The symptoms of polycystic ovarian syndrome are familiar to many women of child-bearing age. That is hardly surprising because between 7% and 10% of women in this age bracket (12 to 45) are affected by it.
It is also believed to be the leading cause of infertility as a result of chronic anovulation, a menstrual cycle in which ovulation fails to occur, and is a metabolic problem that affects several body systems. The most obvious signs of this syndrome will be the irregularity or absence of the menstrual cycle, or abnormal bleeding. This is caused by cysts growing on the ovaries that are neither painful nor cancerous.
Polycystic ovaries are not necessarily problematic in themselves; the syndrome tends to go undiagnosed in many women. But it does cause hormonal imbalances that can lead to a multitude of unpleasant symptoms, including the metabolic syndrome characterised by central obesity and insulin resistance, and other symptoms such as high blood pressure, elevated blood fat levels, depression and anxiety.
It is harder for women with this syndrome to fall pregnant and those who do can experience additional problems that can lead to serious conditions such as gestational diabetes, pregnancy-induced high blood pressure, miscarriage and premature delivery.
One of the most distressing symptoms is dramatic weight gain, which can lead to obesity. And with that comes the risk of many dangerous chronic conditions that have a bad knock-on effect on the woman’s health.
Sadly, many women suffering from the syndrome find that losing weight is an almost impossible challenge. And, interestingly enough, this aspect of the condition is also revealing as far as the possible cause of the syndrome is concerned.
A research study by the University of Pittsburgh in the United States studied two groups of women: one had been diagnosed with the syndrome whereas the other was confirmed to be without it. They all followed the same diet over a specific period, after which the researchers ascertained that women diagnosed with the syndrome were able to maintain their weight with fewer kilojoules than those women without it.
This, they discovered, was the result of the former group being far more efficient in converting kilojoules into bodily fat. Why? Many researchers believe the condition is genetic and an evolutionary throwback — the result of a “thrifty gene”, a physiological defence mechanism from the feast-or-famine situation our early ancestors faced thousands of years ago.
The consequence is that the body stores far more fat for a famine situation, and this stored fat leads to obesity. The multiple hormone disorders associated with the syndrome are also not good news, especially for women with insulin resistance. The latter is associated with type 2 diabetes, which invites a host of other long-term serious health conditions.
Another problem is the elevated levels of androgens, which are male hormones. Symptoms often differ but the increase in androgens can contribute to typical male characteristics in appearance such as facial hair and baldness. Depression and anxiety are other adverse symptoms of elevated androgens. Polycystic ovarian syndrome cannot be cured but can be managed.
Optimal treatment of the syndrome is complex and requires a multidisciplinary team of professionals that must include a gynaecologist to manage the infertility aspect and the menstrual irregularities; an endocrinologist to manage the hormonal imbalances, including the insulin resistance; a dermatologist to treat skin problems and hair loss or gain; a nutritionist to manage the obesity; and a mental health professional to treat the depression.
Polycystic ovarian syndrome will be discussed on SABC2’s Bonitas House Call on June 25 at 9am
This article originally appeared in the Mail & Guardian newspaper as a sponsored feature