I have very irregular periods and have been told that I have polycystic ovaries. I am very worried about this and don't know the long-term implications. Does it mean I will find it hard to get pregnant? Am I at risk of getting ovarian cancer? How can I get more information?
Dear Doctor,
I have very irregular periods and have been told that I have polycystic ovaries. I am very worried about this and don’t know the long-term implications. Does it mean I will find it hard to get pregnant? Am I at risk of getting ovarian cancer? How can I get more information?
Alicia, 27, Kacyiru
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Dear Alicia,
Polycystic disease is one of the most common ovarian disorders in women. It is the cause of impaired fertility in 5-10% of women of reproductive age worldwide.
Dr Rachna Pande.
The exact cause for polycystic disease is unknown but several studies have suggested a strong genetic factor. If a close relative suffers from polycystic disease, there are high chances that another woman in the family might suffer from the same disease.
Polycystic ovaries develop when ovaries are stimulated to produce excessive amounts of male hormone androgens and testosterone. The typical manifestations of polycystic ovarian disease are irregular menstrual cycles and absence of or diminished ovulation which impairs fertility.
When the existing male hormones in the body such as androgens and testosterone are elevated, the result is excess body hair, hoarseness of voice and increase in body mass among other. All these are masculine features.
Along with these features there may be acne over the face. Acne along with excess hair becomes quiet embarrassing for a young woman.
An affected individual may have one or several of these features depending on level of hormonal imbalance.
The hormonal imbalance in the body also causes insulin resistance and high cholesterol levels which leads to obesity and diabetes. One may have excess thirst, appetite and frequent urination due to development of diabetes.
Diagnosis of polycystic ovarian disease is established by ultrasound which shows multiple cysts in the ovary. Also other causes for menstrual irregularities and hirsuitism (excess body hair in a woman) like adrenal tumors, thyroid diseases, are excluded by suitable tests.
It is not that a woman with polycystic disease cannot conceive. Fertility is boosted just by weight reduction itself in many cases. Regular physical exercise and a low calorie diet including very less fats, consumption of more vegetables, fruits, whole grains and nuts can help to achieve this.
If a woman knows the exact time of ovulation precisely through recording basal body temperature or with the help of ultrasound and also has intercourse during that period, she can become pregnant. Drugs like clomiphene which are used to stimulate ovulation can help a woman to conceive.
Diabetes can be very well controlled by weight reduction and anti diabetic drugs. Metformin, a drug used to control diabetes also helps in weight reduction. Some studies show that it boosts ovulation to some extent though routinely it is not used for this purpose.
Acne can be treated by antibiotics and local hormonal preparations. Hirsuitism can be taken care by waxing and electrolysis methods.
If one still fails to conceive, numerous assisted reproductive techniques can help the individual to have a baby.
Surgical excision of the cysts, with hormonal therapies is used in severe cases. One needs not to be disheartened by polycystic ovarian disease. Numerous options are now available to treat it.