Women who are overweight, and or experience heavy or irregular menstruation, could be at risk of polycystic ovary syndrome. According to Michel Baingi, a general doctor in Kigali, polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-aged women and affects approximately four to twelve per cent women’s hormone levels. Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance results in skipping menstrual periods, which makes it hard to get pregnant. He says, the underlying cause of PCOS is unknown. However, a genetic basis that is both multi-factorial and polygenic is suspected. Specifically, an increased prevalence has been noted between affected individuals, their sisters and mothers. Study shows that many women have PCOS but don’t know it, in one study carried out, about 70 per cent of women with PCOS hadn’t been diagnosed. He adds that PCOS is a syndrome, or group of symptoms that affects the ovaries and ovulation. Its three main features are; cysts in the ovaries, high levels of male hormones, irregular or skipped periods. Baingi explains that it is currently unknown if hypothalamic dysfunction is a primary cause of PCOS or it is secondary to abnormal steroid feedback. SIGNS AND SYMPTOMS He explains that in women with PCOS, complaints can be from varied endocrine effects and may include menstrual irregularities (a lack of ovulation prevents the uterine lining from shedding every month. Some women with PCOS get fewer than eight periods a year), infertility, manifestations of androgen excess, or other endocrine dysfunction. Symptoms classically become apparent within a few years of puberty. Baingi says elevated levels of male hormone may result in physical signs, such as excess facial and body hair (hirsutism), and irregularly severe acne and male-pattern baldness. The ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function frequently. He notes that heavy bleeding can also be a sign of PCOS, since the uterine lining builds up for a longer period of time, so the period a woman gets can be heavier than normal. “Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back, another symptom can also be weight gain. Up to 80 per cent of women with PCOS are overweight or obese. Hormone changes can also trigger headaches in some women,” he says. Baingi states that these signs and symptoms may vary widely between women as well as within individuals over time. He adds that hormone imbalances can affect a woman’s health in many ways. PCOS can increase the risk of infertility, metabolic syndrome, sleep apnea, endometrial cancer, and depression. DIAGNOSIS Dr Mohamed Okasha, a gynaecologist obstetrician at Legacy Clinics, states that doctors diagnose PCOS if women have at least two of three main symptoms — high androgen levels, irregular periods, and cysts in the ovaries. A pelvic exam, blood tests, and ultrasound can confirm the diagnosis. He also notes, if you have a diagnosis of PCOS, your doctor might recommend additional tests for complications. These tests may be; periodic checks of blood pressure, glucose tolerance, and cholesterol and triglyceride levels, screening for depression and anxiety and screening for obstructive sleep apnea. TREATMENT Baingi explains that the choice of treatment for each symptom of PCOS depends on a woman’s goals and the severity of endocrine dysfunction. Thus, an ovulatory woman desiring pregnancy will undergo significantly different treatment than adolescents with menstrual irregularity and acne. He says, patients often seek treatment for a singular complaint and may see various specialists from dermatologists, nutritionists, aestheticians, and endocrinologists prior to evaluation by a gynaecologist (surgical). He notes, weight can be lost by doing exercises. Okasha says, any diet that helps you lose weight can help your condition. However, some diets may have advantages over others. Studies comparing diets for PCOS have found that low-carbohydrate diets are effective for both weight loss and lowering insulin levels. editorial@newtimesrwanda.com
