PCOS- an emerging epidemic in India

Polycystic Ovarian Syndrome is one of the commonest hormonal diseases diagnosed in women of reproductive period. There is a wide range in the prevalence of this disease throughout the world ranging from 7% to 28%.There are few pan India studies but  studies done in South India and Maharashtra report the  prevalence of PCOS  as 9.13% and 22.5% (10.7% by Androgen Excess Society criteria) respectively.

PCOS causes

     Irregular or delayed menstrual cycles or no menses at all for months

     Infertility

     Excessive or rapid weight gain and metabolic syndrome

     Excess hair growth on the face, chest, abdomen, or upper thighs ( hirsutism)

     Severe acne or acne which occurs after adolescence and does not respond to usual treatments

     Patches of dark , velvety skin called Acanthosis Nigricans

     Multiple small cysts in the ovaries.

     Depression and mood swings

What causes PCOS? The cause of PCOS is not exactly known but it is associated with raised production of androgens (male hormones) in the body and hence the hirsutism and irregular cycles. Insulin resistance is also an important feature of this disease; that is in pcos, the body does not respond to the insulin produced in the body—leading to weight gain and a tendency to develop Diabetes.

What are the Long Term Consequences of PCOS?

If unrecognised and untreated, PCOS increases the risk of Type2 Diabetes and Cardiovascular Disease including Hypertension. Women with PCOS are at increased risk of developing GDM or Diabetes associated with pregnancy. There is also an increased risk of developing sleep apnea and daytime sleepiness.

Cancer and PCOS

Untreated PCOS and long periods of irregular cycles can lead to endometrial hyperplasia and an increased risk of developing endometrial cancer.There does not appear to be any association with breast or ovarian cancer.

Treatment/ Reduction of Long term risks :–

      Lifestyle changes including regular exercise and dietary changes is the first line of treatment.

     Eat a balanced healthy diet including fruits, vegetables, whole grain cereals, lean meat like chicken, fish and low fat milk products.

     Avoid excess fats like oil, butter and cheese.

     Eat regular meals. Do not skip breakfast.

     Exercise regularly ( 30 mins at least 3 times a week)

     Drug therapy may be required for specific problems like infertility and hirsutism. In severe / morbid obesity, anti obesity pills may be prescribed. Hormonal pills are often prescribed to regularise the cycle.

     Have regular  health check ups

Is there a cure?

There is no cure but maintaining a healthy lifestyle goes a long way towards reducing the symptoms or preventing the long term consequences of PCOS.

 

September is PCOS awareness month organised in many parts of the world to raise awareness about this most critical and under diagnosed disease affecting millions of women worldwide. The worrying aspect of the epidemiology is that out of 10 women diagnosed in India, 6 are teenagers. The cause for this is not exactly known but poor eating habits and lack of exercise are the likely culprits. Hence raising awareness is the need of the hour for early diagnosis and treatment and prevention of long term morbidity. There are several famous celebrities including Bollywood actress Sonam Kapoor who have opened up in the recent past about their struggle with PCOS . Their stories will hopefully raise awareness and encourage more young women to seek help.

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