Sneha Sharma had gone four months without a period when she was diagnosed with the polycystic ovarian syndrome (PCOS). Her doctor performed a pelvic exam and swiftly pronounced a diagnosis. “Looks like polycystic ovaries,” she said nodding, pointing to a grey abyss inside the scan. Dr. Bhatt had barely completed her monologue when a nurse entered, signalling a growing queue of patients snaking through the lobby. The diagnosis was done. There was no going back now. PCOS, it was. Only it wasn’t. Because seven years later, Sneha would find that she didn’t have polycystic ovaries; she never did have them. Her diagnosis had been wrong, and inadequately supplemented.
More than 1 million cases of PCOS emerge every year in India, but dig deeper and you’ll notice a disturbing trend taking shape. Many of these cases are mistakenly labelled as polycystic, whereas they are actually rooted in stress-related or lifestyle-related problems. If you’ve been diagnosed with PCOS, it’s imperative that you know whether you’ve been evaluated correctly.
In this guide, we highlight the steps involved in delivering a PCOS diagnosis.
Diagnosis of PCOS
Step 1. Detailed Discussion
There is no single test that can determine the presence of polycystic ovaries. To begin with, your doctor will ease you into a discussion about your medical history and delve into your menstrual pattern (irregular, heavy or absent), symptoms and weight gain, if any. You will also be assessed for any physical signs like excess body or facial hair, difficulty getting pregnant, patches of thick darker skin, thinning hair on the scalp, acne and insulin resistance.
Step 2. Pelvic Exam
A pelvic exam involves the manual investigation of reproductive organs for abnormalities, protrusions or masses.
Step 3. Hormone Tests
A blood test can measure hormonal health and indicate whether menstrual problems are being caused by factors other than PCOS.
Step 4. Ultrasound
A transvaginal ultrasound can reveal the shape and size of the ovaries as well as the thickness of the uterine lining. The ultrasound is performed using a wand-shaped device which is inserted into the vagina. This then projects images based on sound waves.
Step 5. Additional Tests
Although not applicable in all cases, your doctor may deem a selection of extra tests necessary for you. In addition to baseline blood tests, you may be prescribed tests for glucose tolerance, cholesterol and triglyceride. You may also be checked for depression, anxiety and sleep apnea.
Treatment of PCOS
PCOS is tethered to a host of lifestyle and diet influencers. In turn, your treatment for the condition may be linked to augmenting aspects of your lifestyle and nutrition. PCOS can trigger infertility, obesity, acne and hirsutism.
A low-calorie diet coupled with a regular exercise regime is recommended for PCOS, as is weight loss if you teeter on the higher end of the scale. Losing as little as 5% of body fat can alleviate the symptoms of PCOS and also improve the effects of medication.
Minimisation of Symptoms
A combination of medications can work well in managing PCOS. Oral contraceptives can serve to control hormone levels and thereby regularise periods. They can also reduce excessive hair growth and minimise the risk of endometrial cancer, mid-cycle bleeding and acne. Aside from birth control, progestin is a useful shield against endometrial cancer. Progestin is usually administered for about two weeks every one or two months.
PCOS can often derail ovulation, but with the right treatment, this can be set back on track. Clomiphene, letrozole and metformin may be used individually or as a combination to stimulate the ovaries and improve the chances of conception. Metformin is a useful treatment if you are showing signs of prediabetes, because it slows down the onset of type 2 diabetes. If your doctor thinks that the medications mentioned above are not suited for you, gonadotropins may be considered for you. These are injectable hormonal medications that help in encouraging ovulation.
Hair Growth Management
Excess facial and body hair is a common outcome of PCOS. Birth control pills reduce the production of androgen in the body, helping to arrest excessive hair growth. Likewise, spironolactone and eflornithine may also be prescribed to the same effect. Electrolysis and laser are some long-term treatments you may want to consider if you prefer getting rid of excess hair growth permanently.
It’s important to be in the know at every stage of your PCOS diagnosis. Ask questions, get into details and own your condition. PCOS can be managed effectively with the right treatment, and you can go on to lead a happy, healthy life with the condition. By being in control, you can steer life the way you want to, and trump your polycystic problems one day at a time.