Article 11: Living with polycystic ovarian syndrome……..

– Dr Madhura Mandlik

Polycystic ovarian syndrome, famously short formed to PCOS, is a disorder associated with hormonal imbalance. In India around one in every five women is living with PCOS. It is the most common hormonal abnormality in the women of reproductive age group and remains one of the foremost causes of infertility.

Most of you reading this would be aware about what this syndrome entails. But let’s simplify it…….

Most women attain menarche at the age between 10-16 years. Once menarche is attained, a woman usually menstruates for 4-5 days at an interval of 28-32 days. On or around the 14th day of a woman’s cycle she ovulates i.e the egg is released. The main problem in PCOS is an anovulatory cycle which leads to androgen production. These multiple cysts in the ovary, usually diagnosed on ultrasound examination, are only seen in around 15% of women.

Now what are androgens ?

Andro means male. Androgens are hormones which are normally secreted in a man, most commonly testosterone. When these hormones are produced in a female in quantities higher than normal , it leads to symptoms of hyperandrogenism.

Polycystic ovarian syndrome is present in adolescent girls as acne , hirsutism (excessive facial , abdominal or chest hair) and menstrual irregularities. They can also show obesity, insulin resistance in the form of deranged blood sugars and acanthosis nigricans (dark pigmentation of skin in the axilla , around the neck ). In the reproductive age group women with PCOS will present most commonly with infertility. This syndrome does affect most menopausal women as it pre-disposes them to diabetes mellitus, cardiovascular disorders and metabolic syndrome.

PCOS is somewhat of a lifestyle disorder which can be managed with modifications in our daily life. This is and always will be the first step in tackling this syndrome.

  • Obesity is found to be strongly associated with pcos. It also is a modifiable risk factor. Studies have found that a high calorie diet containing refined food , monounsaturated fatty acid increases the risk of obesity thus increasing the risk of pcos. Women with pcos tend to gain weight mainly around their abdominal area and also have a tough time losing weight. Dietary modifications with moderate exercise goes a long way in tackling pcos. It’s imperative to accept and follow a healthy lifestyle with exercise and a healthy balanced diet.

  • Insulin resistance also is an integral part of pcos wherein women present with deranged sugars. Obesity worsens insulin resistance.
  • Premenstrual syndrome is not PCOS. Pcos does entail low mood , mood swings and irritability but having pcos does not mean one has pms. PMS commonly presents as bloating, abdominal cramps , irritability , headaches but this is more often seen in ovulating women.
  • Infertility is a common presentation of pcos in the reproductive age group. Given the advancements in medical sciences and artificial reproductive techniques this issue seems to be addressed well.

Living with pcos is an everyday battle. To be honest it is at times annoying because most of the time your doctor will tell you to lose weight and you feel like yelling out ‘I am trying to!!!! ‘ . But the key remains in harboring patience and discipline.

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