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PCOS and infertility problems
Prevention of ovulation and the
growth of male hormones might result
in infertility in a woman with
polycystic ovarian syndrome, says Dr
Duru Shah, eminent gynaecologist
BY DR DURU SHAH
Polycystic Ovarian Syndrome (PCOS),
also known as Stein-Leventhal
Syndrome, is a health problem that can
affect a woman’s menstrual cycle,
fertility, hormones, insulin
production, heart, blood vessels and
appearance. It is estimated that 6-10%
of all the child bearing women are
affected by PCOS and most don’t even
know they have it!
Setting a chain reaction:
Strangely, though PCOS was identified
more than 75 years ago, scientists and
doctors are still not sure about the
exact causes of this syndrome.
Nevertheless, one of the first
affected areas is the menstrual cycle
in a woman. Ovaries in a woman have
follicles (tiny sacs called cysts)
filled with liquid that hold the eggs.
Each month, about 20 eggs start to
mature, but usually only one becomes
dominant. As the one egg grows, the
follicle accumulates fluid in it. When
that egg matures, the follicle breaks
open to release the egg so it can
travel through the fallopian tube for
fertilization. When the single egg
leaves the follicle, ovulation takes
place.
In women with PCOS, the ovary doesn't
make all of the hormones it needs for
any of the eggs to fully mature. They
may start to grow and accumulate
fluid. But not a single egg becomes
large enough. Instead, some may remain
as cysts, which is why the name
‘polycystic’, meaning more than one.
Since no egg matures or is released,
ovulation does not occur and the
hormone progesterone is not made.
Without progesterone, a woman’s
menstrual cycle is irregular or
absent. The cysts now produce male
hormones called androgens that set a
chain of reactions leading to acne,
excessive hair growth, weight gain,
and ovulation problems.
As PCOS affects ovulation, the most
affected are the women of
child-bearing age. Firstly, it
disables the woman of conceiving a
child. Further, PCOS in pregnant women
results in a higher rate of
miscarriage, gestational diabetes,
pregnancy-induced high blood pressure,
and premature delivery. Identifying
the following symptoms and getting
treated for them will to some extent
provide take care of the problem.
Irregular or absent periods
High levels of male hormones resulting
in acne, excess hair on the face &
body
High blood pressure and high insulin
levels or diabetes
Infertility or inability to get
pregnant because of not ovulating
Pelvic pain
Thinning of the scalp hair or balding
(medically known as alopecia)
Weight problems or obesity especially
around waist
Patches of dark brown or black skin on
the neck, arms, breasts or thighs
Skin tags or tiny excess flaps of skin
in the armpits or neck area
Sleep apnea ? excessive snoring and
breathing stops at times while asleep
Treatment
Various treatment options are
available for women with PCOS.
However, let us be clear that PCOS is
not completely curable, only its
effects can be minimised. Anyway that
should not worry women with any of the
symptoms mentioned above. They should
consult a gynaecologist, who will
conduct certain tests to test for PCOS.
Ultrasound and pelvic tests will help
evaluate the problems in ovary and
vagina. Treatments are based on the
symptoms each patient is having and
whether she wants to conceive or needs
contraception. Depending on the
symptoms and the need, a gynaecologist
can suggest birth control pills,
diabetic medications, fertility
medicines and if need be, a surgery to
treat PCOS.
Understand that PCOS is only a minor
hiccup. Let it not take away your
happiness. Awareness is the key and
women with PCOS with a little bit of
caution and treatment can lead a much
better life.
BY DR DURU SHAH |
