Polycystic Ovarian Syndrome (PCOS) - also known as the Stein-Leventhal Syndrome - has been getting much-needed attention in the Kingdom lately, and with good reason. According to recent studies, PCOS is one of the most common illnesses affecting women at approximately 6-7 percent. In the Kingdom, this has become a common occurrence and is one of the leading factors behind female infertility. Dr. Aqeela Ayaz is an Obstetrician and Gynecologist at Hera'a General Hospital in Makkah, and she told Saudi Gazette that PCOS is a remarkably common condition in the Kingdom, although lack of awareness has made the suffering of patients with PCOS a largely silent affair. “Most women realize that they have PCOS when they visit a clinic because of infertility or menstrual cycle disturbances,” she said. According to the National Women's Health Information Center, PCOS is a health condition in which a woman's hormones are out of balance. It affects a woman's menstrual period, fertility, hormones, heart, blood vessels, as well as appearance, mostly in the form of excessive facial and body hair. With PCOS, women typically have high levels of androgens - male hormones - missed or irregular periods, and a number of small cysts in their ovaries. PCOS symptoms may vary from one woman to another. Some suffer from mild symptoms, while others are affected more severely by a much wider range of symptoms. “General symptoms of PCOS include irregular or no menstrual periods, infertility, acne, obesity, excessive facial and body hair, loss of hair on head, depression and mood swings,” Dr. Ayaz indicated. Diagnosis and treatment Dr. Ayaz explained that the diagnosis of PCOS depends a great deal on the history of the patient with questions about symptoms like menstrual period, hair growth and infertility being asked by the specialist. “Moreover, the patient needs to undergo lab tests to check blood sugar and hormone levels; an ultrasound if needed to look for polycystic ovaries,” she added. The treatment again varies with the severity of symptoms as well as the patient's wishes. “The first step of treatment is lifestyle modification i.e. the incorporation of a healthy lifestyle with a balanced diet, decreased consumption of sugar, salt and caffeine as well as regular exercise,” explained Dr. Ayaz. “A woman who suffers from PCOS needs to lose weight if she is overweight as this is the primary treatment.” Umm-Eman is a 45-year-old mother of three who told Saudi Gazette that she has had PCOS for 18 years and recommends a change in diet and weight loss as the best treatment. There are also a number of medicines specialists normally prescribe to patients. “The patient will be given a low dose of birth control pills to help regulate her period; anti-androgen drugs are used to combat excessive facial and body hair growth,” she added. Metformin - used to treat Type 2 Diabetes, is also used to blood sugar levels and reduce the level of androgen. If the patient is trying to get pregnant, the doctor will also prescribe fertility drugs. “I was diagnosed with PCOS about three years ago when I was trying to get pregnant,” said Mai Ahmed, a 28-year-old housewife, “I took some medication but nothing helped me. After a year, I tried to lose weight and lost about 15 kg in the process, and after a few months I got pregnant. Losing weight helped me.” Hanan Hamid, on the other hand, is a single 25-year-old woman who was diagnosed with PCOS two years back. “I took some medication to balance the hormones, as well as birth control pills for my irregular period,” she said. “When I stopped the pills, however, my period became irregular again; the doctor has advised me to visit once I get married, so that I can start taking the medication for ovulation.” The disorder creates a number of complications for women, but Dr. Ayaz stresses that though there is no cure for it, women should not worry about it too much. Lifestyle changes can largely correct the hormonal imbalance without the medical intervention. However, she urged that women must not ignore it as a negligible problem. Over time, untreated PCOS can lead to serious health problems like diabetes, high blood pressure, heart disease and - very rarely - endometrial cancer. PCOS is - according to a number of studies - the most common disturbance of the pituitary gland and the ovaries. It is therefore, by default, a major cause for female infertility in the Kingdom, accounting for 90 percent of the cases, if not more.
