Have you heard of Polycystic Ovarian Syndrome or the term PCOS being thrown around. Desiree Munn, the Practice Manager of Blouberg Family Practice asked Dr Sheena Mathew to explain to us what PCOS is all about.
WHAT IS PCOS?
PCOS is the most common endocrine condition affecting women of reproductive age and a leading cause of female infertility in this group. At least 70% of women with PCOS remain undiagnosed in primary care.
What causes PCOS?
The precise cause of PCOS is unknown but it is likely a complex interaction of genetic and environmental factors. It affects all races and ethnicities, but you are at a higher risk if you are overweight and a family member (mother, sister or aunt) has PCOS.
How is PCOS diagnosed?
The investigations for PCOS diagnosis will entail a physical examination, blood tests and an ultrasound examination. In order to diagnose PCOS, at least 2 of the following criteria need to be present:
- Hyperandrogenism – physical signs or blood level indications of too much androgens (male hormones).
- Ovary dysfunction – irregular periods with long cycles or no ovulation
- Polycystic ovaries on ultrasound (> 12 follicles per ovary)
How do I know if I have PCOS?
Women with polycystic ovary syndrome (PCOS) can present with a wide spectrum of signs and symptoms including acne, hirsutism (dark, coarse hair growth in male-like pattern), obesity, menstrual irregularities and infertility. These symptoms are caused by androgen excess, anovulation, insulin resistance and metabolic syndrome.
Dermatological features: High levels of androgens (male hormones) leads to acne, hirsutism, oily skin, balding. In adolescents, diagnosis can be more challenging as puberty can also cause some of these signs.
Reproductive features: No menstruation (amenorrhoea), long cycles > 35 days (oligomenorrhoea), heavy bleeding (menorrhagia), subfertility, higher risk of pregnancy complications. Irregular cycles are common when menstruation initially starts (menarche) but these regulate within 2-3 years. It is advisable to have an assessment if irregular cycles (< 21 days or > 35 days) persist 2 years after menarche.
Metabolic features: Insulin resistance, obesity, lipid abnormalities, diabetes and cardiovascular risk.
Psychological features: Increased risk of depression and anxiety.
This is chronic condition with no cure and treatment is based on addressing individual presentations.
Obesity management: Diet, exercise, lifestyle changes, drugs, surgery.
Insulin resistance management: Lifestyle interventions as above, insulin sensitizers (Metformin, Inositol).
Menstrual irregularity management: Oral contraceptives to regulate cycles.
Infertility management: Lifestyle interventions as above, insulin sensitizers, ovulation induction agents.
Since many women with PCOS are insulin-resistant, diet is important in managing the condition. A PCOS diet is structured to maintain a healthy weight, promote stable insulin levels and to help boost mood. Foods that are high in saturated fat and sugar or are highly processed are discouraged. While there is no formal diet, an eating plan should include:
- Low-GI foods, which keep insulin levels stable
- Fatty fish, like salmon and sardines
- Fresh fruit and vegetables
- Low-fat dairy
Blouberg Family Practice is now stocking Pcositol, a nutritional supplement with high dose Inofolic and other vital supplements that support insulin metabolism and ovarian functioning in PCOS patients.
Should you be concerned about PCOS or Infertility for yourself or for someone that you know, please contact Des on (021) 023 0480 or email firstname.lastname@example.org. You can also make an online appointment at https://bloubergfamilypractice.co.za/ for an assessment.