PCOS - growing concern for gen-next

Poly Cystic Ovarian Syndrome (PCOS) is like an epidemic in Mumbai today, especially amongst girls within the age bracket of 16 to 25. Although menstrual problems have always been around, the rampancy of PCOS in particular is alarming.

 Dr Kiran Coelho, consulting obstetrician and gynaecologist, Lilavati Hospital talks about the widespread of this syndrome, "One out of every three girls today suffers from PCOS and I get four to five patients with PCOS-related problems each week." Dr Suchitra Dalvie, consultant gynaecologist at Sushrusha Hospital concurs with Dr Coelho. She notes, "Currently PCOS is common amongst adolescents and a majority of my teenage patients have this problem."

 Dr Nina Madnani, dermatologist at Hinduja Hospital, says, "I encounter many patients with acne, facial hair and other symptoms of PCOS. Out of every 10 patients that I see daily for acne problems, about two of them have the complaint of excess facial/body hair growth." One can't help but reason that since so many young women suffer from this syndrome, the causes for its rampancy may be generation-specific. 

 Key facts

• PCOS (Poly Cystic Ovarian Syndrome), also known as Stein-Leventhal Syndrome, is a common endocrine disorder amongst women in their childbearing years
• It is a hormonal disorder where multiple cysts appear in the ovaries and it can be a leading cause of infertility because this hormonal imbalance disturbs ovulation
• PCOS also may cause overproduction of estrogen and abnormal thickening of the uterine lining
• Some symptoms of PCOS include weight gain, excess facial/body hair, hair loss, severe acne, irregular menstrual cycle and mood problems like anxiety/agitation
• Depending on the physician and the severity of PCOS, the treatment may include hormonal therapy consisting of birth control pills, anti-androgen medication, and other hormone-regulating drugs

 Blame it on the lifestyle

Although the causes of PCOS are internal, the environment plays a vital role in predisposing youngsters to it. Dr Coelho adds, "PCOS has turned into a common health issue and one can attribute it to lifestyle factors such as peer pressure, stress, early menarche, early maturation/stimulation and early exposure to sexually explicit material. Also, air pollution worsens the situation and contributes to the development of PCOS."

 Dr Coelho shuns from compulsive pill-popping as soon as one is diagnosed with POCS. "It has a wide spectrum of symptoms ranging from mild to severe ones. And most of the girls who are diagnosed with PCOS don't need treatment; they just need a lifestyle change. Only the severe cases need treatment, such as girls with extreme hormonal imbalance," she says.

 Health experts believe that despite the generation-factors, PCOS has other causes too. Dr Madnani points out, "A genetic predisposition and stress seem to be the reasons for the rising incidence of PCOS. Stress is due to the increased demand on the girls to beat their peers in appearance and intelligence. Erratic sleep and food habits compound the problem further.  However, it is possible that high occurrence of PCOS today may be due to greater awareness causing women to come forward for medical and cosmetic treatment." 

 Weight woes

Whether PCOS leads to obesity or vice-versa, is a common debate. Expert opinions vary. Dr Coelho says, "Too much junk food consumption, leading a sedentary life and lack of exercise is common amongst today's youngsters, thus making them more prone to PCOS. And Dr Dalvie says, "It is true that one of the effects of PCOS is weight-gain and consequently obesity."

Well, either way, maintaining a fitness regimen sounds helpful. Health and fitness instructor, Namita Jain asserts, "Today obesity is common amongst youngsters and I have encountered women who suffer weight gain due to menstrual issues. The fact that obesity and PCOS are correlated is an established one. So, keeping their weight under check is crucial for teenage girls."

 Infertility counselling

Since extreme cases of PCOS have fertility-related implications, it follows that along with medical attention, patients can benefit from psychotherapy to cope with the anxiety and trauma that accompanies this problem. So is infertility counselling popular today? Dr Varkha Chulani, clinical psychologist, Lilavati Hospital exclaims, "Yes infertility counselling is a growing field and it better be! Depending on the meaning a woman attaches to childbearing, being rendered partially or wholly infertile due to PCOS can lead to mental devastation and distress. Consequently, the overall health of this emotionally distraught woman may suffer.

In the words of Dr Rishma Pai, consultant gynaecologist at Lilavati and Jaslok Hospital, "Not all patients undergo counselling. Only very serious and complicated cases call for customised attention in the form of psychotherapy. And lastly, there is a lot of stigma attached to counselling which prevents a lot of people from seeking therapy for infertility."