS?
The root cause of PCOS is not known. But research suggests that high levels of androgen [testosterone] and high levels of insulin are the two major causes of PCOS. These changes could be due to poor lifestyle, family history, stress, obesity or some other unknown causes.
PCOS affects fertility, appearance and has long term health effects if untreated.
2. Why does PCOS cause infrequent or absent periods?
PCOS occurs due to imbalance in reproductive hormones i.e higher levels of androgens [testosterone] and Luteinizing hormone [LH]. In a healthy female, the ovaries make and release eggs or ova on the 14th day of a regular 28 day cycle. If you have PCOS, the ovaries may not develop or release eggs and hence menstruation does not occur. These unreleased eggs are what show as ‘cysts’ in an ultrasound of a woman having PCOS. This leads to missed or irregular periods.
3. What are the main symptoms of PCOS?
Common symptoms of PCOS are:
- Irregular periods
- Rapid weight gain, inability to loose weight, obesity
- Pimples [acne]
- Hair loss and baldness on the head
- Excessive hair growth on the body and face
- Depression and mood swings
- Low self-esteem and body image insecurities
- Difficulty conceiving
4. What are the long term effects of PCOS?
The more common long term effects of PCOS are:
- High BP
- Endometrial cancer in people who have less than 4 periods in a year
- Snoring, daytime drowsiness
- Obesity, which can lead to knee pain, backache and other health issues.
5. What are poly cysts in my ovaries?
Every menstruating woman has cysts [follicles] in her ovaries. The only difference is that in healthy women, the size of these cysts is small [less than 8mm in diameter]. The cysts seen in PCOS are actually ‘follicles’ that have not released any eggs.
6. How is PCOS diagnosed?
If any two of the following criteria are satisfied, the patient is said to have PCOS:
- Irregular periods
- Excessive hair growth on face and body
- A pelvic ultrasound, where the ovaries show a polycystic appearance
- Increased androgen hormone levels, which are confirmed with blood tests.
7. Can PCOS be cured?
There is no known cure for PCOS. However the symptoms can be managed by lifestyle modification, maintaining an optimal weight, screening for long-term side effects and taking medication if needed. Note that many women tend to experience symptoms on and off.
8. If I have PCOS, does it mean I don’t need a contraceptive?
If you are sexually active and want to avoid pregnancy, you should use a contraceptive even if you have PCOS. PCOS doesn’t mean you cannot get pregnant. Ovulation may still happen and since your periods are irregular, you may not find out soon enough that you are pregnant. Also, contrary to popular misconception, contraceptive pills do not cause PCOS.
9. Can I get pregnant if I have PCOS?
As mentioned above, although PCOS cannot be cured, the symptoms of PCOS and its effects on your health can be managed. With the correct diet, appropriate weight, exercise, and hormonal medicine (if required), your chances of getting pregnant increase. Assisted reproductive measures such as ovulation induction, intrauterine insemination (IUI) and IVF can also help with conception. But these are medical interventions and may involve high level of expenses.
10. Can PCOS affect my health if I do get pregnant?
It is possible that some women with PCOS may develop gestational diabetes, higher chances of miscarriage, pre-eclampsia [high BP complicating mother’s health and baby’s health] and preterm birth.
11. How can I improve my pregnancy outcomes?
Take folic acid [dose adjusted for weight] and keep your blood sugar levels under control. You can lower the risk by reaching a healthy weight before getting pregnant.
12. What can I do to make my pregnancy term safe and healthy?
Avoid excessive weight gain, protein supplements and high sugar foods. Exercise regularly. With modern technology the complications associated with PCOS can now be predicted in the third month itself and can be effectively prevented/controlled. A C-section is not offered/required for PCOS.
13. What can I do to improve PCOS symptoms?
- Balance your intake of carbs and protein. Have a low-carb, high-protein diet
- Increase your iron intake
- Reduce your coffee intake. Caffeine affects estrogen levels and hormonal behaviour
- A balanced low carb, protein rich diet with adequate micronutrients such as iron, chromium and magnesium helps in weight control and reversal of PCOS symptoms. 5 portions of fruits and vegetables help in meeting the requirements of micronutrients. Foods like bananas, spinach, cashews; grapes, apples, onions and tomatoes especially help meet the micronutrients requirements
- Exercise regularly. At least 150 minutes a week with two sessions of muscle strengthening
- Avoid sugar-rich foods
- Work on managing your stress and get enough sleep.
14. How do I know if PCOS is getting better?
The following will indicate that your condition is improving:
- Your period cycle will become regular
- You will start losing weight; even five kilos of weight loss starts showing benefits
- Unwanted hair growth on the face reduces and acne improves
- You will sleep better and feel less stressed.
15. How can we the control long term effects?
Screening should be done regularly [usually annually] for sugars, blood pressure, depression, snoring and endometrial cancer. Long term effects can significantly improve with weight optimisation.
16. Is PCOS a life-threatening condition?
Certainly not, although it significantly affects quality of life if uncontrolled. Symptoms of PCOS can be significantly improved with lifestyle and medication. Consult your local expert for a personalised diagnosis and treatment plan.
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