September is Polycystic Ovarian Syndrome (PCOS) Awareness Month

By Nadine Dirks

What is PCOS? Who gets it, what are the symptoms and what can we do about it?

Polycystic ovarian syndrome (PCOS) is a lifelong disease, that can result in a multitude of health problems later in life. The World Health Organization (WHO) states that it affects between ‘8-13% of reproductive-aged women’, however, this number may be much higher since the WHO also says that roughly ‘70% of affected women remain undiagnosed.’ PCOS is a chronic condition that cannot be cured but managed. In addition, PCOS affects Black and Asian women more commonly than other ethnic groups.

The Symptoms

Doctor Robyn Johnson, a Johannesburg-based doctor dedicated to women’s health shared some insights. Dr Johnson suggests some symptoms we can look out for are:

• Ovarian cysts or large ovaries
• Irregular, missed, or light periods.
• Pelvic pain
• Excessive facial and body hair, particularly on the chest, back, stomach, or upper thighs
• Weight gain, especially around the abdomen
• Infertility
• Hair loss or baldness
• Skin darkening on the back of the neck, armpits, or under the breasts
• Acne-prone or oily skin

So what causes PCOS?

Healthcare providers seem uncertain about the causes, the WHO states that it could be genetic. They go on further to say that women with a family history of type 2 diabetes are a risk group. Dr. Johnson states that some links have been made to people with insulin resistance, irregular menstruation, and extra male hormones. However the cause is still unknown but PCOS can be treated through medications, fertility treatments, and lifestyle changes. The lifestyle changes could be more exercise, changing one’s diet, and managing your weight. Dr. Johnson explains that when someone menstruates, an egg is released, which can be fertilised. This happens during the ovulation which is in the middle of the menstrual cycle. If no fertilisation takes place, the egg is broken down and exits the body as a period. However, When the body does not create sufficient hormones to allow for ovulation. Dr Johnson says ‘the ovaries develop tiny cysts, which subsequently produce androgens.’ The leftover androgens cause the symptoms, signs, and long-term issues (such as infertility) This is part of how the diagnosis of PCOS is made. Once Drs can exclude other issues, they can better diagnose PCOS.

How do healthcare providers diagnose PCOS?

Medical News Today shares expertise from specialists, who suggest that PCOS is difficult to diagnose. Especially since sometimes general practitioners are ‘unaware of the diagnostic criteria.’ One of the experts suggests that if a patient has two out of three results/symptoms listed on the diagnostic criteria then a diagnosis can be made. The three major symptoms are polycystic ovaries. Dr Johnson explains as ‘several tiny cysts’, she states these cysts present as tiny fluid-filled sacs. The second symptom is high androgen levels, and the third symptom to look for is irregular menstrual cycles.

Dr. Johnson gives us a detailed insight into what to expect during the diagnostic process. She suggests that PCOS symptoms can overlap with many other conditions so to be certain. She suggests a pelvic examination, including an ultrasound to observe the ovaries and check for abnormalities. As well as blood tests to check androgen levels, blood glucose levels, and cholesterol levels. This process is usually done by a specialist, says Dr Johnson. Once these examinations and tests are completed, then a diagnosis can be made.

Since PCOS is a disease that affects various parts of the body, the specialists may include a gynaecologist, an endocrinologist, or an infertility specialist according to Mayo Clinic.

What treatments are available?

Although PCOS cannot be cured, there are treatments available to assist with some of the symptoms.  Dr Johnson shared some of the treatment options:

• Birth control pills to improve period control and lower testosterone levels; this can also help with acne.
• Diabetes medicine reduces insulin resistance caused by PCOS; this also helps to reduce excessive testosterone levels, halt hair development, and normalise ovulation.
• Lifestyle modification, which includes a change in diet, increased activity levels through exercise, and stress management; is especially crucial if a woman wishes to become pregnant in the future.
• Other medications may help with acne, and the chances of becoming pregnant, if desired.

Mayo Clinic also suggests limiting one’s carbohydrate intake, to assist with keeping insulin levels from rising. Including losing weight to assist with lower insulin and androgen levels.

When and where to seek help

Dr. Johnson urges women not to suffer in silence and to seek out healthcare as soon as possible. If you are noticing similar symptoms as listed above, don’t wait rather seek help and rule out other conditions in the process. It is important to go and see a doctor if you have any symptoms associated with PCOS. Dr Johnson advises that you could seek help from your doctor who could refer you to the appropriate specialists. This includes public healthcare centres, if a private specialist is unattainable.

This PCOS Awareness Month make sure you or someone you know, knows the symptoms of PCOS so they can get care if needed. Or perhaps to share with someone who may be complaining about symptoms like pelvic pain, excessive bodily hair growth, or irregular menstrual cycles, amongst other things. The sooner people with PCOS get diagnosed the better because this could reduce long-term complications associated with the disease. Equally importantly, the sooner people can be treated to improve the quality of their lives.

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About the author:

Nadine Dirks is a prolific writer, opinion-maker, activist, and communications expert. Her work, interests, and expertise lie in intersectional feminism, gender, and sexuality and includes sexual and reproductive health and rights, particularly of marginalised people.