Regularly Irregular
by: Froilan Santos, M.D

Women with normal ovulatory function menstruate regularly each month. Have irregular menstrual periods alerted you as a red flag? Have you been irregularly menstruating since the menarche (start of menstrual period)? It cannot be stressed importantly enough to have the regularity of menstrual cycles in your compass! A normal menstrual period generally lasts up to 7 days, every 28-35 days interval before the onset of a woman’s next menstrual period.

Once your cycles become irregular, or worse, have been irregular ever since puberty years from menarche, be observant of other accompanying symptoms reflective of hormonal imbalances such as presence of excess androgen (testosterone) in the form of acne break-outs, thinning hair (from excessive hair loss) and hirsutism (excess body hair in other body parts, presence of hair growth in unusual body areas such as the nape, back, abdominal area, nipple, etc.) and in the long run, unexplained weight gain. If positive for the above-mentioned symptoms, you have polycystic ovarian syndrome (PCOS).

What is PCOS?

PCOS is a complex hormonal, metabolic and reproductive disorder that affects 15% of women. It can lead to lifelong complications and other serious conditions including severe anxiety and depression, obesity. endometrial cancer, type 2 diabetes, liver disease and cardiovascular disease. The National Institutes of Health (NIH) estimate more than 50% of women with PCOS will become diabetic or prediabetic before age 40.

The most dreaded symptom in the child-bearing age is infertility due to anovulatory cycles. This can be confirmed by ultrasound with the identification of an ovary with many small cysts resembling a string of pearls at the periphery of the affected ovary/ovaries hence its name: polycystic ovary.

Some studies have shown women with PCOS to be at three times higher risk for endometrial cancer and may also be at increased risk for ovarian and breast cancer. Moreover, some studies also have shown that due to symptoms of anxiety and depression, suicide attempts are up to seven times more common in women with PCOS than other women.

Pre-teens and teens can develop PCOS. Earlier diagnosis can give them the opportunity to better manage the emotional, internal and physical effects of PCOS. It can also help them prevent the onset of more serious illnesses related to PCOS.

PCOS can be hereditary too. If your grandmother, mother or siblings have it, there is an increased chance that you may inherit PCOS. It can only be managed symptomatically.

Despite affecting millions of women and the serious health consequences, PCOS is unknown to most people and a staggering 50% of the women living with PCOS are going undiagnosed.

Awareness is key. The first line in the management of PCOS is pretty simple: STAY within your ideal body weight with proper diet and exercise. For those who are overweight and obese, just a 5-10% body weight loss is already half the battle! Losing weight with exercise and a balanced diet is key in subsiding the symptoms, preventing long-term complications. While this may not be achieved for quite some time, second line treatment is managing the hormonal imbalance with combined oral contraceptive pills (containing progestin and estrogen) to offset the symptoms of irregular cycles (for better cycle control) and controlling the symptoms of hyperandrogenism (acne, excess body hair, massive hair loss) and depending on other findings such as glucose intolerance would warrant other medications for the control of blood glucose levels, cholesterol-lowering drugs if with dyslipidemia or if with a concurrent thyroid dysfunction.

Are you regularly irregular? Then please see your Specialist Doctor for a check-up! As the saying goes, prevention is always better than cure. Do away with the long-term complications by staying within your ideal body weight with regular check-up with your doctor.