PCOS Management

PCOS is very common, occurring in about 15% of the female population in the reproductive age group. The symptoms may include any or all of the following: excess hair growth (hirsutism), persistent acne, irregular periods and infertility. It is frequently associated with being overweight which makes the symptoms more severe but is equally seen in women of normal weight. There is often a family history of PCOS as it is thought to be caused by a combination of genes which over express themselves to produce the symptoms.

The term polycystic ovaries describes ovaries that contain many small cysts (about twice that of normal ovaries), usually no more than 8mm each. These cysts are egg containing follicles that have not developed properly due to a number of hormonal abnormalities.

The basic problem is that the ovaries are producing too much of the male hormones, androgens. Although every woman in their reproductive years produces androgens, the symptoms of PCOS appear when an excess of these hormones (particularly testosterone) are circulating. The first symptoms usually appear at the time of puberty and may be particularly severe when associated with overweight. The diagnosis may be made on the symptoms alone but an ultrasound examination of the ovaries and some simple blood tests are usually performed.

The good news is that once the diagnosis has been made, there are many ways to treat the syndrome, mainly depending on the objective of the treatment with a very high degree of success.

Endometriosis Treatment & Management

Endometriosis is a condition where tissue similar to the lining of the uterus (womb) is found elsewhere in the body, usually the pelvis. It is a benign (non-cancerous) but very painful condition, which is characterised by the presence of endometriosis deposits mainly in the pelvis (the ovary, areas around the womb, on the bladder and the intestines). Every month these cells react in the same way to those in the womb, building up and then breaking down and bleeding. However, unlike the cells in the womb that leave the body as a period, this blood has no way to escape.

Endometriosis affects many women in Uganda and can affect any woman of childbearing age.

Endometriosis can cause infertility; in fact, it is one of the commonest causes of infertility and there is a definitive link between endometriosis and infertility. Endometriosis is seen in about 20 to 25% of women referred to fertility clinics worldwide.

There is very good evidence that in women with endometriosis who are trying to get pregnant, a combination of endometriosis treatment and fertility treatment is often successful. Early detection and excision of endometriosis will often improve pregnancy rates.repeated surgery for endometriosis lowers the ovarian reserve and thus surgery should always be planned with fertility in view . In other cases, intervention through intrauterine insemination-IUI or IVF may offer better success. The specific type of endometriosis treatment varies on the severity, age of the woman and other factors.

Even though endometriosis can fertility issues, once you are pregnant the pregnancy is expected to be normal.