When discussing hormonal conditions in women, the focus has always been on menopause and fertility, neglecting a serious condition that affects thousands of women across Kenya.
Polycystic Ovarian Syndrome (PCOS) is a common hormonal condition affecting women of reproductive age. It begins in adolescence, but symptoms can fluctuate over time.
Dr Felix Oindi, a consultant obstetrician and gynaecologist at the Aga Khan University Hospital in Nairobi, says PCOS is a health problem that affects women's hormone levels.
"Women with PCOS produce more male hormones than usual, which can lead to problems such as irregular periods, acne and excessive hair growth," says Dr Oindi.
He explains that you are more likely to get PCOS if it runs in your family if you are overweight/obese, if you have Type 2 diabetes, if you have a sedentary lifestyle or if you are not active enough.
According to Dr Oindi, the exact cause of PCOS is not known. However, several factors may contribute, including genetics, which runs in families, and insulin resistance: where many women with PCOS have difficulty using their body's own insulin, leading to high insulin levels that can cause the ovaries to produce more male hormones.
Also hormonal imbalance, where high levels of male hormones could prevent the ovaries from releasing eggs normally.
According to Dr Oindi, patients with PCOS will complain of irregular menstrual cycles, with periods coming too often, not often enough or not at all, and difficulty getting pregnant.
Others will also complain of severe acne that doesn't improve with treatment, difficulty losing weight or unexpected weight gain, thinning hair leading to hair loss on the scalp, and excess hair on the face, chest or back.
Diagnosis
To diagnose PCOS, Dr Oindi says a physical examination is done to check for signs such as extra hair and acne. Blood tests to check hormone levels and an ultrasound to look for cysts in the ovaries may also be done. We will also ask questions about your periods, weight changes and family history," adds Dr Oindi.
Treatment options
Unfortunately, there is no cure for PCOS, but Dr Oindi says the symptoms can be managed by eating a healthy diet and exercising to lose weight.
Medications for PCOS include birth control pills to regulate periods and reduce male hormone levels, metformin to help with insulin resistance, fertility drugs to help get pregnant if needed, and anti-androgens to reduce hair growth and acne.
If not managed well, PCOS can lead to infertility, and the patient will also develop Type 2 diabetes due to insulin resistance. She will have heart problems due to high blood pressure, high blood sugar and high cholesterol.
"The patient will be susceptible to cancer of the lining of the uterus (endometrial cancer), develop breathing problems during sleep (sleep apnoea), especially in overweight women, and develop depression and anxiety due to hormonal changes and body image issues," says Dr Oindi.
When should I see a doctor?
Dr Oindi lists several circumstances when you should see a doctor, including if you're missing your periods; notice excessive hair growth on your face, chest or back; have trouble getting pregnant; have severe acne that doesn't clear with treatment; experience unexplained weight gain or difficulty losing weight; and develop symptoms such as thinning hair on the scalp or severe mood swings.
Despite the seriousness of the condition, there is not much data on how common PCOS is in Kenya. Globally, Dr Oindi says it is estimated that about 6 to 10 per cent of women of reproductive age have PCOS.
