In an in-depth interview with Sade Oguntola, Dr. Osundara explained the symptoms, causes, treatment options, and implications of PCOS, emphasizing the importance of awareness and individualized care.
What Is PCOS and How Common Is It?
PCOS is a syndrome—a combination of symptoms and signs—that most often affects young women. The hallmark symptom is irregular menstruation, which often prompts women to seek medical attention. “Some women menstruate only two or three times a year, and some may have periods just once annually,” Dr. Osundara said.
Other notable symptoms include excessive hair growth on the face, chest, abdomen, and chin, acne, and a deepening voice, all linked to hormonal changes caused by PCOS. Obesity is also commonly associated with the condition, though not all overweight women have PCOS.
In Nigeria, PCOS affects up to 7 out of every 100 young women, and cases are regularly seen at the Gynaecology Clinic in UCH, Ibadan. Most patients are between 16 and 25 years old, though some present in their 30s. Many women are now seeking care after reading about PCOS online and recognizing similar symptoms in themselves.
Symptoms to Look Out For
Aside from irregular menstruation, other features of PCOS include:
- Heavy, prolonged, or painful periods
- Difficulty conceiving or infertility
- Female-pattern baldness or hair thinning
- Oily skin
However, irregular periods alone are not diagnostic of PCOS. Confirmation requires assessment by a gynecologist, including basic tests and laboratory investigations.
Obesity and Heredity
PCOS can present with weight gain and an “apple-shaped” body, but not every overweight woman has the condition. Heredity may play a role, as daughters of women with PCOS or a family history of diabetes may have higher risk. However, there are many cases where daughters of women without PCOS still develop the condition.
Women with PCOS are also at increased risk of developing diabetes mellitus, high blood pressure, cardiovascular disease, high cholesterol, sleep apnea, obesity (especially abdominal), and uterine lining cancer.
PCOS and Infertility
PCOS can affect fertility because hormonal imbalances—particularly elevated testosterone—interfere with ovulation. Normally, testosterone in women is converted in the ovaries to estrogen, but excess testosterone can prevent egg release, leading to irregular or absent periods and difficulty conceiving.
“Many women with PCOS experience infertility, but it is treatable,” Dr. Osundara said. “The ovaries may not release eggs properly, but medications and lifestyle changes can correct this.” She noted that many patients at UCH have successfully conceived after treatment.
Treatment Approaches
Treatment is tailored to the individual and may include:
- Lifestyle modifications: Weight control through balanced diet, regular exercise, adequate sleep, and avoiding alcohol and recreational drugs. Weight loss often restores menstrual regularity and improves fertility. Some patients may be underweight and require guidance on healthy weight gain.
- Medications: Prescribed to restore ovulation, correct hormonal imbalances, treat acne, and reduce long-term risks such as uterine cancer.
- Fertility interventions: Advanced fertility treatments, including IVF, are rarely required but may be used if ovulation cannot be restored with medication.
- Surgery: Simple procedures may occasionally be needed in a minority of cases.
Dr. Osundara emphasized that acne treatment is done with caution in women planning pregnancy and may involve dermatologists.
Importance of Early Detection
Early medical evaluation is crucial to prevent complications. Delayed treatment can result in prolonged infertility, and in some cases, women may approach menopause without seeking help. Young women with irregular periods should consult a gynecologist to confirm the cause and receive appropriate care.
“Even if someone dislikes menstruation, its absence could later contribute to difficulty in conceiving. Early assessment ensures timely intervention,” she said.
Awareness and Misconceptions
Awareness of PCOS is increasing in Nigeria, largely due to online information. However, misinformation remains a problem. A common myth is that women with PCOS cannot get pregnant, which Dr. Osundara clarified is false. Many women with PCOS can achieve natural conception if ovulation is restored, fallopian tubes are open, and male fertility factors are normal. Assisted conception is now more advanced, making pregnancy more achievable than in the past.
Growing Global Burden
Studies suggest PCOS prevalence is increasing worldwide, though reasons remain uncertain. Dr. Osundara noted that PCOS likely existed previously but went undiagnosed due to lack of awareness and limited diagnostic resources. Today, improved access to laboratory tests, imaging, and specialist care in Nigeria is helping more women receive timely diagnoses.
The exact cause of PCOS is still unknown, and the contribution of dietary or environmental factors remains unclear.
When to Seek Help
Dr. Osundara advises seeking medical attention as soon as menstrual irregularities or other symptoms appear. Early evaluation allows for effective treatment and better long-term reproductive outcomes.
Can Women with PCOS Conceive Without IVF?
Not all women with PCOS require IVF. If ovulation is restored, the fallopian tubes are healthy, and male fertility is normal, pregnancy can occur naturally. IVF or other assisted reproductive techniques are only necessary in specific situations identified after thorough evaluation.
Conclusion
Dr. Osundara urges women to seek appropriate consultation when they suspect PCOS. Increased awareness, early detection, lifestyle management, and individualized treatment can help women regulate menstrual cycles, manage associated symptoms, and achieve pregnancy without necessarily relying on advanced fertility treatments.
“PCOS is treatable, and many women can conceive naturally. Early medical intervention remains the key to managing this condition effectively,” she said.