The 16 year old Adenike went to the hostel bathroom to urinate during classes. Unexpectedly, urine and blood began to flow out. The floor and walls of the bathroom was splattered with clots of blood. Imagine the horror of a young girl experiencing her first period (menstruation) in such way. Panicky and terrified, she raised an alarm which prompted the students whose classroom was nearby to rush to the hostel.
“Girls of these days..she must have had an abortion”, the matron murmured. On overhearing this statement which was accompanied with her schoolmates bashing side talks, the innocent Adenike fainted. That was the beginning of a traumatizing and a life changing event in Adenike’s life. Her sweet sixteen took a horrific turn.
A decade later, after numerous suspicions of endometrial cancer, fibroid, misdiagnosis, and prolonged bleeding (3 months interval), Adenike consulted the umpteenth gynaecologist, who, after completing a number of hormonal and physical examinations, confirmed that it is a hormonal imbalance, Polycystic Ovarian Syndrome specifically.
Polycystic Ovarian Syndrome is the most common endocrine disorder among women, affecting approximately 5-10% of women. Endocrine disorders are disorders that affect the endocrine system in our bodies. They are caused by an imbalance of the hormones of the body, which causes changes in organ size and functioning. Endocrine diseases are condition s where the endocrine glands – Hypothalamus, Adrenal glands and Pituitary gland no longer work properly as a result of imbalanced hormone. Symptoms can vary greatly from individual to individual but must commonly include irregular cycles, infrequent periods or no periods at all, etc. It can cause ovulation problems, lead to difficulties getting pregnant, and increase your risk of developing diabetes and other serious health conditions.
A woman with PCOS produces excess male hormones called androgens. These hormones stimulate the ovaries to produce immature eggs called follicles. Instead of maturing, the follicles remain small and grow in clusters instead of releasing their yolk and increasing in size as they would during normal ovulation. Hence the name polycystic ovaries — meaning lots of small cysts on the surface of the ovary.
Because of these changes in their ovaries, women with PCOS tend to have high levels of male sex hormones called androgens such as testosterone and DHEAS (dehydroepiandrosterone sulfate). Androgen is a hormone that stimulates hair growth and sex drive in both men and women. In excess amounts, it can result in changes like those seen with PCOS — acne, excess hair growth on face or body, or thinning hair on scalp.
Symptoms of PCOS
Although not all women with PCOS will have symptoms, it’s important to be aware of symptoms that can indicate PCOS and other conditions.
Women with PCOS may experience signs/symptoms such as:
Irregular periods – Most women with PCOS have cycles that are longer than normal. Some have cycles that are very irregular or might skip a month. – Because of this, it can be harder to figure out when you’re ovulating and to know if you’re pregnant. – If you have PCOS and are trying to get pregnant, you might want to see a fertility specialist.
Excess hair growth – Hirsutism is hair growth that is not normal for you or extra hair on your face. – Some women with PCOS have a few extra hairs on their face and others have hair growth that’s very noticeable. – This can be treated with medications such as anti-androgens.
Weight gain – Many women with PCOS are overweight or have obesity. – Overweight can mean you’re heavier than is healthy for your height. – Obesity is very serious and can lead to serious health problems.
Dry skin, brittle nails, and thinning hair – Some women with PCOS have dry skin and brittle nails. – Hair loss can be a sign of other conditions, including PCOS.
How PCOS is Diagnosed
Since the symptoms of PCOS vary, it’s important to see a healthcare provider to make sure you have PCOS and not another condition. Your healthcare provider will likely do a physical exam and ask you about your health history. You might also get tests to look for high levels of androgens, rule out other conditions, and help predict your future health. You may get blood tests to check hormone levels, look for other conditions, and look for signs of anemia (low iron in the blood). Your healthcare provider may also order a pelvic ultrasound to look for other conditions.
Types of PCOS
People often talk about PCOS as if there is only one type, but there are actually different types of PCOS. The most common types of PCOS include: –
PCOS with regular menstrual cycles – In this type, women have normal periods, but they may be more painful.
PCOS without regular menstrual cycles – In this type, women don’t get regular periods and may have trouble getting pregnant.
PCOS with mild hair growth – In this type, women don’t get lots of hair on their face and body.
PCOS with severe hair growth – In this type, women get lots of hair on their face and body.
Risk Factors for Developing PCOS
While we don’t yet know what causes PCOS, we do know that it affects many women, especially those of reproductive age. For example, if a group of women between the ages of 18 and 35 are examined and tested, about 20% will have PCOS. But if the same test is done with a group of women between the ages of 35 and 44, about 50% will have PCOS. It’s not clear why the numbers change with age, and more research is needed.
Consequences of Having PCOS
There are many health risks associated with having PCOS.
Women with PCOS are at an increased risk of developing diabetes because of their higher levels of androgens. They are also more likely to have problems getting pregnant and to give birth to babies who are larger than normal and at risk of being born prematurely.
Certain types of PCOS may also be associated with a higher risk of heart disease, heart attack, and stroke.
Women with PCOS are also more likely to have depression and anxiety.
Women with PCOS can take steps to manage these health risks.
Treatment/Management of PCOS
All women with PCOS should have regular health checkups and blood tests.
If you have PCOS and are trying to get pregnant, talk with a doctor about your fertility.
You might want to see a dietitian for diet and nutrition advice. And you should get regular exercise. Controlling PCOS through diet and exercise – Eating a healthy diet and getting regular exercise can help control PCOS. Regular exercise and a healthy diet can help control blood sugar and help prevent diabetes.
Medications – Certain medications can help control the symptoms, improve fertility, and prevent long-term complications associated with PCOS. Birth control pills – Birth control pills help control the menstrual cycle and can help prevent an unwanted pregnancy. Metformin – A diabetes medication called metformin can help control blood sugar and insulin in people with PCOS.
Other medications – Other medications can help lower androgen levels and can be used together with metformin.
Surgery – Surgery can be used to treat some cases of severe PCOS.
By 2026, the market for treating polycystic ovarian syndrome, which was valued at $2,902 million in 2018, is expected to have grown to $4,184 million, with a CAGR of 4.7 percent.
Having polycystic ovary syndrome, or PCOS, during your reproductive years can be a challenging diagnosis to work with. That said, there are many ways to manage the symptoms, risks, and complications that may arise from having PCOS. By understanding what PCOS is, what the symptoms are, and what risks and complications you may face, you can better manage your health.
