PCOS, and why you need to know about it!

It’s one of the most common hormonal disorders faced by women, yet very few of us know much about it. It’s about time we talk about PCOS (Polycystic Ovary Syndrome), an endocrine disorder that affects between 5-10% of women worldwide. It is a condition in which the body produces an abnormal amount of androgens (male sex hormones). The month of September marks Polycystic Ovary Syndrome awareness month, and here’s why we need to talk about it:

Dr Renuka Matti, the IITB hospital gynaecologist, says that more than ~20% of the women in India suffer from PCOS, and the numbers are only increasing. If not detected and treated in time, PCOS can lead to severe complications, such as diabetes, breast cancer, high blood pressure and sleep apnea. Dr Renuka also says that early detection and treatment is the key to dealing with PCOS. Thus, it is crucial that we spread awareness about this disorder. So how would someone know if they or one of their friends are suffering from PCOS?

Symptoms

We asked Dr Renuka this very question. According to her, one of the most telling signs are delayed periods. As much as 40% of the patients complaining about menstrual problems are diagnosed with PCOS.

But, there are other symptoms that may point to PCOS as well:

• Excess body or facial hair
• Weight gain, especially around the abdomen
• Acne or oily skin
• Tags or patches on the skin

It is crucial to identify these symptoms and seek medical help as soon as possible. This is easier said than done, majorly because of the stigma that surrounds this issue.

Stigma

The experiences of girls in the institute show that the stigmatized status of PCOS/PCOD has significant consequences for their health and social well-being. This part of the article intends to make the voices heard of girls and women suffering from PCOD/PCOS and make it a sex-friendly discussion. Having such conversations will help students be more confident in approaching support and diminish hesitation in taking the necessary treatment.

The stigma around PCOS/PCOD is attributed to its intricate symptoms associated with the individual’s external appearance. Although what causes PCOS is still unknown, it is widely seen as a lifestyle disorder, indicating that lifestyle is imbalanced to some extent, making it difficult for one to accept herself. Furthermore, its relation to women’s reproductive health makes it a sensitive and even a taboo topic for some people to discuss. The fear of judgement by others is another cause of it not being discussed so openly. 

A point to note here is, Polycystic Ovarian Syndrome does not necessarily lead to infertility in all women. 

Other than stigmatization, there are many other challenges faced by girls at the institute, compounded further by the irregular and stressful lifestyle which a lot of us lead.

What are the challenges faced?

After speaking to a number of girls in the institute from varied backgrounds, we found out that the following challenges are faced with respect to the institute schedule.

1. Maintaining a proper healthy diet in the institute:

The hectic schedule and the culture of working till late in the institute often lead to one extra meal during midnight. It is identified that most of the eateries in the institute provide fast food and are not healthy. Students find it challenging to maintain a balanced and nutritious diet in such situations, and they resort to such eateries for their post-dinner meals.

       2. Visiting gynaecologists at an early age is viewed as a taboo amongst many families:

With the stigma around women’s menstrual health, It is crucial to have a strong support system from friends and family. One interviewee mentioned that parents hesitate to get their kids consulted with a gynaecologist and prefer going to the general physician. The hesitation towards gynaecologist consultation for adults is viewed as a challenge as it leads to late diagnosis, which is a problem in itself. 

       3. Maintaining a proper sleep cycle:

We all know how challenging it is to maintain a fixed sleep time when in a hostel – it could be an upcoming assignment deadline giving you nightmares, a friend’s birthday celebration, wing meets or exams – it’s tough to say “NO”!  The short term priorities often hijack the sleep schedule. It is crucial to note that an improper sleep cycle is one of the reasons for hormonal imbalance. It is essential to discipline oneself, draw your boundaries in order to adopt a regular bedtime routine and aim for six to eight hours of sleep each night. 

       4. Coping up with the stress and fitness:

Upon interviewing, we found that students face high stress levels while dealing with academics, newly introduced social life, relationships, and peer pressure. Dr Renuka had referred some students to psychologists for stress management in the past and had seen a significant improvement in their well being and symptoms of PCOS. 

Further, making time for fitness is difficult for some students; while juggling academics and various extracurricular activities. She also mentioned that students’ lack of motivation to exercise and occasional corner cutting often prevents them from getting the full benefits of recommended stress management activities.

So then, what can women who have been diagnosed with PCOS do, to deal with these challenges and mitigate the severity of their symptoms?

Solutions

Medically, there’s no cure for PCOS, and even its occurrence cannot be traced down to one single factor/attribute. The IITB gynaecologist, Dr Renuka suggested, “I recommend the patients to go on a 6-month weight loss journey with or without medication.” While anti-diabetic supplements, Myoinositols and oral contraceptives are recommended by doctors in different stages to keep the symptoms under control, in the long term, only lifestyle changes will help you sustain. 

The dietician at FeMeal, Anam Golandaz, also has a similar opinion – “Ensure that your diet is rich in protein, low in carbs and has a low glycemic index. Keep a check on your calorie intake, and don’t ever binge eat or resort to unhealthy snacking. Have dry fruits, peanuts and fruits handy so that you are always on track.” 

Although it may seem difficult, being able to maintain such a lifestyle in the institute is possible. Avoiding unhealthy snacking and instead consuming fruits (can be bought from YP Gate),  walking/cycling 3-4 km daily, ordering healthy food and staying away from the oily dishes in the mess can help keep symptoms under control while in insti.

At the Institute level, small steps need to be taken to tackle the issues faced by students suffering PCOS/PCOD. Most of the interviewees raised concerns about the unavailability of diet food in the mess. “It is not possible to survive solely on mess food”, – says one of our interviewees while expressing her concern about the oily food and high carbohydrate diet served in the hostel mess. A healthy diet with less oil should be made available; while ensuring the nutritional value for the girls in H10/H15, similar to the Jain food facility in the mess. 

There are multiple medical facilities available for students at the Institute’s hospital. The Institute provides free of charge diagnosis and treatment for students suffering from PCOS/PCOD. The Jeevan reimbursement scheme covers the cost of medication; if any prescribed medicine is not available at the hospital’s pharmacy. The Institute had previously conducted awareness classes regarding vaccination and contraception as a part of freshers’ orientation; It was discontinued later. We discussed the scope and impacts of awareness classes with the experts, and we believe it will help in spreading awareness about PCOS. At the same time, the awareness classes can reduce various health conditions caused due to lack of information. Moreover, we recommend adding the PCOS treatment facilities available at IITB hospital to the brochures/handouts given during the orientation. 

Maintaining a healthy lifestyle by adopting good eating habits, looking after fitness, and a stress-free environment is essential for those suffering from PCOS. And it’s definitely not easy; there is a huge motivation barrier to behaving “ideally” every single day. This is where the support of a community can help, and FeMeal, an IITB students’ initiative for women with PCOS, focuses exactly on that. One can benefit from taking part in community events, discussing issues with peers, sharing their experiences – whether good /bad, do’s and don’ts, getting recommendations and deriving their daily dose of motivation from the community. It helps to feel connected to people going through a similar situation. Further, there’s always new research and never-ending material available out there which is difficult to keep up with. In such cases, discussions with a community can be beneficial. Understanding what worked for someone else also pushes you to try it out. FeMeal is striving to redefine “peer-pressure” into “peer-motivation” with its new initiatives and we hope girls can benefit from it! 

Conclusion: 

PCOS cases have shown a sharp rise in the last few years. Despite it being a common condition in India, there’s still misinformation, myths and taboos doing rounds in the market. The lack of honest and open conversation has led to a lot of women ignoring the initial signs. Early diagnosis of PCOS is a boon, as it can prevent some of the long-term risks associated with PCOS. Girls at IITB and other universities face many challenges in adopting a healthier lifestyle due to various factors, including diet, stress due to competitive environment, academic and non-academic commitments. And hence can be at higher risk of diagnosing with PCOS/PCOD. Hence, the onus is on each one of us to create a conducive environment for those facing such challenges, and here are few primary things we need to ensure:

1. Do away with the myths & stigma –  Research well before commenting or criticizing.
2. Don’t judge: Understand that there are factors beyond one’s control involved in such conditions, and healing is a really slow process.
3. Provide moral support: Introduce them to people facing similar challenges so that they don’t feel lonely in their battle. Motivation is the key to achieving lifestyle changes. Here’s FeMeal’s PCOS community to get started: https://chat.whatsapp.com/Dlf3HfTT0ReEUOC4YH9rc5
4. Lastly, don’t overreact or over sympathise. One would rather be confined to themselves than being at someone else’s mercy.

If you learnt something new from this article, make sure you pass it on to your fellow mates because change starts with us!

*FeMeal is an IITB students’ initiative aiming to create positive lifestyle changes using simple scientific methods