There are a number of medical disorders that women can be faced with over the lifetime. One that is becoming increasingly common is one called Polycystic Ovarian Syndrome (PCOS).
I have decided to highlight this disorder because it’s becoming a common finding in young females in Guyana. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary, as seen during an ultrasound exam.
The exact cause of PCOS is unknown, but early diagnosis and treatment, along with weight loss, may reduce the risk of long-term complications such as type 2 diabetes and heart disease.
PCOS signs and symptoms often begin soon after a woman first begins having periods (menarche). In some cases, it develops later during the reproductive years, for instance, in response to substantial weight gain.
PCOS has many signs and symptoms that you may notice or feel. All of these can worsen with obesity. Every woman with PCOS may be affected a little differently.
To be diagnosed with the condition, your doctor looks for at least two of the following:
- Irregular periods – this is the most common characteristic. Examples include menstrual intervals longer than 35 days; fewer than eight menstrual cycles a year; failure to menstruate for four months or longer; and prolonged periods that may be scant or heavy.
- Excess androgen – elevated levels of male hormones (androgens) may result in physical signs, such as excess facial and body hair (hirsutism), adult acne or severe adolescent acne, and male-pattern baldness (androgenic alopecia).
- Polycystic ovaries – polycystic ovaries become enlarged and contain numerous small fluid-filled sacs which surround the eggs.
WHEN TO SEE A DOCTOR
See your doctor if you have concerns about your menstrual periods, if you’re experiencing infertility or if you have signs of androgen excess such as acne and male-pattern hair growth.
Doctors don’t know what causes PCOS, but these factors may play a role:
- Excess insulin – insulin is the hormone produced in the pancreas that allows cells to use sugar (glucose) to make energy. If you have insulin resistance, your ability to use insulin effectively is impaired, and your pancreas has to secrete more insulin to make glucose available to cells. Excess insulin might also affect the ovaries by increasing androgen production, which may interfere with the ovaries’ ability to ovulate.
- Low-grade inflammation – your body’s white blood cells produce substances to fight infection in a response called inflammation. Research has shown that women with PCOS have low-grade inflammation and that this type of low-grade inflammation stimulates polycystic ovaries to produce androgens. This may occur due to the unhealthy foods that are more frequently consumed in this age.
- Heredity – if your mother or sister has PCOS, you might have a greater chance of having it, too. Researchers also are looking into the possibility that certain genes are linked to PCOS.
Having PCOS may make the following conditions more likely, especially if obesity also is a factor:
- Type 2 diabetes
- High blood pressure
- Cholesterol and lipid abnormalities, such as elevated triglycerides or low high-density lipoprotein (HDL) cholesterol, the “good” cholesterol
- Metabolic syndrome — a cluster of signs and symptoms that indicate a significantly increased risk of cardiovascular disease
- Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver
- Sleep apnea
- Depression and anxiety
- Abnormal uterine bleeding
- Cancer of the uterine lining (endometrial cancer), caused by exposure to continuous high levels of estrogen
- Gestational diabetes or pregnancy-induced high blood pressure
WHAT CAN YOU DO?
- Keep your weight in check – obesity makes insulin resistance worse. Weight loss can reduce both insulin and androgen levels and may restore ovulation. No single specific dietary approach is best, but losing weight by reducing how many calories you consume each day may help with polycystic ovary syndrome, especially if you’re overweight or obese. Use smaller plates, less processed foods, reduce portion sizes and resist the urge for seconds should help your weight
- Consider dietary changes – low-fat, high-carbohydrate diets may increase insulin levels, so you may want to consider a low-carbohydrate diet if you have PCOS — and if your doctor recommends it. Don’t severely restrict carbohydrates; instead, choose complex carbohydrates, which are high in fiber. The more fibre in a food, the more slowly it’s digested and the more slowly your blood sugar levels rise. High-fibre carbohydrates include whole-grain breads and cereals, whole-wheat pasta, barley, brown rice, and beans. Limit less healthy, simple carbohydrates such as soda, excess fruit juice, cake, candy, ice cream, pies, cookies and doughnuts.
- Be active – exercise helps lower blood sugar levels. If you have PCOS, increasing your daily activity and participating in a regular exercise program may treat or even prevent insulin resistance and help you keep your weight under control
Life with PCOS can be stressful and even depressing, being as healthy as you can will help to make life with PCOS much more tolerable.