PCOS, otherwise known as Polycystic Ovarian Syndrome, is the most common hormonal disorder that affects women. In fact, up to 10 per cent of women in Singapore may have PCOS. Most of the time, it can manifest with a wide variety of symptoms. Many women may not be aware of their conditions and they can go undiagnosed.
From irregular menstrual cycles, acne, increased facial and body hair, and even obesity, the symptoms of PCOS range on a spectrum. Amelia*, a 35-year-old woman, shares, “It was horrible. I was putting on weight no matter what kind of diet I tried. My legs were growing hairy. My period was all over the place and my moods swings were so bad. It was a nightmare. I felt so unattractive. The doctor even told me that my fertility could be affected. That was very hard to hear.”
Some of the more challenging parts came later on. When “My friends and family kept telling me to lose weight and to “take more care of myself”. They probably meant that I should make myself look more presentable. But that made my moods even worse. I even heard some people talking behind my back about me finding excuses for being fat and how I should just eat less.”
To understand more about PCOS, we spoke with Dr Grace Huang, the resident doctor at DTAP Clinic Robertson. And she answered some commonly asked questions about this hormonal disorder.
If you have symptoms suggestive of PCOS, your doctor may ask you to undergo further blood tests and scans. PCOS is diagnosed through a combination of clinical symptoms in the form of a history of irregular menses, hormonal blood tests to look for excess levels of male hormones, and imaging, usually an ultrasound scan of the pelvis to look for the presence of multiple cysts in the ovaries.
A healthy lifestyle with a good diet and exercise can help to reduce the symptoms of PCOS. If you are overweight, just reducing your body weight by two to five per cent can help with the return of normal menstrual cycles and reduce your risk of diabetes, heart disease and other illnesses.
Medications such as the oral contraceptive pill may be used to treat menstrual irregularities and reduce symptoms of excess androgens like acne and hirsutism. Metformin, an oral diabetic medication, may be used to reduce insulin resistance and help with weight loss. Specific medications to induce ovulation may be prescribed to women who wish to get pregnant but have difficulty conceiving.
Polycystic ovarian syndrome is more common one may think and can cause significant health complications. It is important not to overlook or dismiss possible symptoms of PCOS. If any of these symptoms sound familiar to you, it may be best to make an appointment with your doctor to get them checked out.
Women with PCOS have three times the risk of early miscarriage (during the first trimester) compared to
women without PCOS. They are unfortunately also at an increased risk of pregnancy-related complications like gestational diabetes which can result in large babies with an increased risk of diabetes later in life, pre-eclampsia (dangerously high blood pressure), and preterm birth.
Paying close attention to one’s health during pregnancy and maintaining a healthy lifestyle and blood glucose levels can help to reduce the risks of these complications.
Unfortunately, PCOS does not go away with menopause. During menopause, women may experience weight gain, an increase in body fat and metabolic disturbances like hyperlipidemia due to declining levels of estrogen. Women with PCOS are already at an increased risk of insulin resistance which may be further compounded by menopause.
The management of PCOS after menopause remains similar – good dietary and lifestyle habits as well as
control of cardiovascular risk factors like diabetes, hyperlipidemia, hypertension and obesity.
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*The name has been changed to protect the privacy of the individual