Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels.
Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes their body to skip menstrual periods and makes it harder for them to get pregnant.
With more and more women being diagnosed with PCOS, we decided sent over some of your (our readers) budding questions about PCOS to Dr Navdeep Singh Pannu, and here are his professional opinions.
About Dr Navdeep Singh Pannu
Dr Navdeep Singh Pannu is a member of the Malaysian Medical Association and the president of the Malaysia Society of Assisted Reproductive Technology (MSART). He regularly conducts and participates in observational studies to improve treatment effectiveness. His expertise in Reproductive Medicine provides possibilities for fertility investigation and treatment that best suit the circumstances of each individual couple.
1. What are the sign of PCOS that I should be aware of?
Well, firstly there are many signs and symptoms of PCOS. The initial signs would be irregular menstrual cycles, or no period/menses at all for a few months. Especially after the age when they’re supposed to have their menses, most reach menarche after the age of 11 plus.
At the same time, many patients also have other symptoms like increasing weight gain, or an increase in facial hair, and body hair growth which indicate an increase in male hormones. These patients who are keen to conceive or get pregnant will have difficulty getting pregnant due to irregular menstruation and irregular ovulation. The other signs and symptoms of PCOS would be things like scalp hair loss, very oily skin, and lots of acne too but those are not the main defining signs. The main ones are irregular cycles, increased body weight, or difficulty in conceiving.
All these symptoms and signs are treatable, in the sense that we can manage them, as well as reduce their effects. We can treat it so that we can get the desired effects of having a regular cycle to improve chances of conception. Women in an advanced age group have similar symptoms too, such as an increase in hair growth, and irregular cycles.
However, there is something that they have to beware of as they get older, is that their body would start to produce fewer good eggs, and this would lead them to have fertility problems and irregular cycles. The question here is with PCOS, whether younger or advanced age groups, they too experience the same irregular cycles, increased body weight, and facial hair.
2. If I have PCOS does that mean that I can’t conceive a baby?
Well, basically that’s not true. PCOS patients too can conceive babies be it naturally with medication or even advanced treatment like IVF. It does not mean they cannot get pregnant and it is definitely a treatable cause. In other words, we have to ensure their hormone imbalances are treated to help achieve regular ovulation to increase fertility chances. More importantly however is to always consider your age. If you have not conceived after 6 months of actively trying (this means having sex 2-3 times a week), you should seek advice from a fertility expert. If you’re unsure, do take the fertility questionnaire at www.startingafamily.com which will help you determine whether you should see a doctor or keep trying.
So generally to treat PCOS patients wanting to conceive, there are many methods available. Firstly, are ovulation induction pills called clomiphene citrate. These tablets are given during a menstrual cycle to help increase the production of eggs, making them more fertile. Secondly, there is a procedure called Intrauterine Insemination (IUI) where we take the husband’s sperm and inject it directly into the womb. Thirdly, is In Vitro Fertilisation (IVF) which is typically referred to as ‘test tube babies’.
Additionally, older women with PCOS are more likely to develop conditions such as diabetes and hypertension. This is something they should take note of as the abnormality in their uterine lining, known as hyperplasia, and cause their lining thicken as a result of not having their period for an extended period of time. Long-term thickening of the lining causes a specific change that may result in hyperplasia. This could not only make conceiving a baby more difficult, but also develop into cancer if it is not addressed.
3. Can PCOS be cured?
Unfortunately, PCOS can’t be cured or prevented. However, we can manage it depending on the patient’s objectives. If they want a regular cycle then we would prescribe pills to regulate their cycles accordingly. If they desire to get pregnant then as I have mentioned above we would prescribe fertility drugs or medication. There are other procedures called laparoscopic ovarian drilling, for this procedure we will drill holes into the ovary with the idea that it could help regulate their cycles, and eventually, within 6 months most of the patients will able to conceive naturally.
Other ways to manage it are through lifestyle changes, such as having a healthy diet, exercising, and trying to lose some form of weight. Especially for patients that are obese. If they can reduce at least 10% of their body weight more than 90% of them eventually get a regular menstrual cycle and lots of them are able to conceive naturally. So it is ideal for them to maintain a healthy lifestyle, exercise, and an ideal weight. Other than that, do reduce alcohol, caffeine, carbohydrates, and sugar in your diet. The same goes for women of an advanced age group though it is still ideal for them to consider IVF treatment.
4. Can PCOS be prevented? If yes, How?
We cannot prevent PCOS but we can manage it. The idea here is to control the symptoms. If you think you might have PCOS, you need to see your doctor right away. The signs and symptoms of PCOS can be similar to other conditions, so it is important to rule these out before a diagnosis of PCOS can be made. If you are diagnosed with PCOS, we would prescribe medication such as Metformin. It is a type of medicine for diabetic patients, this medication helps the body to regulate sugar more efficiently and assists them to lose some form of weight and you may experience loss of some appetite. Another type of supplement that would help is Inositol which you can get over the counter. It also helps the body to regulate the sugars more efficiently and hence prevent patients from gaining a lot of weight.
Maintaining a healthy lifestyle, an ideal weight, and reducing sugar intake could help prevent the symptoms. There are no current proven methods to prevent PCOS but with these small steps, medication and advice from doctors can prevent the adverse outcome of PCOS. While PCOS can’t be prevented or cured, the signs and symptoms can be avoided or potentially treatable.
5. If I suspect I have PCOS, what should I do now?
If you think you might have PCOS, you need to see your doctor. The signs and symptoms of PCOS can be similar to other conditions, so it is important to rule these out before a diagnosis of PCOS can be made. Below are some of the tests your doctor might recommend to test for PCOS and to exclude other conditions. For example, an ultrasound scan or a certain blood test to ensure that you don’t have hormonal abnormalities or diabetes.
Usually, patients with PCOS may have concurrent thyroid disorders, diabetes, obesity, or hypertension The doctor will have to run tests to ensure that they can control other diseases which are typically related to PCOS. If you are diagnosed with PCOS, do not worry as I have mentioned above although PCOS can’t be cured, the symptoms can be managed by changing your diet and medications and if you are currently in the planning stages or considering starting a family, you can always visit startingafamily.com to kick start your pregnancy journey.
6. Do we need to avoid any foods if we have PCOS?
There are certain foods that should be avoided, such as foods that contains high in sugar and carbohydrates. If our body does not burn of the excessive calories in sugar and carbohydrates, it would be converted to fats which would lead to an increase in body weight and that would increase our insulin resistance. Hence, we would have diabetes and adverse effects related to diabetes and PCOS.
Women suffering from PCOS should reduce the following foods:
• Sugary drinks.
• Fried foods.
• Processed meats (ex. sausages, hamburgers, and hot dogs)
• Refined Carbohydrates (ex. white bread, pasta, and pastries)
• Processed food (ex. cakes, candy, sweetened yogurt, ice creams with excess sugar)
Patients with PCOS have an increase in insulin resistance. They would need to push out lots of insulin just to break down small amounts of sugar. This excess insulin is the main reason that disrupts their hormonal profile, and their ovulation. Due to this insulin resistance, sugar is not metabolised adequately. This is where the medication metformin is able to help by regulating the body sugars more efficiently.
