UNAIR NEWS – Lately, some women through their social media pages share experiences on changes occuring in their bodies. Some claim to experience irregular menstrual cycles, excessive hair and acne, weight gain, psychological disorders, and even difficulty to get pregnant.
In this regard, a gynecologist and oncologist, Professor Dr. H. Budi Santoso, dr., Sp.OG., (K), made a response. According to him, some of these phenomena are part of Polycystic Ovary Syndrome (PCOS). It is a hormone disorder experienced by women in fertile period.
“So, PCOS is a condition where a woman’s body experiences hormonal imbalance. In women with PCOS, androgen hormone production is more dominant than estrogen. However, PCOS is not included in the disease category, but rather a collection of symptoms from several things, “he said.
The man known as Prof. Bus explained that polycystic symptoms had been known since 1721 through the research of Antonio Vallisneri and two American gynecologists in 1935, Irving Stein and Michael Leventhal. Until a few decades ago, the main cause was still unclear. However, through changing times, PCOS understanding and handling has also developed.
“But keep in mind that PCOS is different from PCO. Usually, PCO appears in the form of ovarian cysts and it is common in women. Although the symptoms are similar, PCO is not dangerous and often goes away by itself. If the PCO is accompanied by excessive hair growth, menstrual disorders, infertility disorders or other hormonal disorders, then it is PCOS, “said Prof. Bus.
Reproductive Problems Affected by Women’s Lifestyle
According to the doctor who is also the Vice Dean II of Faculty of Medicine (FK) Universitas Airlangga, the prevalence of PCOS in women tends to increase. In journals of the 90s, it was only around 4-6%. Then, in a study conducted in Surabaya in 2007, Prof. Bus found about 4.5%, while other studies showed 8-12%. In fact, there are researchers who claim it was found in 12-20% of women in reproductive age.
“The increasing prevalence of PCOS in women can be caused by various factors. Lately, people tend to have unbalanced diets and consume excessive calories intake. It is not balanced with regular movements or exercise so it causes obesity,” explained Prof. Bus.
Obesity can trigger declining work of body cells to insulin and make the pancreas produce more insulin, so the body experiences insulin resistance. In women, high levels of insulin in the blood can inhibit the growth and development of follicles. This condition prevents the process of oocyte release (ovulation) which then results in disrupted fertility or infertility.
“Manifestations of blocked ovulation (anovulation) are irregular menstruation and the predominance of androgen hormone in female body. In fact, androgens are hormones that are generally owned by men. Therefore, women with PCOS will have some symptoms such as hirsutism, psychological disorders, irregular menstruation, binge eating disorder, hyperandrogenism, to difficulty of conceiving, “said Prof. Bus.
Nearly 60% of PCOS women are obese. Although PCOS actually has two types, the obesity and slim type. However, both have different conditions and treatment. In the obesity type, the infertility process takes place due to insulin resistance, while the slim type is caused by high luteinizing hormone (LH).
Diagnosis, Treatment and Risk of PCOS
In its development, there are three groups proposing diagnostic criteria for PCOS sufferers, the National Institutes of Health (NIH) from the United States, the European Society for Human Reproduction and Embryology / American Society for Reproductive Medicine (ESHRE / ASRM) or Rotterdam Criteria, and the Androgen Excess Society (AE-PCOS).
“Experts in Indonesia use Rotterdam criteria to establish diagnoses. There are three criteria seen in women with PCOS, menstrual disorders oligomenorrhea / amenorrhea, hyperandrogenism, and the presence of small egg cells like cart wheels that will be seen when conducting transvaginal ultrasound. If there are two from three criteria, we can be sure that the woman has PCOS, “he said.
If you are aware of the symptoms of PCOS, a woman should immediately see a doctor to get the right treatment as the treatment of PCOS really requires discipline and patience. However, Prof. Bus confirmed that the effort to minimize the impact of PCOS is quite easy to implement.
“The key is to adopt a healthier lifestyle. First-line of treatment is to lose weight for the obesity type as much as 10% of initial body weight and maintain diet. Next, exercise regularly. A simple way can regulate menstruation and increase fertility. It does not heal completely, because it becomes female’s locus minoris but it can be controlled, “he stressed.
In addition, there are treatment efforts through the administration of some drugs that are tailored to complaints. If PCOS is detected since teenage, the doctor will give a medication that functions to regulate menstruation, such as metformin and birth control pills. The use of metformin is recommended for obese type PCOS to treat insulin resistance, while birth control pill is given to the slim type PCOS to reduce LH.
“Usually the administration of drugs is carried out for 4-6 months while observing the condition of the body. In the past, the community and pharmacists were often mistaken about the function of the two drugs. It demanded efforts to explain it. But now I understand. If it is not done it can increase the risk of other diseases, ” added Prof. Bus.
The author of Women’s Reproductive Health book series also said that, in its journey, PCOS can be a long-term problem if not treated immediately. It may increases the risk of diabetes mellitus, cardiovascular disease, dyslipidemia, malignancy in the endometrium (hyperplasia), and breast (cancer/tumor).
“In terms of food, PCOS women should reduce their consumption of carbohydrates sufficiently, consume foods that contain vitamin D or magnesium, avoid processed foods, and pay attention to diet. So, lifestyle must be healthy and disciplined, because actually PCOS is preventable disease, “ordered Prof. Bus. (*)
Author: Nabila Amelia
Editor: Khefti Al Mawalia