Below is all you need to know about Polycystic ovarian syndrome (PCOS), its symptoms, how it is diagnosed, and various resources available to those who have PCOS.
Polycystic ovarian syndrome affects an estimated five to 10% of women of childbearing age. In women without PCOS, during each menstrual cycle, egg-containing follicles grow on the ovaries. One egg matures faster and is eventually released (called ovulation), while the other follicles disappear.
In polycystic ovaries a number of undeveloped follicles remain and form benign oestrogen-releasing cysts that throw the natural hormones off balance, leading to anovulation and possibly a pattern of other symptoms, including unwanted hair growth, acne and menstrual abnormalities.
Can you have polycystic ovaries without having PCOS?
Yes, although most women with polycystic ovaries have PCOS.
What are the symptoms?
About half of women who have polycystic ovarian syndrome are obese, have excessive hair growth and acne. The condition has long-term health implications as women with PCOS may have an increased risk of developing diabetes and heart disease.
How is it diagnosed?
Your gynaecologist will look at your symptoms, order a series of blood tests to measure your hormone levels, and perform an internal ultrasound to check for cysts.
What are the treatment options if you're trying to get pregnant?
Losing weight can help improve your ovulation. Fertility drugs are regularly used to stimulate the growth of eggs. These include tablets containing clomiphene citrate, eg. Clomid, or fertility injections containing FSH (follicle stimulating hormone), eg. Menogon. Ovulation is triggered by using an injection called HCG (Human Chorionic Gonadotrophin). This is used to determine exactly when intercourse should occur.
How does Clomid work?
Clomid stimulates the ovaries to mature an increased number of follicles, increasing the likelihood of ovulation and pregnancy. It also increases the chance of multiple pregnancies by five per cent.
How does PCOS affect pregnancy?
Unfortunately, the syndrome is thought to increase the incidence of miscarriage in early pregnancy by up to one in five, although there is conflicting data on this, warns Dr Zephne van der Spuy. There is ongoing research to back up theories that controlling insulin levels and ovarian drilling can reduce this risk.
Help and support
Go to Clomid support group, www.webmd.com. Share your side-effects or worries with others in the same boat. For example, vaginal dryness can diminish the chances of conception. A natural lubricant called Preseed (available at Dischem Pharmacies) was recommended by other users. No question is too embarrassing.
PCOS support group, www.verity-pcos.org.uk is a UK-based charity with a warm and welcoming community of PCOS sufferers. Groups include "trying to conceive", "pregnancy and motherhood" and even a group of "normal weight" sufferers.
To chart, or not to chart...
A popular way to track ovulation is Basal Body Temperature charting. Using a special thermometer (available from most pharmacies for about R100), you take your morning “waking” temperature. You chart these over the course of your cycle, with a gradual rise in temperature indicating ovulation has occurred.
Be warned, women with PCOS often have irregular temperatures and fertility drugs tend to make one ovulate later than normal. This website is useful, however, if you are on Clomid to help you predict the best time for babymaking or to establish if you are ovulating at all. You are also able to view other women with PCOS’ charts online. www.fertilityfriend.com
A real life story of a woman with PCOS who managed to fall pregnant
Lisa Morris, thin and in her early 30s had no idea she was suffering from polycystic ovarian syndrome. After a year of fertility drugs, she finally conceived. To read more, go to: "How I beat PCOS"
What the experts say...
- What is the link between food and PCOS?
Diet certainly contributes to the disorder. PCOS sufferers are insulin-resistant – their bodies do not allow insulin to effectively convert the glucose (derived from carbohydrates) into the muscles to be converted to energy. The body has to produce excess insulin to achieve this, which means your body is literally in full-time “storage mode”, storing each and every bit of fat that is eaten, as well as causing the other symptoms of PCOS.
- Can a change in diet restore fertility?
Yes, however a low-carb diet may worsen the insulin resistance problem, after short-term success, leading to rebound weight gain. You need to slow down the release of glucose in the blood by choosing low Glycaemic Index carbohydrates that minimise insulin production (a full GI list is available at www.tabithahume.com).
Other diet strategies include: eating regularly; cutting out all saturated fats (eg dairy products) and limiting the intake of other fats (olives, avocados etc); eating plenty of fresh fruits and vegetables; eating only lean meats; including two servings of fish per week; taking a vitamin B supplement.
- What about fertility treatments and diet?
During fertility treatment, people can be very emotional and will crave high GI-carbohydrates because they flood the body with glucose, but they can worsen the hormonal rollercoaster. Stack up with fat-free high-GI goods instead.
- What pre-pregnancy supplements should I take?
A 1000mg salmon oil or flaxseed supplement; staminogro to improve fertility, a good multivitamin and folic acid and an all-round calcium supplement.
For more information, or to book an appointment, contact Tabitha on 011 706 7623.
Recommended reading: Eating for Sustained Energy 2 by Gabi Steenkamp and Liesbet Delport
THE SPECIALIST OBSTETRICIAN Dr Zephne van der Spuy
- Where is the latest research into PCOS and fertility focused
My personal work focuses on research into abnormal lipid (fat) profiles and family patterns in women with PCOS. If we can pick up a potential risk for developing the syndrome in adolescent women, we can help them manage the condition into adult life.
- What are the newest treatments being used?
The use of metformin has become popular and there’s good data to suggest it improves the outcome when used in conjunction with other treatments. For example, certain patients are more likely to respond to clomiphene citrate when taking it. Some data suggests it might help those who have had recurrent miscarriages.
- What’s the first step when trying to conceive if you have PCOS?
If you are overweight, lose a few kilos. A five per cent weight loss is enough to make a huge impact.
- Does pregnancy "cure" PCOS?
Unfortunately, there is no cure for PCOS but it can be effectively managed. PCOS improves in your forties, however. As the number of follicles in the ovaries reduces, fewer hormones are produced and periods tend to regulate.
THE HOLISTIC HEALER Dr Colin La Grange
- What major factor contributes to PCOS?
Stress is one of the key causes. In some cases stress levels increase the levels of cortisol, our “stress hormone”. This causes insulin resistance. Women have entered a work environment that is geared towards stress creation, while female physiology is not designed to function with such extremes. The cyclical nature of the reproductive and stress system in women causes a swing in the hormone levels from one extreme to another far more violently than in men.
- What alternative treatments do you recommend for PCOS?
In our treatment program, we treat PCOS using acupuncture, laser, light and colour therapy, NSA (Network Spinal Analysis), reflexology, herbal and homoeopathic medication (including Chinese medicine), with a focus on sugar, insulin and androgen balance. Weight loss is often a major factor in the success of PCOS treatment. Since sufferers of PCOS tend to carry the stress of many of the people in their circle, they also need to take time for themselves.
- Can your therapies reduce the risk of miscarriage?
Yes. The lowered risk from our treatment is to support the optimum growth of the follicle so the egg within it, and the corpus luteum which comes from it, are both great quality and are therefore sustainable.
To find out more about the LIFE CENTRE, visit www.lagrangeinstitute.com