The PCOS Puzzle
The PCOS Puzzle
No two days are the same for a doctor. Every morning when I sit in my OPD, I have no idea what’s in store for me. It’s like Pandora’s box! I meet so many different kinds of people. It’s incredible to see the wide range of problems that bring them to me.
The practice of obstetrics and gynaecology has seen a sea of changes over the past many years. The types of gynaecological disorders that are common today were rarely seen 20 years back. Treatment options have also advanced in so many ways.
One such commonly encountered condition at every gynaecologist’s clinic is polycystic ovarian syndrome (PCOS).I am sure all of you have heard about it from someone or the other.
It is the most common hormonal disorder of those in the reproductive age group. The age group affected ranges from 13 to 40 years. More commonly diagnosed in the younger lot, the 13 to 25 years age bracket is most vulnerable. A lot of research has been done on PCOS and a lot is ongoing too.
First and foremost it is a syndrome not a disease, which means, multiple complaints combined in one. It may cause menstrual irregularities, weight gain, acne, excessive hair growth, infertility and long term metabolic and cardiovascular problems. The insulin pathway is affected causing a diabetes- like condition in the body. These girls may be prone to cardiac problems, diabetes or even certain genital cancers later in life. The root cause is an imbalance of multiple hormones.
I find it most challenging to explain to the patients what they have, why they have it and even how I plan to treat it.
When I was doing MBBS and post graduation in ObGy, we were always asked one question on PCOS in the theory examination. I used to dread answering it because it involved a lot of understanding of the hormonal pathways and formed a complicated sort of theory answer. Thinking about it today, it was a lot easier just writing down the answer in the examination than actually treating a patient of PCOS!
This disorder is so rampant now that often by just looking at a girl who walks through my OPD door, I can make out that the diagnosis is ultimately going to be polycystic ovaries!
It is a problem which should not be taken lightly. In my opinion, it is worse than having high blood pressure or diabetes!
Why has this disorder suddenly become so common? All research studies have attributed this to the ‘change of lifestyle’ in terms of diet ( junk food, eating outside) and sedentary lifestyle ( lack of exercise).
Both these causative factors are modifiable and totally in our control.
The mainstay of treatment for girls with polycystic ovaries is diet and exercise, which regularises the hormones and gets the body back to normal. No amount of medicines can get the same results.
As parents, all of us want the best for our children. To see a teenage girl becoming obese, having menstrual problems which may go onto having problems with her pregnancy, is not what any parent wants.
I feel that we have to try our best to avoid all these problems from the very beginning. It may sound absurd but we need to pay attention to a child’s diet right from infancy and toddlerhood! All studies have shown that the first 6 months of exclusive breastfeeding reduce chances of the child becoming obese later in life. Once weaned, parents need to be a vigilant about what to give the child to eat. Wrong food habits lead to early obesity which lead to other complications like Polycystic ovaries, obesity, infertility diabetes etc.
Along with diet another important aspect is exercise. Children these days are not as active as children were 20 years ago. Encourage your child to go out of the house and play for at least 1 hour in the day instead of being stuck with gadgets and screens inside the house. Sadly, sporting activities among teenager girls has become a rarity today. Evenings for them is either sitting and chatting with some friends or being on the iPhone or iPad. ‘No time for exercise’ is not an excuse. All of us can spare 1/2 hour to 1 hour a day at least 5 times a week for exercise, especially if it’s going to avoid other health issues later in life. Our day to day lifestyle is very sedentary. My grandparents in their late 80’s are more active than many adults who are only in their 60’s, purely because of their active lifestyle from the beginning.
So make those efforts early on, and see the results later.
Hormones are a tricky lot. A little bit here and there can upset them and create a ruckus! So let’s try to control what’s in our hands now, to lead a better and healthy life ahead!