women

A mysterious hormonal condition is afflicting thousands of Indian women. It’s making them heavier and hirsute and stealing their health and happiness. Are you a victim?

One evening, around three years back, my roommate and I were relaxing with a hot cup of tea when, out of the blue, she remarked. “You seem to have put on a lot of weight lately”. I had barely recovered from the shock of that bald-faced statement than I realized she wasn’t done. “You’re becoming hirsute and your acne problem seems to have worsened”, she said bluntly.

Now although I was somewhat offended by my BOF’s frankness, I realized I was more worried than upset. Probably because I realized she was simply echoing what was already playing on my mind. I not only looked fat, I felt fat; acne mottled my oily face which was already scarred by earlier attacks (even my neck area hadn’t been spared). And I seemed to have developed a chronic back pain that sapped my energy.

The private anguish of PCOS

The private anguish of PCOS

My friend informed me that she’d gone through a similar phase some time back and had al so suffered menstrual irregularities. “It turned out to be a condition called Poly Cystic Ovarian Syndrome. So go see a doctor, stat”, she urged. I dismissed my roomie’s misgivings, thinking I was just going through the normal hormonal changes that any 19-year-old faces. Instead I sought a dermatologist for my acne. But a month of treatment brought no visible improvement.

And then to my alarm, I realized 2 months had slid by without any sign of my menses. Maybe my friend is right, after all!

With a sinking heart I went to see a gynecologist and described my symptoms to her.

I was put through a whole gamut of tests – ultrasounds of the abdomen, blood work to check for hormonal levels, Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). Dehydroepiandrosterone (DHEA) and testosterone, thyroid function for menstrual irregularities and male pattern hair growth, Glucose Tolerance Test (GTT) for blood sugar level. Even my cholesterol levels were checked! And then I got my diagnosis – it was indeed Poly Cystic Ovarian Syndrome (PCOS)!

What Is PCOS?

I started researching my condition and along the way discovered that scores of other young women were in the same boat as me – Khyati (19) fashion designing student, Shristi (23) literature student, Aastha (21) interior designer, and Jayati (24) philosophy student. I learnt PCOS is a group of symptoms rather than a single condition per se. In fact, cysts on the ovaries, the symptoms for which the disorder is named, are not even necessarily present. The classic signs are obesity (present in 50 to 60 per cent of cases), excessive facial hair growth, and irregular periods.

I started researching my condition and along the way discovered that scores of other young women were in the same boat as me

I started researching my condition and along the way discovered that scores of other young women were in the same boat as me

Also common are elevated triglycerides (undesirable fats in the blood), high LDL, or “bad” cholesterol, and low HDL, or “good” cholesterol.

The way the disorder manifests itself varies. Some women have all of the symptoms, while others have very few, which can make diagnosis somewhat tricky.

Many of the symptoms of PCOS are thought to be the result of excess levels of the hormone Insulin

In many women who have the disorder the ovaries are enlarged and feature numerous small cysts along the outer edge of each ovary. In a normal menstrual cycle, one egg is released from a dominant follicle (16+mm size) – essentially a cyst that bursts to release the egg. In PCOS, there is a so-called follicular arrest, i.e., several follicles develops to a size of 5 to 7 mm, but no further, leading to infrequent or absent menstruation (amenorrhea). Blood tests often reveal hormonal imbalance.

In many women who have the disorder the ovaries are enlarged and feature numerous small cysts along the outer edge of each ovary

In many women who have the disorder the ovaries are enlarged and feature numerous small cysts along the outer edge of each ovary

A Mysterious Syndrome

Doctors don’t fully understand the exact cause of polycystic ovary syndrome, but some of the following factors likely play a role:

It’s believed that the majority of women who have PCOS are compromised by a hormonal imbalance known as insulin resistance. That means the body resists the workings of the hormone insulin, whose job it is to get sugar channeled from the bloodstream to all of the tissues and organs, where it’s needed for energy. To overcome the resistance, more insulin is secreted, and many of the symptoms of PCOS are thought to be the result of excess levels of this hormone. For instance, according to Stanford University insulin expert Gerald Reaven, MD, too much insulin causes the ovaries to manufacture abnormally high levels of the male hormone testosterone, which in turn contributes to irregular menstruation. The high testosterone levels are also to blame for the ovarian cysts (that can interfere with fertility, excess facial hair, acne, and male-pattern hair thinning seen in some women with PCOS, as well as the tendency for these women to store excess body fat in their abdomens, like men. Research shows that excess abdominal fat only further aggravates insulin resistance and thereby worsens the symptoms of PCOS.

Low-grade inflammation. Your body’s white blood cells produce substances to fight infection in a response called inflammation. Eating certain foods can trigger an inflammatory response in some predisposed people. When this happens, white blood cells produce substances that can lead to insulin resistance and cholesterol accumulation in blood vessels (atherosclerosis). Atherosclerosis causes cardiovascular disease. Research has shown that women with PCOS have low-grade inflammation.

Heredity. If your mother or sister has PCOS, you might have a greater chance of having it, too. Researchers also are looking into the possibility that mutated genes are linked to PCOS.

Abnormal fetal development. Some research shows that excessive exposure to male hormones (androgens) in fetal life may permanently prevent normal genes from working the way they’re supposed to – a process known as gene expression. This may promote a male pattern of abdominal fat distribution, which increases the risk of insulin resistance and low-grade inflammation. Researchers continue to investigate to what extent these factors might contribute to PCOS.

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