Do I have Polycystic Ovarian Syndrome (PCOS)?
PCOS is one of the most common hormonal disorder caused in women of reproductive age. It is caused by hormonal imbalance and metabolic issues in women, also affecting their physical appearance and overall health. Although most experts believe that there are a number of causes including genetic factors that cause PCOS, the exact cause of the condition still remains unknown. Androgen is a male hormone which is produced in the body of every women but in very small amounts, the excess presence of Androgen causes male pattern baldness and excess facial hair growth which are two symptoms of PCOS. High levels of male hormones can also cause the ovaries to not release an egg during the menstrual cycle. Another cause of PCOS, as believed by experts is Insulin resistance, insulin is a hormone that converts the food we consume into energy. When the body does not respond to insulin, the insulin levels in the blood becomes higher than normal which in the long run could cause Type 2 Diabetes.
Women with PCOS have similar symptoms but they may experience them differently. The severity and the type of symptoms visible in women vary. The most common symptom experienced is irregular periods, delay of normal menstruation, fewer than normal periods and painful menstrual flow. Excessive body or facial hair, male pattern balding from the scalp, acne, infertility, weight issues, skin discoloration, acne, difficulty in losing weight etc are the most commonly seen symptoms of PCOS. This may not all appear together in a woman, some may have one of the symptoms, and others may have more than one. For a lot of women, the process of being diagnosed with PCOS in itself could be a challenge, for instance in the case of balding or skin discoloration, a Gynecologist will not be our choice of Doctor. PCOS can go undiagnosed for a period of time because the symptoms may overlap with other medical conditions women face. On conducting blood tests, physical tests, pelvic test and an ultrasound, if a women has one of any the symptoms; namely multiple cysts on each of the ovaries, excess androgen levels, irregular periods, she will be diagnosed with PCOS.
What is the cure?
There is no permanent cure or treatment for PCOS. Each symptom can be individually managed and treated. On experiencing any visible symptom or any bodily change, one should consult a Doctor, and on being diagnosed with PCOS, the Doctor would prescribe medication and treatment options depending on the symptoms. Fertility treatments are available to help women conceive. But the ideal way to treat PCOS is through nutrition and exercise, losing as little as 5% excess weight can help women reduce symptoms. Losing weight is an extremely important aspect of the condition and even though it may seem difficult to lose weight, one should continue the effort because it helps avoid the risk of certain conditions that may affect women with PCOS much earlier than women without PCOS. Health issues like heart diseases, stroke high cholesterol, diabetes, high BP are linked to long term consequences of PCOS. Surgery is the last resort for PCOS where laparoscopic drilling is done to trigger ovulation in women, the surgery can be an option for women who do not ovulate even after losing weight or trying fertility medicines.
Endometriosis, on the other hand, is a health condition that affects almost 100,000 women in the UAE. It is a condition that sees no differentiation and appears in women across all age groups. Endometriosis is when a condition when the tissue that lines the uterus begins to grow outside the uterus in areas like in pelvic organs and rarely beyond. With endometriosis, the tissue would act like it normally would, it will break down and bleed with each menstrual cycle, but since the tissue is displaced it has no way to exit the body.
Are the symptoms similar to PCOS?
Endometriosis may appear with symptoms or also be asymptomatic. Similar to PCOS, Endometriosis has no designated cause but the menstrual blood containing the lining that has to flow out of the body may flow back into the pelvic cavity through the fallopian tubes in a condition called retrograde menstruation, the immune system may be unable to recognize the tissues growing outside the uterus, heredity factors, a surgical after effect where after a Hysterectomy or C-section the endometrial cells may stick to an incision.
The severity of the condition depends on the exact location, extent, and depth of the endometrial lining deposit. Symptoms of the condition differ in each woman. Some women may experience painful periods, pain during intercourse, painful urination, excessive bleeding, infertility, digestive issues like diarrhea, constipation etc. Sometimes this condition is asymptomatic. Some women wild mild endometriosis may experience severe pain and sometimes women with severe endometriosis may have mild pain.
Can it be treated?
Unlike PCOS, Endometriosis has the option of surgical treatment. Endometriosis is generally treated with medication or surgery depending on the severity of the symptoms and depending on whether or not the woman chooses to conceive.
Surgery is beneficial if the woman is experiencing severe pain. Hormone therapy is used to treat pain related to Endometriosis. Generally, on consultation, doctors would suggest surgery be the last resort and will begin with pain relief medications. Conservative surgery, assisted reproductive technology and hysterectomy are the surgical methods used. Conservative surgery is done in case the woman wishes to become pregnant, assisted reproductive technology like IVF will help in conceiving and is preferable if the conservative surgery does not produce effective or desired results. Hysterectomy is the choice of procedure is the condition is severe and if the woman does not desire to conceive because in this surgical procedure the reproductive organs are removed.
The key to successful fertility treatment
Endometriosis is a progressive disease and can recur after stopping treatment. The key to successful fertility treatment is not delaying pregnancy. A woman diagnosed with Endometriosis desiring pregnancy should complete her family at the earliest. Endometriosis affecting the uterine wall can cause a condition called Adenomyosis can cause severe bleeding and pain during periods, the condition also causes infertility. Laparoscopic surgery is performed if the woman wishes to conceive where the surgeon removes any visible endometriosis implants and scar tissue that may be causing pain or infertility. The definitive or curative treatment for the condition is the removal of the uterus and ovaries.
These are all methods by which the quality of life for a woman living with the condition can be improved. For both PCOS and Endometriosis, the type and method of treatment should be decided by a healthcare professional depending on various factors like age, severity of the condition and the symptoms associated with it. These are both conditions that are widely present in women but generally goes unnoticed because a lot of times women tend to ignore a lot of the symptoms associated with these conditions.
Dr. Ann Mini Mathew
Specialist Obstetrician/Gynaecologist
Aster Hospital Mankhool
News Source – Mother Baby child Magazine 2016
