PCOS: Ovar[l]y cautious
A few simple changes in lifestyle can help tackle polycystic ovary syndrome.
A few simple changes in lifestyle can help tackle polycystic ovary syndrome. DESIGN BY ESSA MALIK
Puberty can be challenging, but combined with the polycystic ovarian syndrome (PCOS) it can become unbearable. It is a hormonal imbalance that occurs in women, mostly teenagers, causing unwanted changes such as weight gain, irregular periods, acne, excessive hair growth on the face and body and fertility problems, leaving many women depressed or disoriented. And although the condition is not fatal, it raises concern.
When Uroosa first found out that her 15-year-old daughter, *Fatima, was suffering from PCOS, she was devastated. “Being a parent it was a matter of great concern for me because apart from excessive hair growth she was gaining weight and was 67kgs at the age of 14, which is disproportionate to her 5 feet 3 inch height,” she says. “After a year she started having irregular periods and failed to lose weight.” Along with the weight problems, Fatima has excessive hair growth on the back, belly, thighs and chin and ever since her diagnosis, avoids opening up to her mother about her concerns.
But even with the mostly overt symptoms, detection at times is difficult. Gynecologist Samrina Hashmi, has come across several women during her years of practice who suffer from PCOS but show no visible symptoms. While the causes are not fully known, genetics is widely accepted as the primary factor. “It’s a lifelong struggle because you cannot change your genes,” says Hashmi.
“The disease is quite common in South Asia because of the gene,” argues Iffat Ahmed, a gynecologist at the Aga Khan University Hospital. “Apart from genes, obesity is a trigger for PCOS. Previously obesity was not common but these days our lifestyle has changed,” she says. Ahmed traces the problem to the overconsumption of processed and junk food, as well as chicken. “Genes are not a trigger. In fact, the cause of PCOS is perhaps a complex genetic disorder. The condition is most common among diabetic families,” she explains.
Studies conducted in the UK show that South Asian immigrants suffer from diabetes putting their women at a higher risk of developing PCOS. Fatima has a family history of diabetes; her father, paternal grandmother and maternal grandfather are all diabetic. “I keep telling Fatima to eat healthy and exercise but she is too young to understand. She also gets angry over small things now, but earlier she was very patient,” says her mother. And while diabetes is one of the causes, it is not the only determinant. Twenty-four-year-old Faria claims her family has no diabetics but she was still diagnosed with PCOS. When acne first appeared on her face, she went to consult a dermatologist. However, when the recommended medicines aggravated her problem she sought relief from a gynecologist who determined the acne’s causal factor. “Eventually, I was told I have small cysts in my ovaries,” she says.
In Pakistan, nearly 30 out of every 100 women suffer from a hormonal imbalance which in turn increases the risk of obesity. The condition is the result of a disorder in the female endocrine system when abnormal levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are secreted. The excess LH causes the ovaries to overproduce androgens which upset the ovulatory process, resulting in eggs dying within the follicle and forming cyst-like structures in the ovary. Similarly, elevated insulin levels in diabetic patients increase ovary size, trapping them. Eventually the eggs inside the ovary form cysts which are detected via an ultrasound.
Although the cysts are non-cancerous, they give women quite a scare. Treatment options are available but there is no permanent cure for the condition. “Most mothers refuse to take their daughters to a gynecologist but this should not be the case,” says Faria. “I underwent treatment for an entire year and I am completely fine now. I don’t have irregular periods, no acne, no weight gain and hair growth has also gone back to normal.” Her doctors have reassured her that she will face no fertility problems in the future if she exercises regularly and avoids carbohydrates to control the symptoms.
“A woman with PCOS can have 40% to 70% fertility problems which can be treated,” says Ahmed. It is important to get up and go to bed early, include more fruit and vegetables in your diet and consume less meat, she advises. According to Hashmi, it is important to consult a gynecologist even if no symptoms surface. “In PCOS some women have no symptoms and they have children as well, but later in life they can suffer from so many diseases,” she adds.
Unfortunately, most people in the country don’t adhere to a healthy lifestyle, Ahmed laments. Hypertension, diabetes, cardiovascular disease and uterine cancer are some of the possible long-term problems. And in the country where a woman’s worth is mostly weighed against her ability to reproduce, PCOS can be a lifelong sentence of anxiety.
PCOS was discovered by Stein and Leventhal in 1935 and was originally known as the Stein-Leventhal syndrome. The 2003 Rotterdam consensus workshop on diagnosis of PCOS, sponsored by the National Institutes of Health, has concluded that at least two of the following three symptoms should be present to meet the diagnostic criterion:
1. Anovulation or menstrual irregularities
2. Cyst-like formations present in the ovaries
3. Signs of androgen excess
*Name has been changed to protect identity.
Published in The Express Tribune, Sunday Magazine, April 13th, 2014.
When Uroosa first found out that her 15-year-old daughter, *Fatima, was suffering from PCOS, she was devastated. “Being a parent it was a matter of great concern for me because apart from excessive hair growth she was gaining weight and was 67kgs at the age of 14, which is disproportionate to her 5 feet 3 inch height,” she says. “After a year she started having irregular periods and failed to lose weight.” Along with the weight problems, Fatima has excessive hair growth on the back, belly, thighs and chin and ever since her diagnosis, avoids opening up to her mother about her concerns.
But even with the mostly overt symptoms, detection at times is difficult. Gynecologist Samrina Hashmi, has come across several women during her years of practice who suffer from PCOS but show no visible symptoms. While the causes are not fully known, genetics is widely accepted as the primary factor. “It’s a lifelong struggle because you cannot change your genes,” says Hashmi.
“The disease is quite common in South Asia because of the gene,” argues Iffat Ahmed, a gynecologist at the Aga Khan University Hospital. “Apart from genes, obesity is a trigger for PCOS. Previously obesity was not common but these days our lifestyle has changed,” she says. Ahmed traces the problem to the overconsumption of processed and junk food, as well as chicken. “Genes are not a trigger. In fact, the cause of PCOS is perhaps a complex genetic disorder. The condition is most common among diabetic families,” she explains.
Studies conducted in the UK show that South Asian immigrants suffer from diabetes putting their women at a higher risk of developing PCOS. Fatima has a family history of diabetes; her father, paternal grandmother and maternal grandfather are all diabetic. “I keep telling Fatima to eat healthy and exercise but she is too young to understand. She also gets angry over small things now, but earlier she was very patient,” says her mother. And while diabetes is one of the causes, it is not the only determinant. Twenty-four-year-old Faria claims her family has no diabetics but she was still diagnosed with PCOS. When acne first appeared on her face, she went to consult a dermatologist. However, when the recommended medicines aggravated her problem she sought relief from a gynecologist who determined the acne’s causal factor. “Eventually, I was told I have small cysts in my ovaries,” she says.
In Pakistan, nearly 30 out of every 100 women suffer from a hormonal imbalance which in turn increases the risk of obesity. The condition is the result of a disorder in the female endocrine system when abnormal levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are secreted. The excess LH causes the ovaries to overproduce androgens which upset the ovulatory process, resulting in eggs dying within the follicle and forming cyst-like structures in the ovary. Similarly, elevated insulin levels in diabetic patients increase ovary size, trapping them. Eventually the eggs inside the ovary form cysts which are detected via an ultrasound.
Although the cysts are non-cancerous, they give women quite a scare. Treatment options are available but there is no permanent cure for the condition. “Most mothers refuse to take their daughters to a gynecologist but this should not be the case,” says Faria. “I underwent treatment for an entire year and I am completely fine now. I don’t have irregular periods, no acne, no weight gain and hair growth has also gone back to normal.” Her doctors have reassured her that she will face no fertility problems in the future if she exercises regularly and avoids carbohydrates to control the symptoms.
“A woman with PCOS can have 40% to 70% fertility problems which can be treated,” says Ahmed. It is important to get up and go to bed early, include more fruit and vegetables in your diet and consume less meat, she advises. According to Hashmi, it is important to consult a gynecologist even if no symptoms surface. “In PCOS some women have no symptoms and they have children as well, but later in life they can suffer from so many diseases,” she adds.
Unfortunately, most people in the country don’t adhere to a healthy lifestyle, Ahmed laments. Hypertension, diabetes, cardiovascular disease and uterine cancer are some of the possible long-term problems. And in the country where a woman’s worth is mostly weighed against her ability to reproduce, PCOS can be a lifelong sentence of anxiety.
PCOS was discovered by Stein and Leventhal in 1935 and was originally known as the Stein-Leventhal syndrome. The 2003 Rotterdam consensus workshop on diagnosis of PCOS, sponsored by the National Institutes of Health, has concluded that at least two of the following three symptoms should be present to meet the diagnostic criterion:
1. Anovulation or menstrual irregularities
2. Cyst-like formations present in the ovaries
3. Signs of androgen excess
*Name has been changed to protect identity.
Published in The Express Tribune, Sunday Magazine, April 13th, 2014.