What does PCOS mean?
Irregular menstrual cycles and acne are common problems young women suffer from. However, many do not realise that these seemingly trivial symptoms may be due to a more serious underlying condition. Polycystic ovarian syndrome (PCOS) is the most common endocrine (hormonal) disorder affecting young women. It is estimated that up to 10% of women in Singapore may have PCOS.
Women with PCOS may often but not always have multiple cysts in their ovaries or have hormonal imbalances such as excess androgens (male hormones) and insulin resistance. In PCOS, ovulation does not occur regularly, resulting in menstrual irregularities.
It can manifest with a wide variety of symptoms, and many may not be aware of their condition and go undiagnosed.
What are the symptoms of PCOS?
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One of the typical symptoms of PCOS is an irregular menstrual cycle, often with long intervals between periods (oligomenorrhea) or missed periods.
Symptoms like acne, hirsuitism (increased facial and body hair), and male pattern hair loss are a result of excess male hormones.
While obesity is common amongst women who suffer from PCOS, it is important to note that many women with PCOS in Singapore actually have a normal BMI.
What are the possible complications of PCOS?
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PCOS is a very common cause of infertility. Since women with PCOS do not ovulate regularly, they may run into difficulties conceiving. Those who successfully conceive are at higher risk of complications during pregnancies, often suffering from gestational diabetes.
Insulin resistance seen in women with PCOS places them at a higher risk of certain diseases such as Type 2 Diabetes and cardiovascular disease. There is also an increased risk of endometrial (uterine) cancer due to the hormonal imbalances.
It can be psychologically distressing and women may also suffer from anxiety and depression related to acne, excess hair, hair loss, bodyweight concerns, or infertility.
How do I know if I have PCOS?
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If you have symptoms suggestive of PCOS, your doctor may ask you to undergo further blood tests and scans.
PCOS is diagnosed through a combination of clinical symptoms in the form of a history of irregular menses, hormonal blood tests to look for excess levels of male hormones, and imaging, usually an ultrasound scan of the pelvis to look for the presence of multiple cysts in the ovaries.
How can I manage or treat PCOS?
You can play a crucial role in keeping your PCOS in check.
A healthy lifestyle with a good diet and exercise can help to reduce the symptoms of PCOS. If you are overweight, just reducing your body weight by 2 to 5% can help with the return of normal menstrual cycles and reduce your risk of diabetes, heart disease and other illnesses.
The medical treatment is tailored to suit your symptoms and needs.
Medications such as the oral contraceptive pill may be used to treat menstrual irregularities and reduce symptoms of excess androgens like acne and hirsuitism. Metformin, an oral diabetic medication, may be used to reduce insulin resistance and help with weight loss. Specific medications to induce ovulation may be prescribed to women who wish to get pregnant but have difficulty conceiving.
Polycystic ovarian syndrome is more common one may think and can cause significant health complications. It is important not to overlook or dismiss possible symptoms. If any of these symptoms sound familiar to you, it may be best to make an appointment with your doctor to get them checked out.
About DTAP clinic
Dr Tan & Partners clinic (DTAP Clinic) was established in 2005 at Robertson Walk (Singapore). A pioneer of GP plus, or “General Practice with Special Interest” model in Singapore, with an aim to provide quality healthcare for everyone.
DTAP clinic @ Robertson is an Anonymous HIV test site approved by Ministry of Health (Singapore and supported by Health Promotion Board. To encourage both local and foreigners at risk of HIV to come forth for HIV testing, without the need to provide their details, NRIC or passport, addresses and contacts numbers.
This article was contributed by Dr Grace Huang. She is the resident doctor at DTAP Clinic Robertson, a general practice clinic with a special interest in men and women’s health, and sexual health.
Source:
Singapore Med J 2018; 59(11):567-571 Managing Polycystic Ovarian Syndrome in Primary Care)
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