PCOS and its Landscape in India

Polycystic Ovary Syndrome is a hormonal disorder common among menstruators of reproductive age. Menstruators with PCOS may have infrequent or prolonged menstrual cycles or excess male hormone levels. The ovaries may develop a small collection of fluid or follicles and fail to regularly release eggs.

Signs and symptoms of PCOS often develop around the time of the first menstrual period during puberty. Sometimes PCOS develops later, for example, in response to substantial weight gain.

Signs and symptoms of PCOS vary. A diagnosis of PCOS is made when you experience at least two of these signs:

• Irregular periods: Infrequent, irregular or prolonged menstrual cycles are the most common sign of PCOS. For example, you might have fewer than nine periods a year, more than 35 days between periods and abnormally heavy periods.

• Excess androgen: Elevated levels of male hormone may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness.

• Polycystic ovaries: Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.

However, the exact causes of PCOS aren’t known.

One reason cited for the causes of PCOS is excess insulin. If your cells become resistant to the action of insulin, then your blood sugar levels can rise and your body might produce more insulin. Excess insulin might increase androgen production, causing difficulty with ovulation. Research also suggests that certain genes might be linked to PCOS.

PCOS can have many harmful effects for your body.

1. Infertility: If your body doesn’t ovulate, it does not release as many eggs and this often results in infertility.

2. Metabolic syndrome: Almost 80% of menstruators with PCOS are overweight or obese. This often increases the risk for high blood sugar, low HDL (good cholesterol) and high blood sugar. Together these factors are called metabolic syndrome, and they increase the risk for heart diseases, diabetes and stroke.

3. Sleep apnea: This is a serious disorder which causes repeated pauses of breathing at night and it usually interrupts sleep patterns. This is especially common for menstruators who are obese. The risk is 5-10 higher for obese menstruators with PCOS than those without PCOS.

4. Endometrial cancer: During ovulation, the uterus lining sheds. If this does not happen regularly, it can build up. This can increase the risk for endometrial cancer.

How do you treat PCOS?

Treatment of PCOS normally involves making changes to your lifestyle, like weight loss, diet and exercise. Losing just 5 to 10 percent of your body weight can help regulate your menstrual cycle and improve PCOS symptoms. Weight loss can also improve cholesterol levels, lower insulin, and reduce heart disease and diabetes risks.

PCOS in India

Experts say that at least 20% of menstruators in India suffer from PCOS. If not diagnosed and monitored, it can lead to serious health issues. But the lack of knowledge about it amongst menstruators makes it harder to identify. Experts say most menstruators ignore the common symptoms of PCOS and turn to a doctor only when they face trouble conceiving. According to Dr. Anjali Talwalkar, who has a clinic in Kurla, the incidence of the condition has been increasing every year, yet many menstruators don’t think that it may be PCOS even when they notice symptoms. “They simply attribute it to lifestyle. PCOS does arise out of poor lifestyle habits but it has adverse effects and should be treated. Since it is not life-threatening, people don’t care enough about it,” she said.

The treatment of PCOS does not end with managing its symptoms like acne, irregular periods or growth of facial hair. Menstruators need to be aware of all the symptoms so they can identify it, for themselves or in other people. Diagnosis may be tricky, since not all menstruators show all symptoms. However, awareness is the first step to maintaining proper menstrual health. The main aim of medicine is to prevent the onset of harmful diseases, or minimise their interference. For this to happen, people need to educate themselves about the various signs to identify and treat it early.

Dr Duru Shah has the same idea. He is the founder of the PCOS society in India. The Society plans to develop recommendations and protocols for the management of PCOS patients in India. He believes that educating all menstruators about PCOS will lead to better results in their health and especially fertility. He says that it is extremely important to make a correct diagnosis and convince them to have a full follow up.

With self-discipline and determination, menstruators can overcome this difficult situation and live healthy lives. PCOS can become a serious threat if not noticed, and the rate at which we educate ourselves about it determines how we facilitate possible treatments for it in the future.

Written by: Akshaya Krishnan

Graphics by: Rachel Alexander