In the previous issue, we had covered the cause and effects of polycystic ovarian syndrome (PCOS) and how the growths in the ovaries can cause other conditions such as infertility, excessive hair growth, problems losing weight and insulin resistance.
The growths, although benign, disrupt hormone and egg production in the ovaries, and need to be addressed in order for women with PCOS to enjoy a good quality of life.
It is important to remember that PCOS cannot be prevented because it is genetically-linked. However, good management of PCOS can reduce the risks of infertility, miscarriage, diabetes, uterine cancer and heart disease.
Treatment for PCOS is categorised into medications and lifestyle changes. Even then, the doctor will first need to know if you are planning for a pregnancy before commencing treatment because some medications will prevent you from conceiving.
As such, you must be totally honest and specific with your doctor before commencing treatment.
Medications are recommended for women with PCOS when they have specific conditions to address, such as:
Menstrual irregularity: The irregular and sometimes heavy menstrual periods caused by PCOS can have long-term implications such as increased risk for endometrial cancer and iron deficiency.
To manage this, your doctor may recommend birth control pills, a skin patch or vaginal ring containing a combination of oestrogen and progestin to regulate menstrual periods. Being on birth control medications means you will not be able to conceive while taking these medications.
For women with PCOS who are planning to conceive, progesterone (bioidentical hormones) will be recommended instead. This will offer protection against endometrial cancer and regulate menstrual periods without affecting chances of pregnancy.
For pregnancy purposes: As PCOS disrupts your ability to ovulate, the fertility specialist may recommend clomiphene, an anti-oestrogen medication, to increase the production of eggs and increase chances of conception.
If clomiphene does not work, the specialist may recommend follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications that are administered by injection to help with ovulation.
To reduce body hair: Medications to control androgen production may be recommended but do inform your doctor if you are planning to get pregnant or are already pregnant because such medications may cause birth defects in unborn babies.
To control insulin resistance and diabetes: Medications such as metformin that improve insulin resistance may be recommended to slow down the progress of diabetes. They also have the additional benefits of helping with reducing cardiovascular risks, weight loss and ovulation, which will regulate menstrual cycles and improve fertility.
As with all medical conditions, PCOS is best managed holistically with a combination of medical and non-medical treatments.
More so when we know that PCOS is not a curable condition but one that needs good management in order to avoid its implications on the rest of the body. Lifestyle changes are necessary to enjoy a good quality of life. An important part of PCOS management is weight loss, as obesity worsens insulin resistance, affects ovulation and has significant impact upon self-esteem.
Many studies show that just losing 5% of your body weight will make you feel better. Tips to reduce daily calorie count include using a smaller plate to help you reduce portion sizes, and stick to one helping each time.
Choose complex carbohydrates such as whole-grain breads and cereals, whole-wheat pasta, bulgur wheat, barley, brown rice and beans as they are high in fibre.
Avoid simple carbohydrates such as fruit juice, cake, candy, ice cream, pies, cookies and doughnuts. Switch to a low glycaemic index diet.
Some studies suggest that avoiding dairy products and refined products such as processed meats, fast foods, snacks and other junk foods are helpful for women with PCOS.
Plan to have wholesome meals for the sake of your health. It also helps to check with your doctor whether you have any vitamin or mineral deficiencies.
Women with PCOS are known to have lower levels of magnesium, vitamin B, zinc, calcium, vitamin D and essential fatty acids. Apart from getting more of these in food sources, check whether you need supplements to correct the deficiency and normalise your overall condition.
Exercise is an important aspect of PCOS management because it helps control blood sugar levels and helps in your weight loss programme.
Exercising outdoors is a better option over working out in the gym because you get the added benefits of vitamin D from sun exposure and the fresh air will work wonders for your general sense of wellbeing. In conclusion, you need not despair even when you have PCOS. Getting the right information, dispelling PCOs myths and seeking advice from doctors will help you manage your condition so that you can enjoy a good quality of life, just like anyone without PCOS.
By Datuk Dr Nor Ashikin Mokhtar
Published on July 12, 2015, Star Newspaper