Sun | Aug 9, 2020

Managing PCOS with weight loss

Published:Wednesday | July 8, 2020 | 12:10 AMVanessa James/Gleaner Writer
Gynaecologist Dr Patrick Clarke.
Gynaecologist Dr Patrick Clarke.

One in every 10 women worldwide of childbearing age has polycystic ovarian syndrome (PCOS).

According to gynaecologist Dr Patrick Clarke, the syndrome is diagnosed if a woman experiences two of the three criteria associated with the illness.

These include having irregular periods, showing evidence of having excess male hormone (androgens) or the presence of a polycystic ovary on ultrasound. Dr Clarke said most women usually visit the doctor as soon as they realise that they have missed periods and are not pregnant, or they notice excess hair on their bodies.

“Most of the women who present with PCOS either present with the hormonal problems, which is the ‘too much hair’, or they present with irregular periods,” said Dr Clarke. “They have irregular periods, where they don’t see a period for three to four months or more, and when it does come, it lasts for more than the seven days, so they often require medication to stop it.”

PCOS NOT DEAD END

According to Dr Clarke, having PCOS does not mean that a woman should abandon all hope of having children as this disorder can be managed. He said that when one looks into the history of women with PCOS, there is a common thread associated with weight gain.

“If you go into the history of women with PCOS, they will tell you that they started having periods at the age of 12 or 13, and they had regular periods up until 18 or 19, and then their periods started to go haywire,” said Dr Clarke. “When you delve more into it, you see that they left high school, went out into the working world and around that time they put on weight, that’s when their period started to become irregular.”

He noted that this suggests that women are born with the tendency to have the disorder, but it is after weight gain that the effects of PCOS start to manifest itself more. He explained, however, that the syndrome can be managed, and likened it to how one would deal with diabetes.

“You have to look at it like diabetes; once you’ve been diagnosed with diabetes, 10 years from now, you will still have diabetes. If you control it, lose weight and get to a normal BMI (body mass index), you may get to a point where you had to use medication before and you no longer have to use it now,” the doctor said.

He added: “If you lose weight, the symptoms may go away and you may return to your normal period; otherwise, if you stay at your present weight, [it is] more than likely you will need medication, and you will have PCOS 10 years down the line.”

Dr Clarke added, however, that there is a small number of women who doctors refer to as ‘lean PCOS’, as they do not experience the weight-gain aspect of the disorder. He said that they are an exception to the rule and are usually more difficult to treat.

Women living with PCOS usually struggle with infertility. “The reason they have infertility is because they do not ovulate – they do not produce an egg every month – so the woman with PCOS ovulates infrequently, compared with women who have regular periods and ovulate 12 times or more each year,” said Dr Clarke.

However, there is hope for the couple who is desperate for a child, and the woman who has PCOS.

“The couple who presents with PCOS, if you have infertility, we have to rule out other things first. So, the man would have to do a sperm test; we have to ensure the woman’s tubes are okay, also; and then those patients would be treated with what we call ovulation-inducing agents. So, this is given to the woman who doesn’t ovulate, and someone with PCOS would be the perfect patient once everything else checks out,” said Dr Clarke.

He added that weight loss is important, and if this initial step does not work, then other options exist, but this journey is one that is best taken with a doctor.

Dr Clarke explained that there is some evidence that PCOS can be hereditary and if a sister or mother has the disorder, the risk of having the condition is slightly increased.

vanessa.james@gleanerjm.com