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Understanding PCOS – the most common hormonal disorder among women of reproductive age | 21 June 2019

Understanding PCOS – the most common hormonal disorder among women of reproductive age

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Approximately 1 in 10 -12 women in Seychelles are faced with Polycystic Ovarian Syndrome (PCOS). This is an observation made by Dr Farkhondeh Bamsi, gynaecologist at Euromedical Family Clinic Seychelles.

It is in this light that Seychelles NATION obtained the knowledge and advice of Dr Bamsi about PCOS, its complications, and treatment.

 

Seychelles NATION: What is PCOS? What are the symptoms? Who is at risk?

Dr Farkhondeh Bamsi: PCOS is the abbreviation for Polycystic Ovarian Syndrome which is the most common endocrinopathy affecting women of childbearing age.

It is basically a hyper androgenic state (excessive male hormones) and is insulin resistant. The ovaries develop numerous small collection of fluid-follicles and therefore fail to regularly release eggs.

Most affected women in Seychelles have the wrong notion that the small follicles are large ovarian cysts and cause dysmenorrhea (painful periods).

The diagnosis of PCOS is confirmed by laboratory investigations which include serum insulin and androgen hormones to include serum testosterone and Dehydroepiandrosterone (DHEAS); and ultrasound (trans-abdominal and trans-vaginal).

Patients with PCOS can present with any of the following symptoms:

a) Irregular periods delayed by a few weeks, months or even no periods (Amenorrhea)

b) Acne: characterised by pimples, especially on the face

c) Hirsutism: abnormal hair growth, especially on the face and body

d) Infertility: inability of a sexually active, non-contracepting couple to achieve pregnancy in one year

 

Patients who are at risk for developing PCOS include:

-           Obese women in their reproductive age (around 12 – 50 years in Seychelles) with a Body Mass Index (BMI) greater than 30. [BMI = weight in kg / (height in m)²]

-           It is also hereditary (if mother, sister or aunt has PCOS)

 

Seychelles NATION: What are your observations with regard to PCOS among women in Seychelles?

Dr Farkhondeh Bamsi: In Seychelles, PCOS is prevalent among women of reproductive age and my observation shows that one in every 10 - 12 women are facing this disorder; the main reason being obesity which is very much observed here, and the other is hereditary.

Obesity is common due to eating unhealthy food, e.g. takeaways rich in fats and carbohydrates, and also due to a sedentary lifestyle (lack of exercise).

The above situation can be considerably improved by changing lifestyle, e.g. reducing weight by consuming only healthy food (lean meat, fresh vegetables, seasonal fruits, cereals), drinking more than 3 litres of water daily, and finally some forms of exercise like going for walks, swimming or joining the gym.

 

Seychelles NATION: What are some of the complications associated with PCOS?

Dr Farkhondeh Bamsi: Early detection and timely management can prevent complications and patients can have a better quality of life.

-           The complications include:

1) Type 2 Diabetes Mellitus which affects half of the women with PCOS before the age of 40.

2) Women with PCOS have a greater risk of high blood pressure than women in the same age group leading to heart diseases and stroke.

3) Unhealthy cholesterol LDL increases the risk of heart disease and stroke.

4) Sleep apnea, anxiety and depression could be associated with these women.

5) In rare cases, due to unopposed action of estrogen, PCOS can cause endometrial hyperplasia (abnormal thickening of the lining of the uterus) and also endometrial cancer.

6) PCOS patients can have pregnancy related complications like miscarriages, pre-eclampsia (hypertension due to pregnancy) and gestational diabetes.

 

Seychelles NATION: What can women diagnosed with PCOS do to manage their condition?

Dr Farkhondeh Bamsi: Most PCOS cases tend to be overweight, so reducing one’s weight is one of the mainstays in improving one’s condition. They should take proper medical advice as the condition can be improved considerably.

Weight reduction even as little as 5-7% can decrease the amount of androgen and this improves the chances of fertility. Hence, involving a nutritionist actively will play a role in PCOS patients for weight reduction.

Another modality of treatment is using combined oral contraceptive pills to regulate periods and reduce the androgenic hormones. Women who come for fertility treatment have to be started on ovulation-inducing drugs like clomiphene citrate which helps anovulatory cycles. Insulin-sensitising agents like Metformin help PCOS patients for ovulation induction and hence fertility.

The modalities of treatment for hirsutism and acne include medications such as Dianne-35, waxing, bleaching and electrolysis. On the discretion of the obstetrician and gynaecologist, only very few selected cases would need surgical intervention like laproscopic ovarian drilling.

PCOS is a physical, sexual, psychological and social syndrome, hence it is necessary to take a holistic approach which includes lifestyle changes, weight reduction, dietary advice and seeking early medical advice.

For further information, visit or contact Euromedical Family Clinic Seychelles:

-           Address: Eden Plaza

-           Telephone: 4 324 999

-           Email: euromedical.sey@gmail.com

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