Polycystic Ovarian Syndrome (PCOS)
Polycystic ovarian syndrome (PCOS) is a common metabolic condition that affects one in four women of reproductive age. In some ethnic groups, such as Asian (East Indians), Polynesian and Amerindians the incidence may be even higher. Despite its name, PCOS is not a disease of the ovaries but involves the whole body. Its signs range in severity from the very mild e.g. faint facial hair to a “full house“ syndrome with obstinate obesity, absent periods, infertility, excess hair growth, diabetes and heart disease. The severe form afflicts 5 per cent of women of reproductive age. Early diagnosis and appropriate intervention can avoid progress to the severe form of PCOS.
Given the fact that it afflicts up to 25 per cent of women of reproductive age, PCOS should be considered a health hazard for all women. Indeed, one wonders if it should be considered a disease at all - PCOS is more than just a personal problem, because it affects so many women. Because of its impact on different body functions, PCOS is a serious public health issue that deserves community support.
Do you think you may have PCOS?
Polycystic ovarian disease usually manifests at the time of the first period (menarche) or shortly thereafter. Most of the time, it occurs in early adulthood. Rarely does it occur after delivery of a baby.
PCOS was defined some 60 years ago by Drs Irving E Stein and Michael L Leventhal of New York City who coined the term in 1935 describing patients with obesity, amenorrhoea, severe hirsutism, and large polycystic ovaries. There is no good medical reason for patients to reach that stage of disease manifestation before a diagnosis is made. Early diagnosis of PCOS requires a high index of suspicion that is then objectively confirmed by testing.
Symptoms of PCOS
- delayed (or early) puberty
- irregular or no periods
- acne
- excess body or facial hair
- unexplained fatigue
- sugar craving
- hypoglycemia: (low blood glucose) after meals. The most common symptoms are light-headedness, sweating, sudden fatigue and butterflies in the tummy
- excess weight around the waistline
- infertility
- mood swings
- hot flushes (heat intolerance and excess sweating) in young women
- sleep disorders including sleep apnoea
- recurrent spontaneous miscarriages
- inappropriate lactation: often associated with levels of prolactin that randomly swing above and into normal range
- drop in blood pressure on standing up suddenly or with exercise
- acanthosis nigricans: rough, dark skin in the neck folds and arm pits: a mark of severe insulin resistance from any cause