PCOS affects reproductive age, lifestyle disorder, and mental health
Pune: Polycystic Ovarian Syndrome (PCOS) is a common endocrine, lifestyle disorder in young adult women of the reproductive age group that not only impacts one’s physical and mental well-being but can even lead to infertility and lifelong metabolic disorders. PCOS broadly presents with symptoms such as scanty, irregular periods, weight gain, acne, and hirsutism (excess, unwanted facial hair with/ without male pattern baldness), and is characterized by sonography of bulky ovaries with multiple small cysts.
Currently, PCOS cases are spiking in women of reproductive age. “Blame it on sedentary lifestyle, long working hours, irregular eating and sleeping hours, excessive intake of high carbohydrate and high-calorie food and drinks, increased stress levels trying to maintain a work-life balance, and in many cases a genetic predisposition to diabetes that runs in the family. Fertility problems in women with polycystic ovary syndrome (PCOS) are due to the infrequent or absent ovulation (anovulation), arising from a failure of the follicle ( egg) to achieve its potential growth and releasing the oocyte which is capable of fertilization,” said Dr. Sushruta Mokadam, Senior Consultant Obstetrician & Gynecologist, Motherhood Hospital, Kharadi, Pune.
Dr Sushruta added, “Those detected with PCOS tend to have higher male hormones (testosterone) and an important feature is Insulin Resistance. Thus, a woman suffers from a lack of energy but also weight gain in the long run. Insulin levels sequentially rise to combat insulin resistance ( which may be a genetic predisposition in the presence of a family history of diabetes in parents ) and this in turn leads to further weight gain, acanthosis nigricans ( dark skin patches ). PCOS, if untreated, can lead to the risk of life-threatening conditions known as Metabolic syndrome ( hypertension, type 2 diabetes, cardiovascular diseases, dyslipidemia ) in later life.”
“PCOS takes a toll on one’s fertility as women with this condition do not ovulate or release an egg due to the overproduction of estrogen by a woman’s ovaries. As ovulation does not occur regularly, menses get irregular and increased levels of hormones such as testosterone can affect one’s egg quality causing insulin resistance, and gestational diabetes. Thus, it will be challenging for a woman to conceive and embrace motherhood. However, it is possible for a woman to get pregnant with the help of assisted reproductive technology. Any data you want to add? IVF is used to help infertile women diagnosed with the polycystic ovarian syndrome (PCOS), who are unable to achieve pregnancy even with ovulation induction drugs or who have greater chances of multiple pregnancies and are good candidates for single embryo transfers. Another method is oocyte Cryopreservation or egg freezing, a process of extracting, freezing, and storing the woman’s eggs. It allows a woman to halt the ticking of her biological clock and bank her eggs for future use when the woman is ready to get pregnant. Out of the 30 regular patients we get who suffer from infertility issues, 5 have infertility issues because of PCOS ,” said Dr. Nisha Pansare, Fertility Consultant, Nova IVF Fertility, Pune
There is no concrete treatment that makes it go away entirely and the management is multi pronged and holistic. “It involves maintaining a healthy BMI ( Body Mass Index between 19-25 ) through a healthy diet rich in fiber and protein and low on starch and refined foods. Exercise is an altogether essential part of lifestyle modification. Cardiovascular as well as strength and weight training exercise is recommended as per individual requirements. Insulin sensitizers in the form of drugs like Metformin help to control further weight gain as well as aid in weight loss in patients who are seeking to conceive. Assisted reproductive techniques such as IVF are available to those who cannot conceive owing to multiple factors. Clarity and information regarding this disease can win half the battle towards mitigation of possible problems,” concluded Dr Sushruta.