Poly-Cystic Ovarian Syndrome a threat to motherhood

Those nine months are most treasured moments in women’s life. The very idea of contributing to life is simply a flabbergasted affair. However Polycystic Ovarian Syndrome could get in the way of a pregnancy.

According to Dr Shivani Sachdev Gour, Consultant Fertility Specialist and Gynaecologist, SCI Healthcare, New Delhi “Polycystic Ovarian Syndrome (PCOS) is the most common  total body endocrine disease that effects women in the reproductive age starting from the time of puberty to menopause. It affects approximately 10 per cent reproductive age group respectively. It is the most common hormonal disorder and is a leading cause of infertility”.

She further acknowledges, “Both males and females produces hormones. Androgens referred to as males hormones , play a pivotal role in sexual functioning of the body in girls with PCOS, the ovaries produce higher levels of androgens than normal, and this interferes with egg development  and release. Some of the eggs develop into cysts which are little sacs filled with liquid and instead of being released  during ovulation, these cysts build up in the ovaries and even get enlarged, hence the mane polycystic ovaries or poly Cystic Ovarian Syndrome.”

“Apparently women with infrequent menstrual periods, no menstrual periods, and/or irregular bleeding are likely to have PCOS. Increased growth of hair on the face, chest, stomach, back, thumbs, or toes acne, oily skin, or dandruff may be some of the sign associated with PCOS.” quips Dr Shivani.

Infertility or inability to get pregnant because of not ovulating weight gain or obesity, usually carrying extra weight around the waist are part of the Poly-Cystic Ovarian Syndrome. Few cases may present with male –pattern baldness or thinning hair patches of thickened and dark brown  or black skin on the neck, arms, breasts, or thighs skin tags, or tiny excess flaps of skin in the armpits or neck area.

Stressing on the importance of early diagnosis Dr Shivani emphasized, “If PCOS is not diagnosed early and treated properly it can lead to problems like type 2 diabetes, high cholesterol, high blood pressure, abnormal bleeding from the uterus, and very occasionally cancer too.” The most important step is screening the condition and PCOS can be easily diagnosed through Blood tests and Ultrasound  and therefore the chances of having serious side effects are reduced.  

“Fortunately today PCOS can be controlled using serious medications and other techniques like weight loss and exercise. Those are very effective in lessening many of the health conditions associated with this disease, such as high blood pressure and diabetes. Apart from this medications are also available which counter the effects of excess androgens in a woman’s body and lower the insulin levels which should be taken under experts supervision,” she further acknowledges.
Some of the methods commonly used to treat PCOS are enlisted below.

Birth control pills. For women who don’t want to become pregnant, birth control pills can regulate menstrual cycles, reduce male hormonal levels, and help to clear acne.

Anti-diabetic drugs: The medicine, Metformin, also called Glucophage, which is used to treat type 2 diabetes, also helps with PCOS symptoms.   Metformin affects the way insulin regulates glucose and decrease the testosterone production. Abnormal hair growth will slow down and ovulation may return after a few months of use. These medications will not cause a person to become diabetic.

Fertility Medications: The main fertility problem for women with PCOS is the lack of ovulation. Clomiphene (pills) and Gunadotropins (injectables) can be used to stimulate  the ovary to ovulate. PCOS patients are at increases risk for multiple births when using these medications. In vitro Fertilization (IVF) is sometimes recommended to control the chance of having triplets or more. Metformin can be taken with fertility medications and may help to make PCOS women ovulate on lower doses of medication.

Medicine for increased hair growth. If a woman is not trying to get pregnant there are some other medicines that may reduce hair growth. Spironolactone is a blood pressure medicine that has been shown to decrease the testosterone effect on hair. Cyproterone acetate is another medication that blocks this effect. Both of these medicines can affect the development of a male fetus and should not be taken if pregnancy is possible. Other non-medical treatments such as electrolysis or laser hair removal are effective at getting rid of hair. A woman with PCOS can also take hormonal treatment to keep hair from growing.

Surgery: Although it is not recommended as the first course of treatment, surgery called ovarian drilling is available to induce ovulation. This if done via laparoscopy or key-hole surgery. The ovaries are punctured with a small needle carrying an electric current or using laser to voluntarily breech the ovarian capsule. This surgery can lower male hormone levels and help with ovulation.

Life style management and weight optimization: Maintaining a healthily weight is the most important way women can help manage PCOS. Since obesity is common with PCOS, a healthy diet and physical activity help maintain a healthy weight, which in turn helps the body to lower glucose levels, use insulin more efficiently, and may help restore a normal period. Even loss of 10 per cent of body weight can help make a woman’s cycle more regular and increase the chances of ovulation by 25 per cent.