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HEALTH- INFERTILITY PROBLEMS & PCOS

 

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

 

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