A number of women unknowingly go through Polycystic Ovarian Syndrome (PCOS) around the world. In Pakistan, most women learn about PCOS once they themselves are diagnosed with it. You! takes a look...

are you emotionally broken down every time you look at a negative pregnancy test? If you find yourselves with a constant battle with your appearance and pain; you may be one of those millions of women living with a condition called Polycystic Ovarian Syndrome (PCOS).

Women, as homemakers, are the backbone of our families. In urban cities, balancing family and work is a challenge for women. Juggling between work and home, most of them ignore their health. And they only go for health check-ups unless a situation warrants it. According to a study conducted in 2012 by World Health Organization (WHO), 3 to 15 per cent women face infertility due to PCOS. It is the most common hormonal disorder affecting women of reproductive age worldwide.

24-year-old Ayesha Kamran, running a home-based business in Karachi, is one of the many women who have PCOS. At the age of 14, she struggled with multiple issues such as irregular periods, weight gain, unusual facial hairs, hair fall, skin issues along with mood swings and depression. Two years later, she was diagnosed with PCOS; but being unfamiliar with the disorder, she ignored it. “When I was first diagnosed with PCOS, I assumed it will pass with time but that never happened. At 19, I was still getting irregular periods but managed to conceive in the beginning as I had lost some weight. Unfortunately, I miscarried. After six months, I conceived again but since the foetus did not have a heartbeat, the doctors did an abortion immediately. Few months later, I was diagnosed with diabetes and had BP issues which even shocked my doctor. Apart from the physical pain, it had been emotionally distressing for me. Now, I am taking insulin, eating healthy and trying to maintain a healthy lifestyle, but I still deeply regret not taking my condition seriously initially,” she narrates.

While this is not a new condition, PCOS can be a mystery to doctors and patients alike. Dr. Irfana Barakzai, Consultant Gynecologist MCPS, DGO (Gynae & Obs), currently works at Sindh Government Hospital, Hyderabad. She has treated around 150 women with PCOS but still terms its main cause to be ambiguous. “We still cannot specifically term anything as the main cause but according to cases, hormonal imbalance (having high levels of testosterone) has been frequently reported, along with resistance to insulin. Furthermore, there is also a possibility of a genetic occurrence. The classic signs of this disorder are obesity, acne, irregular periods, and facial hair - yet some women never display these symptoms. As a result, many may go years without realising they have PCOS because they do not have the ‘textbook’ symptoms,” she tells.

In Pakistan, most women learn about PCOS once they themselves are diagnosed with it. “As far as the prevalence in Pakistan is concerned, there is very less data available from the rural areas of the country but estimates in urban areas show that one in every 10 women struggle with PCOS. Moreover, roughly 40 per cent of women dealing with fertility issues are found to have this condition,” informs Dr Irfana.

PCOS and infertility

The joys and fears of conceiving a baby and anticipating a pregnancy are often magnified for women who face the complications from PCOS. However, it is important to note that if a woman has PCOS it does not mean that she will never be able to get pregnant. Manha Danish is an HR professional who wanted to start a family at the age of 24. Sadly, she was unable to conceive after trying for a few months, after which she decided to consult her physician. “I had gained some weight that year and didn’t realise that PCOS could have been the reason. My doctor asked me to get a pelvic ultrasound done which revealed a cyst in one of my ovaries. I was prescribed medication and advised to reduce five per cent of my body weight. I managed to conceive just after 20 days of my treatment, and now I have a year-old son. Though, I still struggle with PCOS but I know that I will be able to control it,” she shares.

While one of the major downsides of this condition is infertility, it is not the only issue that women end up dealing with. Case in point being Maliha Sabah, who despite being a licensed nutritionist and a fitness coach was diagnosed with PCOS at the age of 20. She began gaining weight unusually for the past three years and struggled with hormonal imbalance and skin issues. Given her line of work, the effects of the condition started taking a toll on her, especially the weight gain. “Being a nutritionist myself, it was humiliating for me to be obese. I did a lot of research, after which I figured out that it was my PCOS that was affecting it. When you start gaining weight, it develops cysts which augment the weight gain. But, I didn’t give up. I made my own diet plans, switching them up every 10 days, along with making healthy changes in my lifestyle. Fortunately, I reduced 40 kg in nine months, which helped significantly in controlling my PCOS, so much so that I have no more visible signs.”

International studies have shown that lifestyle change is the only way PCOS symptoms can be controlled. The statistics for PCOS in Pakistan is still not clear as no research has been done on the condition in recent time. One would think that women must be aware of such a commonly found disorder, but that is not the case. Numerous women unknowingly go through this disorder which is why we need more awareness in order to eliminate PCOS.

How to manage PCOS?

PCOS was first described by Stein and Leventhal in 1935 through its symptoms. How PCOS works inside your body is that beta cells of the pancreas release too much insulin, copious amount of insulin release more than usual male hormone in the body. The rise and fall of insulin cause irritability, hunger, shakiness and anxiety. Other than that, high level of testosterone in the body causes sub-infertility in the body. Vast research on this syndrome has revealed that there is no medication that can completely cure it. While there is medication is available but it only controls few of the symptoms not all.

More than treatment, this condition requires management with a combination of medication and a lifestyle change. Dr Irfana advises her patients to initially reduce some weight and then move on to medication. Also, depression is another facet to this multi-faceted syndrome. We know that PCOS is primarily thought to be an endocrine disorder with irregularities in insulin and carbohydrate processing. Not all women with PCOS are insulin resistant but many of us are. So, if you do have insulin resistance, you are also more likely to suffer from depression or mood disorders. To curb this, one needs to get a cure of PCOS. Treating PCOS may hold an invaluable key to overcoming depression.