September marks the PCOS Awareness Month worldwide. PCOS, or Polycystic Ovary Syndrome, is a metabolic, endocrine and reproductive disorder that affects a woman’s hormone levels. The hormonal imbalance interferes with the growth and release of eggs from the ovaries (ovulation), which can lead to missed or irregular periods, as well as other symptoms like weight gain, insulin resistance, excess facial and body hair growth, and hair loss. This condition affects 1 in every 10 women of reproductive age, yet at least 50 percent of women remain undiagnosed as the diagnostic criteria is very broad and debated amongst medical professionals even now, and the symptoms are often attributed to other conditions, or go unnoticed.
“Some widely held misconceptions about PCOS have been created because of a lack of understanding of the condition,” says Dr Anuradha Panda, senior obstetrician and gynaecologist, Apollo Hospitals, Jubilee Hills, Hyderabad. These myths impact diagnosis and treatment, and can even stand in the way of getting appropriate care.
Myth 1: You need to have cysts to be diagnosed with PCOS.
To meet the diagnostic criteria of PCOS, women need to have two of the following three criteria:
- irregular periods
- signs of increased levels of androgens (hormones that give “male” characteristics) such as excess hair growth, acne or hair loss
- enlarged ovaries with lots of small follicles containing immature eggs (known as polycystic ovaries).
“Having ovaries with cysts that turn up on ultrasounds does not equate to PCOS,” says Dr Anuradha Panda. “PCO, or polycystic ovaries, can be present in women without the associated metabolic symptoms (such as obesity, insulin resistance and hyperandrogenemia) that PCOS has.” On the flip side, not everyone who has PCOS might have cysts in their ovaries. “For a diagnosis, we look at a combination of a lot of other factors, such as irregular periods, acne, hair loss, unnatural hormonal levels, and BMI (body mass index),” says the doctor.
Myth 2: PCOS is only about fertility.
PCOS is a reproductive disorder only in part. Although it does affect reproductive functions, it has a range of other nonreproductive effects on metabolic and cardiovascular health that are not as talked about. “Recently, there has been a push to see PCOS as a metabolic syndrome, rather than reproductive,” says Dr Panda. “This is because it is a lifelong condition that has been directly linked to prediabetes, Type 2 diabetes, hypertension, hyperinsulinism, abnormal lipid levels and cardiovascular disease.” Apart from these, PCOS can also cause sleep apnoea, and mental health issues like depression and anxiety. Diagnosis and proper treatment of PCOS is thus needed not just to deal with fertility issues, but also to prevent a wide variety of other chronic conditions.
Myth 3: You can’t get pregnant if you have PCOS.
Since this condition affects the ovary’s ability to release an egg to be potentially fertilised for pregnancy, many women have the fear of never being able to bear a child if they are diagnosed with PCOS. While PCOS is one of the leading causes of infertility in women, it is far from the doomsday scenario that many assume. “Women with PCOS can definitely get pregnant, and naturally too,” assures Dr Panda. “If there are difficulties, one can work with their ob-gyn or a fertility specialist to get them on the right path.”
Myth 4: Weight loss is the only cure for PCOS.
The relationship between PCOS and weight is complicated. Research shows that weight gain and obesity makes metabolic and reproductive issues under PCOS worse. “Losing weight can lead to the improvement of certain symptoms,” says Dr Panda. “While losing upto 7 to 10 percent of body weight is recommended to obese people, it is not true that weight loss is a permanent cure.” This is particularly important to keep in mind as those with PCOS often experience difficulty losing weight, and report a greater susceptibility for weight gain. It is also possible to have PCOS with a normal BMI, in which case losing weight would be detrimental. An overall healthy diet and lifestyle that caters to your body’s needs will lead to better living with PCOS.
Myth 5: You need the birth control pill as a form of treatment.
Hormonal birth control is a common treatment suggested by doctors to deal with irregular periods. Birth control pills may also help reduce excessive hair growth and acne. But the pill does nothing to cure, prevent, or fix PCOS. Studies show that 70 percent of women with PCOS have insulin resistance as the underlying cause of their hormonal imbalance, and birth control pills do not address such underlying causes. As PCOS varies from person to person in terms of severity and causes, it is important to get to the root of the problem by consulting a doctor rather than just try to deal with the symptoms.