Johannesburg – While Polycystic Ovarian syndrome may not be a life-threatening condition, it is frustrating and debilitating for many women across the globe.
Gynaecologist and Fertility Specialist Doctor Razina Patel at the Centre of Advanced Medicine says that while the statistics say one in 10 women suffer from it, she sees more like one in four women.
To explain what the condition in simple terms, Patel said the function of the ovary is to mature eggs to facilitate conception and that when one follicle becomes mature, others will disintergrate.
But she said in women with PCOS the hormonal music is off tune and the follicles get stuck in second gear. They do not mature resulting in numerous small follicles which make the ovary appear like a honeycomb.
She says it’s not cysts per say but fluid filled sacs within the ovary or egg filled spaces that don’t finish the journey to become a mature egg.
“The ovary is filled with immature follicles and can seem to look like bunches of grapes. They are unlike other types of cysts. They don’t cause pain and are about five to seven millimetres in size,” she said.
A sufferer of the condition is 41 year old Marilyn Nhlophe, who relates that she was first diagnosed at the age of 24.
She said after fighting a battle of endometriosis, she got married at 24 and tried having a baby without success for six months. She was then diagnosed with PCOS.
Nhlophe said it was frustrating because she’s always had painful periods, excessive acne as a teenager and was always felt fatigued as a young girl.
“I was told the endometriosis and PCOS were not related, I was just unfortunate to have developed both. But I couldn’t understand the PCOS because I wasn’t overweight at the time which is usually a sign, I also had a regular period but I did bleed heavily and still do,” she said.
She relates that after fertility treatment she successfully had a son, but was never able to conceive again.
Patel agreed that endometriosis is not related to PCOS.
“Endometriosis is when tissue similar to inside of uterus is found outside. The endometrium when it is shed monthly will escape into abdominal cavity and grow on tissue outside uterus.”
Nhlophe said she started gaining weight in her late thirties and was now struggling to lose the weight.
“I also started developing more facial hair and lots more body hair that becomes difficult to maintain. I just feel sick and awkward most days. It’s not easy living with this and it depresses me that I never had another child,” she said.
Patel explained that there is a difference between Polycystic ovaries and Polystic ovarian syndrome.
She said the former is when an ultrasound scan image of the ovaries appear to be polycystic (ovaries containing high density of partially mature follicles).
To have a syndrome is to have a metabolic condition, said Patel.
“To be diagnosed with PCOS, Polycystic ovaries appear on ultrasound, Irregular periods, Increased male hormone in the blood test or associated symptoms such as extra hair growth hair loss on the scalp, acneand being overweight.
Patel also said some women may find it very difficult to drop the extra pounds because of insulin resistance related to PCOS.
“Insulin encourages fat deposition in the abdominal area. Efforts to lose weight may be sabotaged and you not shift weight. Glucophage which is used for diabetes is also effective against insulin resistance and is often prescribed to women with PCOS. But it will only help the body shift weight when you exercise and eat healthy,” she said.
She mentioned although there’s no cure for PCOS, there are many treatment options available and even over the counter supplements which contain the ingredient Myoinositol was proving to be helpful in managing the condition.
Patel also said that it doesn’t cause cancer of the ovaries, but that going months without a period can cause the lining inside the uterus to thicken – which can then cause cancer in that area.
She also said that women with excessive body and facial hair, who are self-conscious about it, shouldn’t only wax, shave or lazer, but rather enquire about medicine which will correct the male hormone causing the imbalance and hair growth.
Improvement in managing the condition no longer requires drilling of the ovaries wedge resections.
“We aim to change the tune of the hormonal music and to facilitate growth of mature egg. So we do ovulation induction treatment. PCOS is stubborn and contaminated by high levels of insulin and male hormones. We first try to get that down,” she said.
Advice from Patel is that women should follow a low GI diet and exercise regularly to reduce the symptoms of PCOS.
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