A Gynaecologist Answers Frequently Asked Questions on PCOS

By | October 20, 2019

Charis Chambers, is a Paediatric & Adolescent Gynaecologist. She diagnoses and treats PCOS patients almost every day.

Below she answers to questions that often bother adolescent girls & their parent. Clear your doubts once and for all.

1. What is the greatest diet challenge faced by PCOS patient?

I believe that the greatest diet challenge faced by PCOS patients has to do with their inherent impaired glucose tolerance. Due to the pathophysiology of PCOS, dietary changes can feel like and uphill battle, like trying to run down an “up” escalator. Patients with PCOS aren’t just trying to reduce calories, they are trying to combat a dysfunctional system. It takes patience, consistency, expert nutritional guidance and compassionate care from health professionals. It not impossible, but the challenge is very real.

2. Exercise is a must to regulate the body hormones. Exercise tips vary from person to person, how do you go about guiding the patient?

I guide my patients with a system called the 5 R’s. I address the relevance of exercise. I specifically address that their PCOS diagnosis make exercise less of an elective and more of a core requirement for success. I discuss risks of failure to exercise, including continued weight gain with further hormonal dysfunction from the hormonally active adipose tissue.

I also discuss the lifelong risks for cardiovascular disease associated with PCOS. I then highlight the rewards of exercising like endorphin release, improved self-confidence, the subtle warming effects that come from intentionally prioritizing self-love. 

I acknowledge and address the roadblocks that could prevent them from succeeding. I also repeat this process and subsequent visits to continue the conversation and emphasize my continued support in their health journey.

3. Medication plays an important role in weight loss when it comes to handling PCOS. Name them. Have these medications to be taken by all patients for lifetime? Why?

 One of the most important medications for patients with PCOS can be a medication called metformin. It is a medication that helps with blood sugar control that is taken by mouth and is indicated in patients with PCOS that are showing signs of metabolic syndrome (a cluster of physical findings that increase cardiovascular and diabetes risk) and glucose intolerance. It has exceptional benefits including aiding in weight loss, delaying the onset of overt diabetes, decreasing levels of androgens (i.e. testosterone), and improved fertility. 

This medication doesn’t necessarily need to be taken for a lifetime as lifestyle modifications could render the drug unnecessary. In patients that may be unable or unwilling to make lifestyle changes, metformin may need to be continued indefinitely with the possible addition of other weight loss or metabolic medications

4. Other significant health issues related with PCOS that should not be ignored by patients and should be carefully monitored? 

Women with PCOS are at higher risk of several health issues including diabetes and cardiovascular disease. These issues are typically monitored with regular evaluation of weight, waist circumference, blood pressure, glucose tests, and lipid panels. These issues cannot be ignored by patients or healthcare providers because they can lead to significant illness and even premature death.

5. Can planning a family be challenging for PCOS patient? When is the time to act?

Planning a family can be more challenging for a patient with PCOS than it is for her peer of the same age without the disorder. 

Infertility is typically diagnosed after a year of trying and no spontaneous conception. PCOS, however, is characterized by the absence or infrequence of ovulation. Ovulation, which is the near monthly release of an egg from the ovary, is required for conception or pregnancy. When you do not ovulate or have fewer opportunities for ovulation, your chances of infertility are significantly increased. 

For this reason, most OBGYNs counsel PCOS patients to seek help with achieving pregnancy earlier than at one year. There are oral medications, like Metformin and ovulation induction agents that can improve fertility significantly for patients with PCOS. The time to act is typically sooner than you think.

6. Irregular periods are a serious concern of PCOS patients? Can you elaborate why? 

Irregular periods can cause several issues. The primary issues that I have noted are bleeding episodes that are not only unpredictable, but also prolonged and painful. When cycles are irregular, they are difficult to plan for and can arise at the worst moments. Whether it involves an important event, a critical career meeting, an athletic competition, or just a white uniform a surprise period can be less than helpful. 

Additionally, the periods for PCOS patients tend to occur after months of growth to their endometrial lining. This gives them more lining to shed and typically causes heavier and longer periods. These periods can be associated with anaemia and increased menstrual cramps. 

Hormonal medication can help regulate cycles with better predictability and shortened duration with lighter flow. 

7. Can a girl suffering with PCOS pursue a sports career?

A girl suffering with PCOS can absolutely pursue a sports career with the appropriate treatment plan and counselling. Since periods can be regulated and metabolic issues can be controlled, a sports career should never be sacrificed due to the diagnosis of PCOS alone. With stories of increased surveillance of hormonal levels like testosterone, one may feel more compelled to treat their PCOS. 

While I am an advocate for treatment, I do not agree with the policing of an athlete’s hormone levels. Furthermore, I feel that cardiovascular disease prevention is a much more appropriate motivator for intervention and lifestyle modification.

8. When is the right time to consult a gynaecologist? Early signs of PCOS?

The recommended age for first reproductive health visit with a gynaecologist is between the ages of 13 and 15, but not every patient is able to establish care that early. The right time for a patient with concerns about PCOS to see a gynaecologist is NOW. 

You don’t have to wait until you meet the diagnostic criteria. You don’t need to wait until your annual visit. You don’t need to wait until you’ve gone a full year without conceiving or having a period. The early signs of PCOS should prompt a visit to your doctor. If you notice increased hair growth or acne and infrequent or absent periods, talk to your health care provider today about your risks for PCOS. 

Early intervention and treatment can literally mean have lifelong benefits.

Women Fitness Team is grateful to Dr. Charis for her valuable time and input.

Women Fitness