AMMAN — Studies
have shown that one in five women suffers from Polycystic Ovary Syndrome (PCOS),
a hormonal condition increasingly affecting women of reproductive age. Although
it is a chronic illness, it can be easily managed through adherence to a
healthy diet and lifestyle.
اضافة اعلان
“PCOS is a
syndrome of ovarian dysfunction associated with complex endocrine and metabolic
dysfunction. It is a lifelong syndrome,” Khalil Barham, an
obstetrician-gynecologist, said in an interview with
Jordan News.
PCOS is a
heterogeneous condition that is associated with an endocrine reproductive
disorder in females, according to Barham. There is no one cause for it,
although evidence implies a complex interplay between hereditary and
environmental variables. It affects women between the ages of 18 and 44.
“The
persistent hormonal disbalance leads to complexities such as numerous cysts, an
irregular menstrual cycle that ultimately leads to infertility among females.
Many candidate genes have been identified to be one of the causes of PCOS,” he
said.
Barham added
that for women with PCOS, changes in ovarian follicle form and function have
been widely documented.
Symptoms of
PCOS, such as ovulatory dysfunction and hyperandrogenism, most commonly appear
during adolescence. Other symptoms include cutaneous signs of hyperandrogenism,
polycystic ovaries (one or both), obesity, and insulin resistance.
Barham
mentioned that obesity is more common in PCOS patients. Obesity is also linked
to PCOS infertility and raises the risk of metabolic syndrome and its
constellation of cardiovascular risk factors, according to Barham.
“The
prevalence of anxiety or depression for females with PCOS living in Jordan is
high and calls for special attention by healthcare specialists and policymakers
in our country. Females who received the PCOS pharmaceutical care service showed
significant improvements in depression scores,” he said.
A thorough
physical examination, as well as an assessment for the presence of hirsutism,
ovarian ultrasonography, and hormonal testing to confirm hyperandrogenism and
oligo-anovulation as needed, are all part of the evaluation of patients prone
to PCOS.
Treatment
for PCOS varies and can include both nonpharmacologic and pharmaceutical
therapies. Weight loss is the most common treatment for PCOS — even a five
percent loss in weight can restore regular menses and increase response to
ovulation-inducing and reproductive medications. Metformin has been linked to a
reduction in metabolic syndrome symptoms in premenopausal PCOS patients.
Barham said
that “clamp studies using Ethinyl estradiol/drospirenone combination failed to
reveal evidence of an increase in either peripheral or hepatic insulin
resistance. Subjects with PCOS have a 1.5-times higher baseline risk of venous
thromboembolic disease and a 3.7-fold greater effect with OCP use compared with
non-PCOS subjects.”
The
gynecologist added that there is presently no genetic test to diagnose PCOS or aid
in treatment strategy selection.
The
evaluation of a woman with PCOS for infertility entails looking for
pre-conceptional issues that could affect response to therapy or lead to poor
pregnancy outcomes, as well as looking at the couple for other common
infertility issues that could influence therapy selection, such as conducting a
semen analysis. A high incidence of impaired glucose tolerance — a known
risk factor for gestational diabetes — and metabolic syndrome with hypertension
are among the factors that may increase the risk of pregnancy in women with
PCOS.
“Before
attempting conception, women should be tested for hypertension and diabetes and
treated if necessary. Although limited clinical trial data is proving a benefit
to this approach, women should be counseled about weight loss before trying
conception,” he said.
Even without
significant weight loss, effective nutrition and exercise strategies can
improve endocrine characteristics, reproductive function, and cardiometabolic
risk profile. Recent research has enabled experts to create micronutrient
intake recommendations. Fat should account for no more than 30 percent of total
calories, with a minimal percentage of saturated fat. Large consumption of
low-GI carbs may lead to dyslipidemia and weight gain, as well as increased
hunger and carbohydrate cravings. Studies suggest that diet and exercise must
be adapted to the demands and tastes of the individual, and calorie intake
should be divided across several meals per day.
“The use of
drugs to either improve insulin sensitivity or to promote weight loss is
justified as a short-term measure and is most likely to be beneficial when used
early in combination with diet and exercise,” said Barham.
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