25 June 2018 | Features | By Dr. Duru Shah
PCOS is one of the prominent causes of infertility, in which ovulation does not occur or occurs irregularly.
PCOS is a gynecological hormonal disorder, which affects 8-10% of women in their reproductive age. It affects women of all ages, from puberty to menopause. The presenting complaints may differ from cosmetic issues like facial hair and acne, irregular periods and inability to conceive, and chronic diseases like diabetes mellitus, high blood pressure, high cholesterol, and uterine cancer. 80% of girls or women are obese and quite a few have excessive pigmentation in the nape of their necks, underarms, groins etc.
PCOS is one of the prominent causes of infertility, in which ovulation does not occur or occurs irregularly. It is possible to assist infertile patients with various forms of medications which help ovulation and various other infertility treatments. As a matter of fact at our Center, we see a maximum of infertile women with PCOS.
As of today, the cause for PCOS to occur is not known, but a lot of research is ongoing and hopefully we should have an answer in the near future. But we do know that PCOS is a hormonal disorder which is genetically determined, with insulin resistance (relative lack of insulin hormone leading to diabetes) as the root cause. It occurs due to an interaction of genetic and environmental factors such as obesity. It is a life-long condition which cannot be completely cured but can definitely be kept under check. PCOS is also accompanied by raised androgen levels ie. excessive male hormone leading to acne, facial hair and loss of scalp hair.
How do we diagnose PCOS? This is done by a detailed history including that of periods, weight gain, hair growth, acne, hairloss on the scalp, and pigmentation, a detailed examination, blood investigations and ultrasound.
The treatment is tailored based on the lady’s symptoms, test results and the desire to get pregnant, or not.
These can be used long term if done under medical supervision. Newer birth control pills, are extremely effective and are low dose, hence less likely to have side effects. Needless to say, they are not an option for women wanting to get pregnant.
Metformin is also indicated if the lady’s blood sugar and insulin are high, or if she is pre- diabetic or already a diabetic.
As already said, PCOS is a lifelong condition, which can have serious cardiovascular and other consequences, if not kept under check. It is therefore important, that the PCOS patient should see her doctor at least once in 6 months, so that her treatment can be optimized and any necessary referrals made. The management may be multidisciplinary, involving the gynaecologist, endocrinologist, physician, dermatologist, nutritionist, fitness expert etc. Nevertheless, a PCOS lady can help herself by maintaining a healthy life style. Regular exercises and healthy eating is the part that she can play and will work wonders in keeping her PCOS under control.
The PCOS Society was recently launched in India as a multi specialty professional Organization which consists of gynecologists, dermatologists, endocrinologists and all other specialties involved in the care of PCOS women. As the Society grows, its agenda is to create a PCOS Support Group for women with PCOS.
Dr. Duru Shah - Director, Gynaecworld , Center for Assisted Reproduction & Women’s health; Panel Consultant – Breach Candy Hospital & Jaslok Hospital