Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects millions of women all over the world. While its prevalence can not be prevented, the approach to PCOS diagnosis and treatment can vary significantly from one country to another. PCOS is prevalent in 8-13% of women of reproductive age, and up to 70% of cases are undiagnosed.
Countries such as India, Thailand, Turkey, Malaysia, Germany, and the United Arab Emirates (UAE) have a unique healthcare system that comprises leading hospitals with world-class hospitals. These hospitals have skilled professionals who are proficient in treating diseases like PCOS.
In this blog, we will explore different approaches to understand the global battle against PCOS better.
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What is PCOS?
PCOS is a significant public health problem. It is one of the most common hormonal disturbances affecting women of reproductive age. PCOS is characterized by two or more of the following:
- Irregular menstrual cycles
- Hyperandrogenism
- Polycystic ovaries
Multiple morbidities associated with PCOS include the following:
- Infertility
- Metabolic syndrome
- Obesity
- Impaired glucose tolerance
- Type 2 diabetes mellitus (DM-2)
- Cardiovascular risk
- Depression
- Obstructive sleep apnea (OSA)
- Endometrial cancer
- Nonalcoholic fatty liver disease/ nonalcoholic steatohepatitis (NAFLD/NASH)
What are the Symptoms of PCOS?
PCOS symptoms often start around the first menstrual period. Symptoms may develop later after you have had a menstrual cycle for a while. Symptoms can differ from person to person. Symptoms may change over time and often occur without a clear trigger.
The possible symptoms of PCOS include:
- Heavy, long, intermittent, unpredictable, or absent periods
- Infertility
- Acne or oily skin
- Excessive hair on the face or body
- Male-pattern baldness or hair thinning
- Weight gain, especially around the belly
People with PCOS are more likely to have other health conditions, such as:
- Type 2 diabetes
- Hypertension (high blood pressure)
- High cholesterol
- Heart disease
- Endometrial cancer
PCOS can also cause anxiety, depression, and a negative body image. Some symptoms, such as infertility, obesity, and unwanted hair growth, can lead to social stigma. This can affect other life areas such as family, relationships, work, and involvement in the community.
Is PCOS Genetic?
Some evidence reports that PCOS has a genetic or hereditary component. If PCOS runs in families, the risk of developing it is often increased.
Which Hormones Affect PCOS?
PCOS women have a hormonal imbalance. This imbalance turns their menstrual cycle, ovulation, and conception upside down. The functioning of your reproductive system relies on the balance of these hormones. The hormones that play an important role in PCOS include the following:
- Luteinizing hormone (LH)
- Follicle-stimulating hormone (FSH)
- Androgens (like testosterone and androstenedione)
- Estrogen
- Progesterone
- Insulin
How is PCOS Diagnosed?
Your healthcare provider will:
- Talk to you about your medical history and symptoms.
- Question you about your biological family's medical history.
- Measure your weight and blood pressure.
- Order a physical exam, looking for hair loss, excess facial hair, acne, discolored skin, and skin tags.
- Order a pelvic exam to look for other causes of abnormal bleeding if present.
- Order blood tests to check hormone and glucose levels.
- Perform a pelvic ultrasound to:
- Have a look at your ovaries
- Check the thickness of the uterine lining
- Look for other causes of abnormal bleeding
How is PCOS Treated?
The treatment for PCOS depends on many factors, such as:
- Age of the patient
- How severe her symptoms are
- Her overall health
The treatment type may also depend on whether or not you want to become pregnant in the future.
If you do not plan to become pregnant, your treatment may include:
- Medications to cause ovulation: Certain medicines can help the ovaries to release eggs normally. These medicines also have certain risks, such as:
- Increasing the chance of multiple births (twins or more).
- Causing ovarian hyperstimulation, where the ovaries release too many hormones.
- Cause symptoms such as pelvic pain and abdominal bloating.
- Hormonal birth control: These help regulate the menstrual cycle. Some forms can also improve acne and help with excess hair growth. Hormonal birth control includes the following:
- Birth control pills
- Patches
- Shots
- Intrauterine device (IUD)
- Vaginal ring
- Insulin-sensitizing medicine: Metformin is used to treat diabetes. It works by helping the body process insulin. Once insulin is under control, some women with PCOS see improvements in their menstrual cycles.
- Medications to block androgens: Some medicines can block the effect of androgens. These medicines help control acne or hair growth.
- Lifestyle changes: A healthy diet and being physically active can help reduce PCOS symptoms and also lose weight. Lifestyle changes can also help:
- Your body uses insulin more efficiently.
- Lower blood glucose levels
- It may help you ovulate
If you want to become pregnant now or in the future, then the treatment for PCOS includes the following:
- Surgery: Surgery can restore ovulation by removing tissue in the ovaries. These tissues produce androgen hormones. With the availability of newer medications, surgeons rarely perform this procedure.
- Drugs inducing ovulation (releasing an egg): Certain medicines induce ovulation in patients with PCOS. Medications like clomiphene and letrozole can be taken orally, while gonadotropins are injected.
- In vitro fertilization (IVF): This can be an option for PCOS women when medicines don't help with ovulation. The eggs taken from the woman are fertilized with her partner's sperm in a petri dish before transferring them to the uterus.
Can PCOS Be Cured Permanently?
Although there is no permanent cure for PCOS, your healthcare provider can assist in managing your symptoms. As a result, the effects of PCOS may change over time, making you less aware of the condition.
What is the Cost of PCOS Treatment in Different Countries?
The cost of PCOS treatment is as follows:
| Country | Cost (USD) |
| 250 - 350 | |
| 1000 - 2000 | |
| 1000 - 5000 | |
| 270 - 2700 | |
| 2100 - 8400 |
To Conclude
PCOS knows no borders and affects women from all corners of the world. However, the journey of living with PCOS and seeking treatment can vastly differ depending on where you call home. From the holistic approaches in India to the cutting-edge medical technology in Germany, the options for PCOS treatment vary widely. Women must know the available treatments and seek care that best suits their needs and circumstances. While the treatment approaches differ, the ultimate goal is to empower women with PCOS to lead healthier, happier lives.
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