The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.
OVERVIEW
Polycystic ovary syndrome (PCOS) one of the most common hormonal imbalances affecting women. The condition affects an estimated 8–13% of women of reproductive age, and up to 70% of cases are undiagnosed.
PCOS is a condition that can affect your periods, fertility, hormones and aspects of your appearance. The biological and psychological effects of PCOS, particularly those related to obesity, body image and infertility, can lead to mental health challenges and social stigma.
Although it can also affect your long-term health, it’s frequently left undiagnosed. Many women don’t know that they have the condition until they try to become pregnant, if at all.
The condition cannot be prevented nor cured, but it can be managed. Early diagnosis and treatment are important in preventing long-term complications like infertility, obesity, diabetes, and heart disease.
PCOS IN SOUTH AFRICA
PCOS is believed to affect around 1 in 5 South African women and account for up to 40% of all female infertility cases here. These numbers may be underestimated as so many cases go undiagnosed. South Africa’s extremely high obesity rate is a significant contributor to our high rate of PCOS, as 68% of South African women either overweight or obese. Excess weight has been shown to play a part in the development of PCOS.
SYMPTOMS OF PCOS
Symptoms can differ between different people, and can even change of time:
- heavy, long, intermittent, unpredictable or absent periods
- difficulty falling pregnant
- acne or oily skin
- excessive hair on the face or body
- male-pattern baldness or hair thinning
- weight gain, especially around the belly
- skin tags on the neck and/or armpits
- headaches and insomnia
CAUSES OF PCOS
PCOS occurs when a woman’s levels of oestrogen and progesterone are out of balance. This causes the growth of ovarian cysts, which can lead to excess androgen (the hormones that give men their male characteristics.), which in turn affects menstrual cycles and fertility, among other things.
Polycystic ovaries are slightly larger than normal ovaries and have twice the number of follicles (fluid-filled spaces within the ovary that release the eggs when you ovulate). The exact cause of PCOS is currently unknown, but certain factors are believed to play a role in the development of the condition:
- Excess insulin: Insulin is the hormone that allows cells to use the sugar we eat for energy. If cells become resistant to insulin, your blood-sugar levels will rise, causing your body to produce even more insulin. This can increase the production of testosterone (male hormone).
- Excess testosterone (an androgen hormone): A higher-than-normal level of testosterone can cause women to exhibit male characteristics such as facial hair, male-pattern baldness, and acne. It causes infrequent ovulation.
- Excess weight: The link between PCOS and obesity is complicated, but what studies make clear is that women who are obese have a greater risk for PCOS, and women with PCOS have a greater risk for obesity.
- Genetics: Research suggests that PCOS may be hereditary. If your mother or sister has PCOS, you may have a greater chance of developing the condition.
- Type 2 diabetes: women with type 2 diabetes are at higher risk of PCOS.
EFFECTS OF PCOS
PCOS increases your likelihood of other health conditions, including:
- Miscarriage or premature birth
- Type 2 diabetes
- Gestational diabetes or pregnancy-induced high blood pressure
- Irregular menstrual cycle. Women with PCOS may miss periods or have fewer periods (fewer than eight in a year)
- Hypertension (high blood pressure)
- High cholesterol
- Heart disease
- Metabolic syndrome
- Sleep apnoea
- Eating disorders
- Abnormal uterine bleeding
- Endometrial cancer (cancer of the inner lining of the uterus)
PCOS can also cause anxiety, depression and a negative body image. Some symptoms such as infertility, obesity and unwanted hair growth can lead to social stigma. This can affect other life areas such as family, relationships, work and involvement in the community.
MANAGING PCOS
While there is no cure for PCOS, a combination of medications and lifestyle changes can help to improve the symptoms.
Medications include:
- Fertility treatments for women struggling to fall pregnant
- Hormone treatments to reduce excessive hair growth
- Treatments for acne
- Medical interventions to assist with weight loss
- Diabetes treatment for insulin management
- Medications to lower cholesterol and blood pressure
Lifestyle changes:
Weight loss has been shown to reduce some of the effects of excess testosterone in women with PCOS. Obese women with PCOS tend to suffer more severe symptoms. Eating a healthy diet, increasing physical activity, and maintaining a healthy weight are all important for women with PCOS. Quitting smoking and decreasing alcohol consumption can also reduce the severity of PCOS symptoms.
DIAGNOSING PCOS
PCOS is diagnosed by the presence of at least two of the following:
- signs or symptoms of high androgens (unwanted facial or bodily hair, loss of hair from the head, acne or an elevated blood level of testosterone)
- irregular or absent menstrual periods
- polycystic ovaries on an ultrasound scan
If you have any of the symptoms of PCOS, it is important to consult your healthcare professional as soon as possible so you can begin treatment to manage your symptoms.
FURTHER READING
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