Interview with Dr. T Shilpa Reddy, Consultant, Reproductive Medicine at Milann Hospital, Kumara Park, Bangalore
According to the National Institute of Health, approximately 10-15% of women of reproductive age have PCOS. The prevalence rate of PCOS is high among Indian women. It is most often diagnosed in women between the ages of 15-44, although it can affect women of any age. PCOS is a common condition and can often go undiagnosed or misdiagnosed. Women need to be aware of the symptoms and be proactive about seeking medical attention if they suspect they may have PCOS. Studies have also suggested a greater focus on PCOS to control non-communicable diseases.
What is PCOS?
PCOS or polycystic ovarian syndrome, is a complex often misunderstood hormonal disorder that happens during the reproductive years in women. It is a condition of hormonal imbalance wherein the ovaries produce excessive hormones, leading to irregular menstrual periods, excessive facial and body hair growth, and fertility problems.
What are the typical symptoms of PCOS?
These include irregular or missed menstrual periods, excessive hair growth, acne, weight gain, and infertility. Some women may also experience depression and anxiety due to the hormonal imbalance associated with PCOS.
But it is also possible to have PCOS without any symptoms. Many women don’t even realise that they have the condition, unless they have trouble getting pregnant or have unusual weight gain. It is important to consult a healthcare provider for a thorough evaluation if you suspect you may have PCOS. Your healthcare provider can order tests to check for the presence of the typical PCOS-associated hormones, as well as any other conditions that may be contributing to your symptoms. Additionally, they can help you create a treatment plan that is tailored to your individual needs.
What are the potential health risks associated with untreated PCOS?
It's important to note that the severity of symptoms and risks can vary widely among individuals with PCOS. Some potential health risks associated with untreated PCOS include infertility,Type 2 diabetes, cardiovascular problems, endometrial cancer, depression and anxiety.
It is important to seek medical attention as soon as possible to prevent any long-term complications. Additionally, early, and comprehensive treatment of PCOS symptoms, such as lifestyle changes and medications, can help reduce the risk of developing other chronic conditions.
Are there known genetic factors that contribute to PCOS, and can it be prevented?
The exact cause of PCOS is not fully understood, research has shown that genetics play a significant role in its development. Here are some key points regarding the genetic factors associated with PCOS:
Family History: Women with a family history of PCOS are at a higher risk of developing the condition, suggesting a genetic component.
Epigenetics: Epigenetic changes, such as DNA methylation and histone modifications, may also play a role in PCOS. These changes can affect gene expression and influence the development of PCOS-related traits.
Environmental and lifestyle factors
Candidate Genes: Several genes have been studied for their potential involvement in PCOS. These genes are related to various aspects of the condition, including hormonal regulation, insulin resistance, and inflammation.
How is PCOS diagnosed, and what tests are typically used to confirm the condition?
There's no single test to specifically diagnose polycystic ovary syndrome (PCOS). The healthcare provider will take a detailed medical history and perform a physical examination. They may also order tests such as bloodwork to check for the biomarkers associated with PCOS, a pelvic ultrasound, or a glucose challenge test to detect glucose intolerance or diabetes or a lipid profile test to check the cholesterol levels.
After a diagnosis is made, your healthcare provider can start a treatment plan to manage your symptoms and help you reach your health goals.
Your health care provider might then recommend:
Pelvic exam. During a pelvic exam, your health provider can check your reproductive organs for masses, growths, or other changes.
Blood tests. Blood tests can measure hormone levels. This testing can exclude other possible causes of menstrual problems or androgen excess that mimic PCOS.
Ultrasound. An ultrasound can check the size of your ovaries and the thickness of the lining of your uterus (endometrium).
After a diagnosis is made, your healthcare provider can develop a treatment plan to manage your symptoms and help you reach your health goals.
What treatment options are available for women with PCOS, and how effective are they?
One size does not fit all in PCOS management. Treatment options vary depending on everyone’s needs. Lifestyle modifications take the centerstage for PCOS management. These include increasing physical activity, eating a balanced diet, and reducing stress- thus addressing metabolic concerns and improving overall well-being. Common treatments include medications such as the birth control pill, insulin-sensitizing medications like metformin(first line treatment for Type 2 diabetes) and thiazolidinediones (insulin senstisers). Additionally, reproductive treatments such as ovulation induction medications, intrauterine insemination (IUI), and in vitro fertilization (IVF) are available for women who want to become pregnant. Research suggests that the combination of lifestyle changes and medications can be quite effective in managing symptoms of PCOS.
Can you discuss the link between PCOS and fertility? What are the options for women who want to conceive?
The link between PCOS and fertility is a complex one. Studies suggest that PCOS is the most common cause of infertility in women. Women with PCOS often have difficulty ovulating, which can make it harder to become pregnant. Additionally, PCOS can also cause conditions such as endometrial hyperplasia, which makes it difficult to conceive. The good news is that there are several fertility treatments available for women who would like to become pregnant. These treatments include ovulation-inducing medications such as clomiphene citrate, letrozole, and gonadotropins, as well as intrauterine insemination (IUI) and in vitro fertilization (IVF).
Are there any recent breakthroughs or research developments related to PCOS that you find noteworthy?
Recent breakthroughs or research developments related to PCOS include an increased focus on lifestyle changes such as diet and exercise in treating the condition. Research has suggested that losing even a small amount of weight can make a difference in symptoms, and even help regulate menstrual cycles. Additionally, there has been some research into the role of vitamin D and an anti-inflammatory diet in PCOS symptom management. Finally, there is currently a lot of interest in exploring how genetics plays a role in PCOS, as well as how environmental factors may influence its presentation and treatment.
What type of diet should women with PCOS follow?
Women with PCOS should follow a diet that is high in fiber-rich fruits and vegetables, healthy proteins, and complex carbohydrates. They should also limit processed foods and refined sugars. Additionally, it is important to maintain portion sizes and manage caloric intake to help achieve and maintain a healthy weight. An anti-inflammatory diet may also help to reduce the symptoms of PCOS. A registered dietitian can work with individuals to customize a meal plan that is best suited to their dietary needs and lifestyle. Supplements may also be recommended to help support the management of PCOS symptoms.
What advice would you give to women who suspect they have PCOS or have recently been diagnosed?
I would tell them to seek out professional medical advice from a qualified healthcare provider. It is important to have a full assessment to determine the type and severity of the symptoms, to get the right treatment. Additionally, I would recommend that they consider lifestyle changes. Finally, I would encourage them to educate themselves on PCOS and seek out accurate, trustworthy information.
How can friends and family provide support to women dealing with PCOS, and what role does awareness play in addressing this condition?
Friends and family can provide support to women dealing with PCOS by listening and offering emotional reassurance. It can be helpful for those closest to the woman to learn about the condition to better understand what she is going through.
Awareness of PCOS is also important in addressing this condition. Raising awareness can lead to better diagnosis and treatment, as well as reduce the stigma that is often associated with it. It can also help inform the public of the risks associated with PCOS and the importance of self-care and positive lifestyle changes. Ultimately, raising awareness of PCOS can help more women lead healthier lives and reach their goals.
