For every five women in India, one can be diagnosed with Polycystic Ovarian Syndrome (PCOS), according to a report published by Metropolis Healthcare, a chain of pathology laboratories, in 2015—an alarming fallout of the increasingly sedentary lifestyles that have become characteristic of our urban existence. And unfortunately, doctors and researchers warn that the prevalence of PCOS is increasing with most women impacted falling in the 15 to 30-years age group. So what is PCOS? Essentially, it is a lifestyle-related metabolic, reproductive and endocrinal disorder which can impact fertility and lead to other problems if left unchecked.
“The exact cause of PCOS is unknown. It is a multifactorial metabolic disorder. In this syndrome, a combination of genetics, diet, lifestyle and environment lead to hormonal disturbances which are responsible for the symptoms of PCOS,” says Dr Shishta Nadda Basu, Senior Director and Head of Department, Obstetrics and Gynecology & IVF, Max Speciality Hospital, Shalimar Bagh, New Delhi.
PCOS gets its name from the fact that women with the problem are found to have developed multiple cysts which cause the ovaries to become enlarged. These cysts are caused by eggs that are not released and remain in the ovaries. While they are not harmful themselves, they can lead to hormonal problems.
What Exactly Happens in PCOS?
“Apart from irregular menstruation, I have gained weight—particularly in the abdominal area and have facial hair,” says Akansha Singhal, a 24-year-old with PCOS.
These, along with acne and thinning of hair on are the basic symptoms of PCOS. Potential underlying symptoms include an increased production of the male hormone, testosterone, depression and the difficulty or inability to conceive. Additionally, if left unchecked for a long period, PCOS can increase the risk of developing serious health problems like type-2 diabetes (due to an increased resistance to insulin), uterine cancer or an increased risk of a heart attack.
However, these symptoms are not always uniform.
“The symptoms of PCOS vary from person to person. They could range from irregular periods, unusual hair growth (hirsutism), obesity and hair loss in some cases. In the long term PCOS can lead to diabetes, cardiovascular problems and even cancer (especially of the endometrium) in later life,” says Dr Basu.
How is it Diagnosed?
PCOS can either be diagnosed through an ultrasound or through hormone profile tests that look at follicle stimulating hormones, oestrogen levels, luteinizing hormones (which help regulate menstrual cycles), etc.
Targeting Lifestyle Change
While there is no definite cure for PCOS, switching to a healthier lifestyle based on better diet and regular exercise can effectively help manage the disorder and reduce its glaring effects. This is usually considered to be the first and most important step.
“The most important thing for women with PCOS is to not panic. Modifications in lifestyle, losing a few kilos and management can go a long way in reducing the symptoms and reducing the risk of long term complications. Many patients of PCOS do not have any trouble conceiving and even if becoming pregnant gets difficult, there are many treatment modalities available to help one conceive,” says Dr Basu.
Other than this, medication through hormonal tablets and oral contraception to regularise menstrual cycles, metformin to control of symptoms and anti-androgens to combat excessive hair growth (for hirsutism) can help women with the disorder. In certain cases, minor surgical intervention is done through a laparoscopy to puncture the cysts.