Health
PCOS engenders infertility, weight gain, irregular period in women
By Tumininu Ojelabi Hassan
Polycystic ovary syndrome (PCOS), is the most common gynaecological endocrine disorder in women of reproductive age. It is classified by the World Health Organisation (WHO) as group II ovulation disorder.
It affects between four percent and 20% of women globally. Africans and African-Americans experience the highest rates of PCOS while Chinese and Caucasian women have the lowest rates. One in six infertile women in Nigeria have PCOS. Local studies have reported rates of between 13.8% and 18.1%, among study populations of women in their reproductive age. Despite its prevalence, it is under diagnosed and under reported in our society.
As the name implies, It is basically a problem with hormones of the reproductive organs in the body. It is a hormonal problem, where small sacs filled with fluid, which also contain immature eggs are developed in the ovary.
Recently, Juliana Olayode, a Nigerian actress, popularly known as “Toyo baby,” shared her struggle with the PCOS on her YouTube channel. According to the actress, she bled nonstop for four months after her period seized for over a year.
“I had polycystic ovarian syndrome (PCOS) and I had Psoriasis. I was bleeding every day for four months and my period did not stop. The way it started was that my period did not come for over a year.
Sometimes, I used like two packs of sanitary towels every day. There was a day when I was at my sister’s house and I slept. I did not want her to know that I was bleeding nonstop. I woke up and the whole bed was full of blood. I had just changed my pad before going to sleep. My sister advised me that I had to go for a check-up immediately. But I was scared about what the doctors would tell me. We went to see a gynecologist. When we were having the tests, I was hoping it was not going to be cancer. Eventually, when the test came out it was PCOS,” she shared.
According to Dr. Adewumi Babatunde, Founder, Quinta Health and a Public health resident, Federal Medical Centre (FMC), Abeokuta, the cause of PCOS is unknown and the solution is not certain. It can be associated with insulin resistance in the body. Some of its symptoms is as a result of higher level of male hormone in the body, that is, a high level of androgen/testosterone in the body and a low level of female hormone (progesterone) in the body.
“PCOS is a hormonal problem that affects how a woman’s ovary works. Hormones are chemicals that help the body function, while ovary is the pouch that stores eggs needed for reproduction. The cause of PCOS is unknown. There is a hormone called insulin and it can be associated with insulin resistance in the body. Insulin is a hormone that controls sugar levels in the body. Some of the symptoms of PCOS include a thicker voice, weight gain, excessive hair growth especially on the chest and face, acne, hair loss, enlarged ovaries which can be seen through scan, irregular period, infertility due to anovulation (the inability to produce eggs) which can lead to difficulty in getting pregnant, earlier bleeding. All these are as a result of a higher level of male hormones in the body, that is a high level of androgen/testosterone in the body and a low level of the female hormone, progesterone in the body,” he stated.
Contrary to people’s belief about PCOS, it does not have any genetic predisposition, it can only be linked to insulin resistance in the body. In complicated cases, people, who are on the big size can come down with type 2 diabetes and heart disease.
Dr. Adewumi further stated that the treatment process of the health condition varies based on the symptoms. He noted that the treatment is not a blanket treatment for everyone, instead it is individualized.
“The treatment of PCOS varies, It is not a blanket treatment for everyone. It requires working with different professionals. The gynecologist works first, then we have the endocrinologist, dermatologist,dietitian and psychologist.
Medications will be administered to stimulate ovulation. Surgery will be done when the treatment doesn’t work. If the patients lose weight, they will eventually get better. Weight loss is a very important treatment for those, who have gained weight, about 5-15% weight loss is recommended and it has shown to reduce the symptoms drastically. However, PCOS can only be managed but it can’t be cured. We can liken it to hypertension, which can only be managed but can’t be cured,” he elaborated.
He noted some misconceptions about PCOS, which has led to the deterioration of the mental health of women with it, hence the need to see a psychologist.
“People have no control over PCOS, it a hormonal health condition that cannot be prevented. However, it is important to live a healthy life. Generally, people should not smoke, not only women with PCOS. Everyone should have a specific diet, eating healthy is important. It is vital to reduce soda and sugar in order to reduce weight, this would reduce insulin resistance in the body, which is a risk factor of PCOS.
“It is important for women with PCOS to see a psychologist due to some misconceptions about PCOS, which affects their mental effect. Some people call them witches due to the hair on their chest and some other masculine features, as a result of the high level of male hormone (testosterone) in their bodies, people talk about their weight, sometimes they attribute it to laziness, which is not true.
“Another misconception is that they confuse it with ovarian cyst. Ovarian cyst is a collection of fluid in the ovary, which can be treated; it is also not the same as polycystic ovaries, it doesn’t have hormonal changes like PCOS,” he added.
He advocated for good healthcare and subsidized quality healthcare for women with PCOS.
“Women with PCOS should have access to good healthcare and also ensure that women’s health is prioritized. They should also have access to subsidized healthcare, it is draining when you spend a lot from your pocket on a health condition because not all doctors can diagnose PCOS and delay in diagnosis can lead to progression of this condition,” he suggested.
Based on a two-year study carried out on the Prevalence rate, presentation and management of PCOS in two major infertility centres in Enugu, south east Nigeria, a total of 342 women presented with infertility in these centres, out of whom 62 had PCOS.
PCOS occurred in 18.1% of women in the two universities’ infertility centers. The common modes of presentation discovered were Infertility (inability to conceive) in 52 (83.9%), oligomenorrhoea in 45 (72.6%), obesity in 32 (51.6%), LH/FSH ratio greater than 2 in 28 (45.2%), hyperprolactinaemia in 26 (41.9%) and hirsuitism in 19 (30.6%) women.
“PCOS is fairly common occurring in approximately one in six infertile Nigerian women. Infertility, oligomenorrhoea, obesity, LH/FSH ratio > 2, hyperprolactinaemia and hirsutism are the commonest presenting features. On individualized management, about two-fifths of them conceive either spontaneously or following ovulation induction, despite poor compliance to recommended drug regimen,” the study concluded.