That overwhelming frustration and anger that feels like it comes out of nowhere, but could probably be related to the inexplicable seven kilograms of weight you’ve just picked up this past year; a menstrual cycle with a mind of its own… also, what is up with these nipple hairs?
If this sounds like a page out of your diary, it’s likely that you’re one of the 8-13% of women who suffer from a common but under-diagnosed condition called Polycystic Ovary Syndrome (PCOS). Per one estimate, a staggering 8 million Southern African women are affected by PCOS, a complex hormonal disorder that often remains undiagnosed and misunderstood.
READ MORE: “I Was Diagnosed With PCOS – Here’s What You Should Look Out For”
Why we need to talk about PCOS in South Africa
Despite so many women carrying the condition, it remains largely unspoken about in social gatherings over tipples of wine. And yet, for women with PCOS in South Africa, it feels all-encompassing, affecting their moods, their self-confidence, mental health and even their fertility.
And as severe as its symptoms are known to be, PCOS typically goes undiagnosed for months and in most cases for years. “Many women and sometimes even their healthcare providers shrug off the symptoms associated with PCOS as a natural part of being a woman. Sadly, this all too often leads to delayed diagnoses,” says Dr Bradley Wagemaker, Medical Director at Lamelle Pharmaceuticals. “It’s sadly very common for women to suffer in silence, thinking that the uncomfortable, inconvenient and even traumatic symptoms of PCOS are nothing more than a normal part of being a woman, or a burden for them to deal with on their own,” says Dr Wagemaker. “Instead, the message we should be sending to all women is that PCOS is manageable and that you may not have to forgo your weight loss goals or your dream of starting a family.”
“While strides are being made in the medical industry and through PCOS Awareness Month in September, to improve the number of women being correctly diagnosed and treated at an early stage, women need to educate themselves on the signs to look out for,” he says. So, let’s talk about it.
READ MORE: Refined Carbs Are Super-Bad For PCOS Symptoms — So, What Can You Eat Then?
What exactly is PCOS?
PCOS is a multifactorial hormonal disorder affecting individuals with ovaries, primarily during their reproductive years. Although its precise cause remains unclear, genetics, hormones, and environment play roles in its development. Surprisingly, the name sheds light on the condition. Poly, meaning many, and cysts, meaning small, liquid-filled sacs. These many sacs sit inside a woman’s ovary and can create hormonal imbalances that lead to difficulties with egg development and its release. This often means late or completely absent periods, or periods that seem to go on forever.
Since the condition is largely hormonal, PCOS causes an overproduction of androgens, a hormone found in large numbers in people with testes and in smaller numbers in people with ovaries. It’s also closely linked to insulin resistance, a condition where your body doesn’t use glucose from your blood for energy efficiently, leading to weight gain.
READ MORE: The Best Way To Lose Weight When You Have PCOS
What are the symptoms of PCOS?
Some of its signs include:
- Heavy, irregular or even absent periods
- Excess facial and body hair (resulting from elevated androgen levels, a hormone most prevalent in men)
- Balding or hair thinning
- Oily skin and acne (mostly at the bottom of your face: along the jaw, chin and neck)
- Small cysts on the ovaries
Women with PCOS may also be more susceptible to insulin resistance, weight gain and psychosocial disorders. It could also lead to endometrial cancer, and other serious and life-threatening conditions, including type 2 diabetes and heart disease.
PCOS also often leads to infertility in women (around 40% in SA); with the hormonal imbalance brought about by PCOS, the ovaries are unable to grow and release eggs, stunting the ovulation stage in a woman’s cycle – that all-important time for baby-making.
While all this sounds grim, there are ways of treating the condition that involves a multi-pronged approach. Another key? Having a medical professional willing to hear you out and really investigate your symptoms to make a thorough diagnosis.
How is PCOS diagnosed?
Diagnosis of PCOS is typically based on a combination of clinical symptoms, hormonal testing, and imaging (such as ultrasound to identify ovarian cysts). It’ll also involve a thorough taking of your medical history and specific tests.
According to the Rotterdam Consensus criteria, the diagnosis of PCOS depends on the presence of two of the following criteria:
- Ovulatory dysfunction (irregular or absent periods)
- Clinical or biochemical hyperandrogenism signs (unwanted body or facial hair or acne)
- Small ovarian cysts visible via ultrasound
READ MORE: 7 Reasons Your Period Might Be Late — Other Than Pregnancy
What’s the treatment for PCOS?
There is no cure for PCOS. By and large, medical professionals will advise lifestyle changes. This will include getting regular exercise of at least 30 minutes a day. This could include walking, hiking or running. Yoga also helps, since it’s known to lower the stress hormone cortisol, which is a key aggressor in PCOS symptoms.
For a holistic approach, the food you eat plays a big part in healing the symptoms that create PCOS. “When it comes to the influence of food in the progression of PCOS, studies have shown that eating foods with low glycemic and high fibre index can decrease some of the complications of PCOS, such as infertility, ‘leaky gut syndrome’, metabolic syndrome, diabetes, and cardiovascular disease,” says Dr Carmen-Rose Madiebo, author of The PCOS Diet. “Foods rich in fibre, and phytonutrients and with a low glycemic index should be prioritized as they can help decrease complications of PCOS. On the other hand, processed foods should be completely eliminated as this can further worsen PCOS symptoms.”
Lean on meds
Of course, there are medications on hand that help alleviate the symptoms of PCOS but they’re not limited to one pill a day. Rather, you’ll find a collection of medications, each to treat a specific symptom.
Doctors often prescribe birth control, which regulates the menstrual cycle and can reduce symptoms. But this might not work for you if you want to fall pregnant or are unwilling to go this route.
Since people with PCOS offer suffer from insulin resistance, medication used to treat diabetes can be prescribed. Metformin is one such drug that helps the body process insulin effectively.
Trying to get pregnant? There are treatment options for you, including those that induce ovulation (the release of an egg), surgery to remove androgen-producing tissue and IVF.
Supplements can play a significant role in reducing your symptoms. These work by reducing the troubling symptoms that come PCOS.
Inositol is a nutritional supplement that helps regulate insulin activity in the body. In this process, the cells in a woman’s body are better able to use the glucose stores available, helping to regulate blood insulin levels, the ripple effect of which is normalised androgen levels and improved PCOS symptoms (bye-bye, weight gain, so long, nipple hairs). This also improves fertility for women who are trying to get pregnant.
Try these supplements:
According to sources, the popular supplement berberine holds promise for women battling PCOS. That’s because it could help the ovaries produce more eggs, reduce the amount of cyst growth and lower androgen levels.
Studies show that when women with PCOS took vitamin D for three months, menstrual regularity improved. It can also improve fertility and pregnancy rates. Plus, despite us living in sunny South Africa, many people are deficient in this nutrient, so stock up!
Vitamin B12 and folate are game-changers when it comes to female fertility. They’re also thought to tackle insulin resistance and mood regulation, something PCOS sufferers could be dealing with.
Since people with PCOS often have low-grade inflammation throughout the body, omega-3 shines as something that’s anti-inflammatory. It also fights insulin resistance and treats high levels of your total cholesterol.
Those with insulin resistance are more likely to have lower levels of magnesium, per research. Magnesium-rich foods are great for boosting your levels. Think leafy greens like spinach as well as pumpkin seeds, almonds and cashews. A supplement might also help.
Zinc’s main focus is the regulation of cell growth but it also deals with hormone release. In a review of studies, zinc was found to positively affect insulin resistance. Bonus: when you take it right before and during your periods, it could lower period cramps.
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