Monday marked the beginning of Polycystic Ovarian Syndrome Awareness week. This came as a pleasant surprise to me as I hadn’t heard of an awareness week dedicated solely to this. I shouldn’t have been surprised, after all, 25% of the population is affected by this…
Polycystic ovarian syndrome (PCOS) is a very common endocrinological (to do with hormones) and gynaecological (to do with females) disorder. Around 1 in 4 women have polycystic ovaries (multiple immature follicles which never quite release an egg) and around 10% of the general population in the Western world has Polycystic Ovarian Syndrome.
But what is it? Well…to put it simply it is a condition in which women of reproductive age experience absent ovulation and missed menses. But of course, that doesn’t really explain the ‘why’ PCOS is still very poorly understood but the basis is that there is an increased resistance to insulin which means that there is an increase in adipose tissue (fat) and an increase in androgens (like testosterone). Because there is an increase in androgens, other hormones like FSH and LH (which are on a negative feedback loop with androgens) do not secrete as much. Now, FSH and LH are needed to release oestrogen and progesterone, without which the immature follicles in the ovaries will not become mature follicles, ready to ovulate…
Still with me?
Right. So. In essence, if there is high insulin resistance, there is high androgens which means low FSH/LH and low Oestrogen. This all leads to ANOVULATION. If there is no ovulation, no egg is released, and the womb lining (endometrium) does not shed. So there is no menses.
Have I lost you?
However, this is only a tenth of what is actually going on. PCOS is far more complicated but thankfully unless you are a scientist or a particularly keen bean, you don’t really care nor require to know why exactly someone has PCOS.
What I can tell you is that its a syndrome which encompasses a lot of symptoms and every woman will have a degree of symptoms. Some have it worse and some have it better. Some deal with it worse and some better. For some, it impacts their quality of life in significant ways whereas others have minimal impact on their lives.
Below is a list of the most common symptoms and co-morbidities of PCOS:
- Hrituism (Male pattern hair on face, stomach, chest, back)
- Sub or infertility (decreased ease of getting pregnant)
- Obesity (due to inherent insulin resistance and lack of menstruation)
- Increased risk of secondary metabolic illnesses like Diabetes
- Isolation, mental health problems
- Increased risk of developing endometrial cancer (due to lack of menstruation and unopposed oestrogen which causes the womb lining to grow)
Living with the condition:
- Hair removal techniques: Shaving, waxing, laser treatment
- Diet and lifestyle control : Maintaing a healthy body weight
- Using contraceptive pills: Overrides androgens in the body and ‘tricks’ the shedding of the womb – important in reducing chances ofcancer
- Community, society and professional support
- Fertility enhancement: IVF, artificial insemination techniques
But everyone is different and everyone deserves to be respected, cherished and not be judged. If there is only thing you take away from this post, let it be this:
PCOS is not a disease nor an illness. Its a life-long condition. Its not treatable but it is manageable. People who have it will have different experiences. As a society, let these women be the ones who define what is ‘normal’ for them. Let us not force our own expectations on what a woman should look like, act or behave. Women are different and unique and all should be respected.
For more information on PCOS click on this link here
P.s – If you notice any inconsistencies in my post, please let me know! I’m by no means an expert and not yet a professional, just someone with a massive interest in this subject. If you feel that you or someone you know might have PCOS, please see a professional doctor.