A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

Get answers to FAQs about transvaginal ultrasound and PCOS with Meri Sehat. Understand the diagnostic process for better health.

Transvaginal Ultrasound For PCOS FAQs

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Iqra Mazhar

This article or video has been recorded by a subject / domain specialists with a proven track record of excellence in their area. 

Could My Child Be Diabetic?

Introduction

<a href="https://merisehat.pk/disease/diabetes-a-complete-overview">Diabetes</a> is one of the most common diseases on this planet. People all over the world suffer from it. However, the fact that a greater majority of its victims are adults means the prevalence of this disease in children often goes unnoticed. The reason for this negligence is that often many cases of diabetes in children go undiagnosed due to the lack of apparent symptoms. 
&nbsp;

Understanding Diabetes In Children

Diabetes, simply referred to as &lsquo;sugar&rsquo; in Pakistan, is an increase in blood glucose levels due to insulin-related problems. That is, the body is not producing enough insulin, or it could be that the body has completely stopped producing insulin<a href="#accordion">[1]</a>.

How is the production of insulin related to high blood sugar levels? Think of it this way. After a person consumes carbohydrate-containing foods, their body breaks it down into glucose in the stomach, and eventually, the broken-down glucose is sent to the bloodstream for use by the body. Insulin is important because it&rsquo;s the only hormone responsible to break down glucose and allowing other cells of the body to consume it for energy.&nbsp;

When insulin does not function effectively, it may lead to diabetes. The problem is triggered when the production of insulin is hindered greatly to the extent it fails to target all the glucose in the body, or when the biochemical is not produced at all by the body. Either way, it leaves a higher concentration of glucose in the bloodstream.&nbsp;

A third possibility also exists &ndash; that is, the body does produce insulin, but the cells do not react to it in the way they should. This phenomenon is known as insulin resistance and it is commonly found in type 2 diabetes. The result is that the pancreas receives the message about the high blood sugar present in the body and the organ starts producing more insulin, overworking itself until it stops producing insulin altogether. 
&nbsp;

Type 2 diabetes is also known as adult-onset diabetes. Despite the name and its common prevalence in people of older ages, children suffer from this, too, and the numbers keep on increasing due to obesity and inactive lifestyle<a href="#accordion">[1][2]</a>. Especially when the person is overweight and has central obesity (lots of belly fat).

Children with diabetes type 2 mostly get diagnosed during their teens. Thus, it is believed to occur due to the hormonal changes that the body goes through during puberty. Every human is different and their bodies take their own sweet time to understand, accept, and adjust according to these changes. So, naturally, it will be confused in the case of insulin production, too.&nbsp;&nbsp;

With 1 in 4 adults, i.e., 26.7% of people in Pakistan having diabetes, it is safe to assume that the genetics of the country is filled with diabetes. The prevalence of type 2 diabetes is around 11.77% in Pakistan<a href="#accordion">[3]</a>. Simply by extension, it is believed that the instances of diabetes in children would be high too but, unfortunately, there is no robust evidence regarding the number of affected children in Pakistan. 
&nbsp;

Diabetes is a life-altering disease. It can turn out to be very limiting for people of younger age groups with symptoms like increased hunger and thirst, frequent infections, and fatigue.

Adult-onset diabetes is a lot easier to manage because the health and lifestyle changes are much easier to adapt to. On the contrary, the body of children at this age is still developing; consequently, they face multiple issues, including heart diseases, eye problems, and even potential nerve damage.&nbsp;

Unfortunately,&nbsp; these issues also progress faster in children with type 2 diabetes than in type 1, making it harder to control<a href="#accordion">[5]</a>. Children are also known to deal with poor kidney function and bad eyesight.&nbsp;

All of this requires strict control of blood sugar levels, which becomes challenging, especially for parents when children don&rsquo;t cooperate. 
&nbsp;

Obesity is not the only condition related to diabetes. When a person is diagnosed with insulin resistance, they may have several other conditions as well. It is common to experience metabolic syndrome with early age type 2 diabetes. This is characterized by: <ul><li>Increased blood pressure</li><li>Low LDL (high-density lipoproteins)</li><li>High triglycerides</li><li>Increased blood sugar level</li><li>Large waist size </li></ul>

Polycystic ovary syndrome (PCOS) and diabetes go hand-in-hand in girls and women. If a girl is exhibiting symptoms like irregular periods, weight gain, and excess body and facial hair, it&rsquo;s possible that she might have PCOS. Hormonal imbalance is the root cause of PCOS, hence, there is a greater probability that the body stops responding to insulin or produces inadequate amounts of it. And, vice-versa, if the child is diabetic, then they are more susceptible to PCOS than other girls their age<a href="#accordion">[4]</a>. 
&nbsp;

The most ideal approach to managing diabetes is to let the kid in on the action, i.e., make them aware of their condition, inform them how their choices will be different from other kids of their age, and the lifestyle changes they need to incorporate to lead a productive life. This is best done by taking one day at a time rather than unloading the information all at once and overwhelming the child.&nbsp;

Empower them from a young age by letting them make their own choices. For example, let them choose which finger to prick for checking blood sugar levels or decide where they feel comfortable taking their insulin shots. This can be slowly built up as they age. They can be trained into taking care of themselves. As teenagers, they can be taught about carb counting and different ways to maintain their dietary intake for optimum results<a href="#accordion">[6]</a>. 
&nbsp;

When it comes to risk factors of type 2 diabetes in children, they are not too different from those experienced by adults. Some of the common risk factors include:

<ul>
	<li>Obesity</li>
	<li>Age &ndash; Most young patients with diabetes type 2 are diagnosed during their early teens</li>
	<li>Activity &ndash; Sedentary lifestyle has been associated with increased insulin resistance</li>
	<li>Family history</li>
	<li>Mother with gestational diabetes</li>
	<li>Ethnicity &ndash; African American, Asian American and Latino are generally more at risk 
	&nbsp;</li>
</ul>

Key Points

<ul><li>Type 2 diabetes is getting very common day by day, especially in children, due to a sedentary lifestyle.</li><li>The best approach for type 2 diabetes in children is to allow them to take control of their bodies as well.</li><li>The key to managing it all is weight maintenance, physical activity, and dietary intake.</li></ul>

[1] Gavin ML, ed. What is type 2 diabetes? (for parents) - nemours kidshealth. KidsHealth.

[2] Prevent type 2 diabetes in Kids. Centers for Disease Control and Prevention.

[3] SA, Meo & Zia, Inam & Bukhari, Ishfaq & Arain, Shoukat. (2016). Type 2 diabetes mellitus in Pakistan: Current prevalence and future forecast. JPMA. The Journal of the Pakistan Medical Association. 66. 1637-1642.

[4] Type 2 diabetes in children. Mayo Clinic.

[5] Holland K. Type 2 diabetes in children. Healthline.

[6] Child type 2 diabetes: Symptoms, causes &amp; treatments. WebMD.

Umna Salah

Madeeha Syed

This article or video has been vetted and verified by Meri Sehat’s specialists. It contains citations and research from validated sources.

The PCOS Lifestyle

Overview

<a href="https://www.merisehat.pk/disease/polycystic-ovary-syndrome-pcos">Polycystic ovary syndrome (PCOS)</a> is the most common endocrine disorder in women, affecting up to 5-10% of all females. It can cause a wide range of troubling symptoms.&nbsp;

The syndrome is caused by an imbalance in sex hormones which results in ovulation problems, irregular periods, and the formation of cysts on the ovaries. PCOS can be managed in several different ways, including lifestyle changes, medications and surgery, if necessary.

right measures

Combating PCOS the right way can be a challenge on its own. With so much information and suggestions out there, it is only normal for you to get overwhelmed and end up not doing anything at all. While PCOS may be a difficult condition to live with, it does not mean that it has to worsen with time. With the right measures, you can manage your PCOS in ways that minimise your symptoms. 
&nbsp;

In several cases, insulin resistance goes hand-in-hand with PCOS. This means that despite your body&rsquo;s ability to produce insulin, the hormone is not being used effectively to maintain your blood sugar level. In this case, the high blood sugar level causes your body to pump out more and more insulin, causing your ovaries to produce more androgens, such as testosterone.&nbsp;

This is why women with PCOS are required to consume a specific diet consisting of: 
&nbsp;

<ul>
	<li>High fiber vegetables, like cauliflower, bell peppers, sweet potatoes, pumpkin, etc</li>
	<li>Anti-inflammatory foods and spices like tomatoes, kale, walnuts, olive oil, turmeric, etc</li>
	<li>Lean meat, such as chicken or fish&nbsp; 
	&nbsp;</li>
</ul>

Foods consisting of refined carbohydrates like starch and sugars may make digestion a challenge in your body leading to increased insulin production. It is recommended to avoid white bread, muffin, sugary snacks, drinks, red meat or any type or processed meat. 
&nbsp;

Your body is going to thank you for incorporating a healthy active lifestyle. Weight control is absolutely necessary in the maintenance of PCOS, but at the same time, weight control can be a massive hassle and twice as difficult to achieve as compared to normal cases.&nbsp;

Experts believe that an average of 150 minutes weekly should be dedicated towards exercising. In this, consistency is the key. Weight loss and an active lifestyle may even aid in improved ovulation and reduce signs of stress.&nbsp; 
&nbsp;

We know a caffeine boost is sometimes all you need to get through the day, but caffeine can do a lot of harm to you than good, especially when it comes to allegedly influencing changes in estrogen levels. Herbal teas or kombuchas are great alternatives giving you an immune boost through that probiotic kick.

However, quitting caffeine is a hard thing to do. It is best done slowly, from transitioning to green tea and then other herbal teas.

&nbsp;

Bottom Line

If your symptoms are severe, it may be time to talk with your doctor about treatment options. However, if you just want to improve your condition and have more regular periods or less hair growth in unwanted places (like on your chin), these tips will help!

Medilink Consultant clinic

ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

Childhood Obesity And PCOS

I need you to picture a room full of kids. Can you hear the giggles, the screams,&nbsp; the energy just bouncing off the walls? Innocence personified, right? But here&#39;s the twist &ndash; among those chubby faces lies a concern that&#39;s quietly but steadily on the rise - childhood <a href="merisehat.pk/disease/obesity">obesity</a>. It&#39;s not just about having a bit of baby fat; it&#39;s a complex puzzle where extra pounds come together with health risks that might surprise you. 
&nbsp;

Understanding the Impact of Childhood Obesity on PCOS

With the ongoing climate change, wars, financial crises, and political unrest, food shortage has become a real dilemma among millions worldwide. And while that translates to more underweight and malnourished children, it seems that another form of malnutrition seems to be coexisting with undernutrition - obesity. Notably, overweight and obesity are responsible for more deaths globally than underweight<a href="#accordion">[2]</a>.

According to the World Health Organization (WHO), there seems to be a global epidemic of overweight and obesity, or &lsquo;globesity&rsquo;<a href="#accordion">[1]</a>. Although once considered to affect high-income countries, the obesity epidemic is now on the rise in middle- and low-income countries. 
&nbsp;

As per recent estimates, the worldwide prevalence of obesity has tripled over the past thirty years<a href="#accordion">[2]</a>.&nbsp; In 2016, there were more than 1.9 billion overweight adults, of which 650 million were obese. However, adults are not the only ones getting affected by globesity. The prevalence of overweight and obesity has risen among children and adolescents as well. From 4% in 1975 to over 18% in 2016, childhood obesity has seen a sharp rise worldwide<a href="#accordion">[2]</a>. 
&nbsp;

Childhood obesity is more than just a few extra pounds. It&#39;s a complex health challenge where excess body weight can significantly impair one&rsquo;s health. The perfect storm for childhood obesity brews from a blend of factors &ndash; a diet heavy in processed foods, lack of physical activity, genetics, and the environments in which children live. But the repercussions are more than skin deep. Childhood obesity isn&#39;t just about appearances; it can lead to immediate health risks such as diabetes, cardiovascular problems, and a range of social and psychological challenges.

&nbsp;

In 2019, approximately 38.2 million children under the age of 5 years were obese or overweight<a href="#accordion">[2]</a>. With the rising prevalence of childhood obesity, researchers are concerned that the prevalence and severity of another disorder may also be increasing in parallel - Polycystic Ovary Syndrome (PCOS).

Approximately 80% of women with PCOS are also obese<a href="#accordion">[3]</a>. And while the two are linked, it is believed that childhood obesity may also be contributing to the rising prevalence of PCOS among women. 
&nbsp;

PCOS is a hormonal disorder that affects women of reproductive age, leading to symptoms like irregular periods, ovarian cysts, and hormonal imbalances. Its long-term health implications include infertility, insulin resistance, diabetes, and cardiovascular problems. While the exact cause of PCOS is not fully understood, researchers have identified a strong association between obesity and the development and severity of PCOS, particularly during adolescence.

A recent study revealed a higher prevalence of PCOS among obese or overweight pubertal patients than adults<a href="#accordion">[5]</a>.The connection between childhood obesity and PCOS in adolescents is rooted in a complex interplay of hormonal and metabolic factors<a href="#accordion">[4][5]</a>. 
&nbsp;

Adolescence is a critical period for the development of both obesity and PCOS. During this time, hormonal changes, growth spurts, and metabolic shifts are occurring rapidly. Childhood obesity, characterized by excess body fat, can disrupt these normal processes and contribute to the hormonal imbalances that are central to the development of PCOS.

One key mechanism linking childhood obesity to PCOS is insulin resistance. Insulin is a hormone that regulates blood sugar levels, but in obesity, cells become less responsive to its effects, leading to elevated insulin levels. This insulin resistance can trigger the ovaries to produce higher levels of androgens, such as testosterone. Elevated androgen levels disrupt the normal menstrual cycle and can lead to symptoms like irregular periods, acne, and excessive hair growth &ndash; all characteristic features of PCOS. 
&nbsp;

Moreover, adipose tissue (fat) itself is metabolically active and secretes various hormones and signaling molecules known as adipokines. In obese adolescents, especially those with central obesity (excess fat around the abdomen), there is an altered secretion of these adipokines. Some of these adipokines, such as omentin-1, are thought to influence androgen levels. Research has shown that omentin-1 levels are negatively correlated with free testosterone levels in obese girls with PCOS. This suggests that the adipose tissue in these individuals might contribute to the hormonal imbalances observed in PCOS<a href="#accordion">[5]</a>.

Pubertal obesity can also exacerbate insulin resistance and hyperinsulinemia commonly seen in PCOS. This contributes to the persistence of hormonal imbalances and can further aggravate hyperandrogenism. Early puberty, which often accompanies obesity, can also play a role. Obesity-related factors may influence the timing of puberty, leading to an earlier onset, and this premature hormonal activation could contribute to the development of PCOS. 
&nbsp;

Overall, the relationship between childhood obesity and PCOS in adolescents is complex and multifactorial. While not all obese individuals will develop PCOS, the increased prevalence of hormonal imbalances, insulin resistance, and disrupted adipokine profiles in obesity creates an environment conducive to the development of this syndrome.

Therefore, addressing childhood obesity through early interventions, such as promoting a healthy diet, regular physical activity, and weight management, is crucial for reducing the risk and severity of PCOS in adolescents. 
&nbsp;

Childhood obesity is a growing concern that not only affects a child&#39;s current health but can also have long-term consequences, including an increased risk of conditions like PCOS in adulthood. As parents, you play a crucial role in shaping your child&#39;s habits and setting them on a path to a healthier future. Here are some tips to help you manage and prevent childhood obesity:

<ul>
	<li>Be A&nbsp;Healthy Role Model - Children often imitate their parent&#39;s behaviors. Show your commitment to a healthy lifestyle by eating nutritious foods, staying active, and managing stress effectively. 
	&nbsp;</li>
	<li>Balanced Meals - Serve a variety of foods from different food groups at each meal. Include colorful fruits, vegetables, lean proteins, whole grains, and healthy fats. Make mealtime a family affair and involve your child in meal planning and preparation. 
	&nbsp;</li>
	<li>Smart Snacking - Keep nutritious snacks like cut-up fruits, veggies, yogurt, or nuts readily available. Avoid stocking up on sugary or high-calorie snacks to reduce temptation. 
	&nbsp;</li>
	<li>Limit Sugary Drinks - Encourage water, milk, or naturally flavored water over sugary drinks. Limiting soda and fruit juices can significantly reduce your child&#39;s calorie intake. 
	&nbsp;</li>
	<li>Active Playtime - Create opportunities for your child to be active daily. Whether it&#39;s playing in the park, riding bikes, or dancing around the living room, make physical activity enjoyable. 
	&nbsp;</li>
	<li>Screen Time Rules - Set limits on screen time for TV, video games, and smartphones. Encourage your child to engage in outdoor play, sports, and other active hobbies. 
	&nbsp;</li>
	<li>Family Activities - Plan family outings that involve physical activity, such as hiking, swimming, or playing a sport together. These activities promote bonding while keeping everyone active. 
	&nbsp;</li>
	<li>Sleep Well - Ensure your child gets enough sleep each night. A consistent sleep schedule supports healthy growth and helps regulate appetite. 
	&nbsp;</li>
	<li>Teach Portion Control - Help your child understand portion sizes and listen to their body&#39;s hunger cues. Avoid using food as a reward or a way to comfort emotions. 
	&nbsp;</li>
	<li>Open Conversations - Talk openly with your child about the importance of making healthy choices. Focus on the benefits of feeling strong, energetic, and confident. 
	&nbsp;</li>
</ul>

Remember, the journey to managing and preventing childhood obesity is about making gradual, sustainable changes as a family. Celebrate small victories along the way and provide plenty of encouragement and support. By instilling healthy habits early on, you&#39;re giving your child the tools they need for a lifetime of well-being. 
&nbsp;

Conclusion

In the world of growing complexities, the connection between childhood obesity and PCOS has unveiled an important truth: our children&#39;s health today shapes their tomorrows. Childhood obesity isn&#39;t just about a number on a scale; it&#39;s a potential gateway to a life impacted by PCOS and its challenges.

[1] Controlling the global obesity epidemic. World Health Organization.

[2] Obesity and overweight. World Health Organization.

[3] T M Barber, Why are women with polycystic ovary syndrome obese?, British Medical Bulletin, Volume 143, Issue 1, September 2022, Pages 4–15, DOI:10.1093/bmb/ldac007

[4] Anderson AD, Solorzano CM, McCartney CR. Childhood obesity and its impact on the development of adolescent PCOS. Semin Reprod Med. 2014;32(3):202-213. doi:10.1055/s-0034-1371092

[5] Fu L, Qu F, Pan J, Wang T, Wang F. Polycystic ovary syndrome in adolescents with obesity. Revista da Associação Médica Brasileira. 2021;67(3):468-473. doi:10.1590/1806-9282.20200890

Nimrah H. Sattar

Humza Khizer

Common PCOS Myths Busted!

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects a large number of women. Unfortunately, it is surrounded by numerous myths and misconceptions.

 
&nbsp;

Understanding Myths about PCOS

<h5>Myth 1: PCOS Is A Rare Condition</h5>

Fact: PCOS is a relatively common hormonal disorder that affects 1 in every 10 women of reproductive age<a href="#accordion">[1]</a>. Symptoms may appear shortly after puberty, but women in their late teens or early adulthood can also be affected.

This may also be due to a delayed diagnosis, as symptoms such as poor sleep, mood changes, fatigue, and darkening of the skin under the breasts, arms, and back of the neck are easy to overlook or misdiagnose. Nearly 50-70% of women with PCOS are underdiagnosed<a href="#accordion">[2]</a>.

The condition frequently runs in families. A woman is more likely to have PCOS if her mother, sister, or daughter has it. 
&nbsp;

<h5>Myth 2: Ovary Cysts Cause PCOS</h5>

Fact: PCOS is a complex hormonal disorder with a variety of symptoms, including irregular menstrual cycles and hormonal imbalances.

Most women have tiny follicles present in their ovaries that appear as small cysts on an ultrasound. But they are not the same as cysts. They are not painful and are not cancerous..

However, it is not uncommon for women to have polycystic ovaries but not PCOS, and vice versa. To be diagnosed, a woman should fulfill 2 of the 3 conditions<a href="#accordion">[3]</a>:

<ul>
	<li>Irregular periods</li>
	<li>Elevated levels of androgen or male hormone, with signs including severe acne and male-pattern baldness</li>
	<li>Multiple follicles or cystic ovaries</li>
</ul>

A diagnosis cannot be made based on a single symptom. 
&nbsp;

<h5>Myth 3: An Irregular Menstrual Cycle Means PCOS</h5>

Fact: PCOS is one of the reasons for an irregular cycle. However, irregular menstrual cycles may occur due to several reasons including but not limited to : extreme dieting, breastfeeding, overexercising, uterine fibroids, pelvic inflammatory disease, thyroid disorders, and stress.

Note: If your cycle is less than 21 days or longer than 35 days, consult your doctor. They may recommend additional tests to identify the cause. 
&nbsp;

<h5>Myth 4: PCOS Only Affects The Ovaries</h5>

Fact: Although PCOS mainly affects the ovaries, it is a systemic hormonal disorder that can affect different parts of the body. It can have an impact on metabolism, insulin sensitivity, cardiovascular health, and fertility. 
&nbsp;

<h5>Myth 5: All Women With PCOS Have The Same Symptoms</h5>

Fact: PCOS presents differently in different individuals. Some women may experience irregular periods, excessive hair growth (hirsutism), and acne. Others may struggle with obesity and insulin resistance. Not all women with PCOS have all the symptoms. 
&nbsp;

<h5>Myth 6: PCOS Is Just A Cosmetic Issue Related To Excess Hair Growth And Acne</h5>

Fact: Male hormones, or androgens, control the development of male characteristics. All women produce a small amount of androgens, but women with PCOS produce more than normal.

Excess androgen causes unwanted hair on the body. Furthermore, it makes the skin oilier than usual and causes breakouts.

However, PCOS can have serious consequences for a woman&#39;s health, including diabetes and mental health issues. Before the age of 40, more than half of PCOS women develop prediabetes or diabetes. PCOS has also been linked to high blood pressure, anxiety, depression, sleep apnea, and endometrial cancer<a href="#accordion">[2]</a>. 
&nbsp;

<h5>Myth 7: PCOS Only Affects Overweight Or Obese Women</h5>

Fact: Because of this misconception, obese women with irregular menstrual cycles are frequently misdiagnosed with PCOS. It also implies that thin women are often not tested for PCOS.

Weight gain and obesity can aggravate PCOS symptoms. But the condition can affect women of all body types, including those who have a healthy weight or are underweight.

Furthermore, weight gain can be a consequence of PCOS due to insulin resistance. 
&nbsp;

<h5>Myth 8: Women With PCOS Cannot Lose Weight</h5>

Fact: People with PCOS have a harder time losing weight. This is a result of decreased insulin sensitivity, which makes it challenging to lose extra weight.

Note: You can achieve your weight loss objectives by working with an endocrinologist and a dietician. 
&nbsp;

<h5>Myth 9: Women With PCOS Should Avoid Specific Foods</h5>

Fact: There is no need to avoid anything as long as it is consumed in moderation. This is typically advised as a preventive measure to keep hormone levels in check. A diet high in fruits and vegetables is said to help people lose weight and reduce inflammatory markers<a href="#accordion">[6]</a>.

Some people with PCOS have celiac disease or gluten sensitivity and may benefit from eliminating gluten from their diets. However, some people do it to lose weight; however, there is no scientific evidence that it aids in weight loss.

Similarly, while dairy consumption is linked to higher insulin and androgen levels, there is no need to eliminate dairy from the diet unless the person is also lactose intolerant or allergic to milk. 
&nbsp;

<h5>Myth 10: PCOS Can Be Cured</h5>

Fact: Although PCOS cannot be cured, its symptoms can be effectively managed with various treatments and lifestyle changes such as quitting smoking and increasing physical activity. 
&nbsp;

The following are some misconceptions about PCOS in Adolescence: 
&nbsp;

<ul>
	<li>
	<h5>PCOS Is Not A&nbsp;Serious Condition</h5>
	</li>
</ul>

Fact: PCOS is a significant medical condition that can have long-term implications for a woman&#39;s health if left untreated. 
&nbsp;

<ul>
	<li>
	<h5>Only Older Women Can Have PCOS</h5>
	</li>
</ul>

Fact: PCOS can affect teenagers and women of all ages. In fact, it often starts during the teenage years, with symptoms becoming more noticeable as women reach their 20s and 30s. 
&nbsp;

<ul>
	<li>
	<h5>PCOS Is Just About Irregular Periods</h5>
	</li>
</ul>

Fact: While irregular periods are a common symptom of PCOS, the condition involves multiple hormonal imbalances that can lead to various symptoms, like acne, hirsutism, weight gain, hair loss, and fertility issues. 
&nbsp;

<ul>
	<li>
	<h5>PCOS Among Adolescents Is Just A&nbsp;Phase And Will Go Away With Time</h5>
	</li>
</ul>

Fact: PCOS is a chronic condition that requires appropriate management. While some symptoms may improve over time, the underlying hormonal imbalances and potential health risks persist without intervention. 
&nbsp;

<ul>
	<li>
	<h5>Irregular Periods During Adolescence Are Normal And Not A&nbsp;Cause For Concern</h5>
	</li>
</ul>

Fact: While irregular periods can be common during adolescence as the menstrual cycle is still maturing, consistent irregularities or other symptoms, like excessive hair growth, acne, or weight changes, should not be ignored. They could be signs of PCOS and warrant evaluation by a healthcare professional. 
&nbsp;

The following are some misconceptions that lead to misunderstanding and misinformation about PCOS among adult women: 
&nbsp;

<ul>
	<li>
	<h5>Poor Lifestyle Choices Cause PCOS</h5>
	</li>
</ul>

Fact: While lifestyle factors, such as diet and exercise, can influence PCOS symptoms and exacerbate insulin resistance, the exact cause of PCOS is not entirely understood. It is believed to be a complex interplay of genetic, hormonal, and environmental factors. 
&nbsp;

<ul>
	<li>
	<h5>PCOS Is Just A&nbsp;Fertility Issue</h5>
	</li>
</ul>

Fact: PCOS does cause fertility problems due to irregular ovulation because it affects the ovary&rsquo;s ability to release an egg to be fertilized.

But it is not just a problem with fertility. It is a chronic illness that may affect a woman&#39;s metabolic health, cardiovascular health, and mental well-being, among other aspects of her health. 
&nbsp;

<ul>
	<li>
	<h5>Women With PCOS Cannot Become Pregnant</h5>
	</li>
</ul>

Fact: Although PCOS can affect fertility, many women with the condition can conceive and carry a pregnancy to term with the help of the right medical treatment or lifestyle changes. Medicines, like clomiphene or letrozole, encourage ovulation. Additionally, FSH injections or Metformin may be used<a href="#accordion">[4]</a>. 
&nbsp;

<ul>
	<li>
	<h5>Women With PCOS Don&rsquo;t Need Contraception</h5>
	</li>
</ul>

Fact: Women with PCOS can have trouble conceiving naturally. They might be using medication to induce ovulation. However, this is not true for all PCOS women; some can conceive naturally despite their condition. The belief that they are infertile or cannot become pregnant as a result of their condition causes psychological distress and influences their contraceptive use<a href="#accordion">[5]</a>. 
&nbsp;

<ul>
	<li>
	<h5>Birth Control Pills Are The Only Treatment For PCOS</h5>
	</li>
</ul>

Fact: Contrary to popular belief, birth control pills are not the only way to treat PCOS; they only help manage some of its symptoms. Individual symptoms and objectives guide the course of treatment. For instance, a woman would definitely forego the pill if she wanted to become pregnant.

Therefore, treatment may include hormone-regulating drugs, dietary changes like an anti-inflammatory diet, and other practices like stress-reduction meditation. 
&nbsp;

<ul>
	<li>
	<h5>PCOS Will Disappear After Menopause</h5>
	</li>
</ul>

Fact: PCOS is a chronic condition. Some symptoms may improve after menopause, but they will not go away completely. Long-term management may still be required to address related health concerns. 
&nbsp;

It&#39;s crucial to have accurate information about PCOS to understand the condition and make informed decisions about management and treatment. If you suspect you have PCOS or are experiencing related symptoms, consult a healthcare professional for proper evaluation and guidance. 
&nbsp;

[1] Polycystic ovary syndrome. Polycystic ovary syndrome | Office on Women’s Health.

[2] Migala J, Upham B, Migala J, Salomon SH, Levine B, Marks JL. 12 common PCOS myths. EverydayHealth.com.

[3] PCOS symptoms. PCOS Awareness Association.

[4] Myth-busting: Truths about PCOS. Wellbeing of Women.

[5] Copp T, Cvejic E, McCaffery K, et al. Impact of a diagnosis of polycystic ovary syndrome on diet, physical activity and contraceptive use in young women: findings from the Australian Longitudinal Study of Women's Health. Hum Reprod. 2020;35(2):394-403. doi:10.1093/humrep/dez274

[6] Angela Grassi M. It’s fine to eat these foods if you have PCOS. Verywell Health

Shermeen Zuberi

8 Signs You Have PCOS

Understanding signs of PCOS

If you have PCOS, here&#39;s how your doctor will diagnose it:<a href="#accordion">[3]</a>

<ol>
	<li>
	<h5>You Have Ovarian Cysts</h5>
	</li>
</ol>

An ultrasound is one of the first tests that doctors recommend. The scan creates images of the inside of your body by using high-frequency sound waves.

A transvaginal ultrasound, in which the ultrasound probe is placed inside the vagina, is usually recommended. If you are a virgin or are nervous about the procedure, your doctor may recommend an abdominal ultrasound, in which the probe is placed on top of the abdomen. An abdominal ultrasound, on the other hand, may not show your ovaries in detail. 
&nbsp;

Ultrasound is most effective on days 2-7 of the <a href="https://merisehat.pk/article/how-your-menstrual-cycle-affects-your-mental-health">menstrual cycle</a>, and on a full bladder. If you are amenorrheic, your doctor may recommend a scan at random or 2-5 days after progesterone-induced bleeding<a href="#accordion">[1]</a>.

The test aids in the diagnosis of PCOS in nearly 90% of women<a href="#accordion">[2]</a>. If you have PCOS, your uterine lining will be thicker than normal, confirming another symptom - irregular or absent periods. They may also show enlarged ovaries that are three times the size of normal. 
&nbsp;

<ol start="2">
	<li>
	<h5>Your Androgen Levels Are High</h5>
	</li>
</ol>

Another test, yes. This time, however, a blood sample will be drawn to test for male hormones.

Most women with PCOS have insulin resistance, which can lead to an increase in androgens in their bodies. However, androgens are occasionally produced as a result of chronic, low-grade inflammation caused by injury or infection. A higher level of androgen causes additional symptoms, such as male-pattern baldness. 
&nbsp;

<ol start="3">
	<li>
	<h5>Your Menstrual Periods Are Irregular</h5>
	</li>
</ol>

Ovulatory dysfunction, also known as irregular periods, refers to absent or unusually long cycles. Some women with PCOS get fewer than 8 periods a year. And some people just do not get it<a href="#accordion">[3]</a>!

This is because a lack of ovulation prevents the uterine lining from shedding each month. It can be worrisome because not ovulating regularly indicates that your body is not producing a sufficient number of eggs to be fertilized.

As a result, PCOS is regarded as one of the leading causes of female infertility. Moreover, not ovulating every month increases the risk of endometrial cancer<a href="#accordion">[3]</a>. 
&nbsp;

<ol start="4">
	<li>
	<h5>You Have Heavy Bleeding Each Month</h5>
	</li>
</ol>

Your uterine lining has been accumulating for quite some time. So, when it sheds, your periods are naturally heavier than usual. 
&nbsp;

<ol start="5">
	<li>
	<h5>Your Metabolism Is Affected</h5>
	</li>
</ol>

Your doctor would order a series of blood tests to determine the levels of these hormones<a href="#accordion">[2]</a>. The results not only help diagnose PCOS but also rule out other conditions with similar symptoms, such as tumors, thyroid problems, and hyperplasia.

<ul>
	<li>Glucose Test: Diabetes affects more than half of all PCOS women. The risk of high blood sugar is increased when PCOS and obesity coexist.</li>
	<li>Lipid Profile: Since PCOS increases the risk of heart disease, it is important to check triglycerides and cholesterol levels.</li>
	<li>Insulin: This can be used to assess how effectively your body is combating insulin resistance.</li>
	<li>FSH And LH: If you have PCOS, your levels of follicle-stimulating hormone fall while your levels of luteinizing hormone rise.</li>
	<li>Estrogen And Testosterone: If you have PCOS, your estrogen levels will be high or the same as normal. Additionally, your testosterone levels will be high.</li>
	<li>Human Chorionic Gonadotropin (hCG): This helps determine whether these changes are truly caused by PCOS or by pregnancy for girls and women who are sexually active. 
	&nbsp;</li>
</ul>

<ol start="6">
	<li>
	<h5>You Have A Family History Of PCOS</h5>
	</li>
</ol>

Numerous studies have shown that if other women in your family also have PCOS, you may also develop the condition. There are numerous genes that affect it<a href="#accordion">[3]</a>. 
&nbsp;

<ol start="7">
	<li>
	<h5>Characteristic Physical Symptoms? Check!</h5>
	</li>
</ol>

You can receive this &quot;reality check&quot; that you might have PCOS during a physical examination at a medical facility. It consists of:

<ul>
	<li>High BMI</li>
	<li>Headaches</li>
	<li>Oily skin and acne</li>
	<li>Male pattern baldness</li>
	<li>Extra hair growth or hirsutism</li>
	<li>Discolored skin patches in body creases 
	&nbsp;</li>
</ul>

<ol start="8">
	<li>
	<h5>You Have Anxiety And Depression</h5>
	</li>
</ol>

This is more than just emotional exhaustion. The majority of PCOS women experience depression and anxiety<a href="#accordion">[3]</a>.

The hormonal changes caused by PCOS, as well as unwanted physical changes (e.g., hair loss, weight gain, infertility) and the social stigma associated with these changes, may have a negative impact on you. 
&nbsp;

Remember that not all PCOS women will exhibit every symptom<a href="#accordion">[5]</a>. If you suspect you have PCOS, please see a doctor for proper diagnosis and treatment. 
&nbsp;

Key Takeaways

<ul>
	<li>The Endocrine Society guidelines state that meeting 2 of 3 criteria - excess androgen, polycystic ovaries, and ovulatory dysfunction - can aid in the diagnosis of PCOS<a href="#accordion">[5]</a>.</li>
	<li>While PCOS is a common health problem, girls and women are frequently misdiagnosed or underdiagnosed.</li>
	<li>Periods are irregular or the cycle is longer than it should be when progesterone levels are low.</li>
	<li>Miscarriages, premature births, and infertility are all more likely to occur because ovaries are unable to produce and release eggs.</li>
	<li>Physical changes in PCOS patients can include acne, male-pattern hair loss on the head, excessive body and facial hair growth, and unexpected weight gain.</li>
	<li>Other physical changes that may occur include dark, velvety patches of skin and skin tags.</li>
	<li>Certain mood disorders, sleep disorders, eating disorders, and psychological disorders are common complications in people with PCOS. They are frequently associated with low self-esteem and a lack of support.</li>
	<li>A family history of PCOS is a major risk factor. It can help with early detection and diagnosis of PCOS.</li>
</ul>

[1] Amreen S. Ultrasound in polycystic ovarian syndrome: What? when? how? why? who? European Medical Journal.

[2] PCOS (polycystic ovary syndrome) diagnosis &amp; blood tests. WebMD.

[3] Watson S. Polycystic ovary syndrome (PCOS). Healthline

[4] Polycystic ovary syndrome (PCOS). JHM

[5] Migala J, Upham B, Migala J, Salomon SH, Levine B, Marks JL. What is PCOS? symptoms, causes, diagnosis, treatment, and prevention. EverydayHealth.com.

[6] Polycystic ovary syndrome (PCOS). Mayo Clinic. September 8, 2022.

[7] Polycystic ovary syndrome. NHS choices.

Endometriosis? PCOS? Which One Is It?

If you&#39;re somewhere between the ages of 10 and 50, there&#39;s a good chance you&#39;ve had your fair share of rollercoaster rides with the monthly cycle we call periods. When the cramps, mood swings, and bleeding gets a little too much,or too little it can put all types of thoughts in our brains. Is it PCOS? Do I have endometriosis? Do I have a hormonal imbalance? So on and so forth.

Both polycystic ovary syndrome (PCOS) and endometriosis are common causes of menstrual irregularity in women. You might have heard of them, but do you really know the difference? Don&#39;t worry, we&#39;ve got your back! In this article, we&#39;ll break down these two conditions, explaining the differences and similarities and why one may be confused with the other. 
&nbsp;

Endometriosis is a common, yet complex reproductive tract disorder that affects approximately 10% of women of reproductive age<a href="#accordion">[1]</a>. This condition involves the abnormal growth of endometrial tissue outside the uterus, commonly found on the ovaries, pelvic cavity, fallopian tubes, or rectovaginal area. These &quot;ectopic&quot; tissues respond to hormonal changes during the menstrual cycle, leading to estradiol-induced growth and destructive changes, much like the inner lining of the uterus.

Unfortunately, endometriosis can cause severe pelvic pain, chronic inflammation, and fertility issues. Despite being a prevalent issue, there&#39;s currently no cure for endometriosis, and treatment options mostly revolve around surgical excision of endometrial lesions or even hysterectomy in severe cases. 
&nbsp;

The exact causes of endometriosis are still a bit of a puzzle. While some theories point to the retrograde flow of menstrual blood as a possible trigger, other evidence suggests a multifactorial nature, involving anatomical, hormonal, immunological, estrogenic, genetic, epigenetic, and environmental factors. 
&nbsp;

Polycystic ovary syndrome (PCOS) is a common gynecologic disorder that affects up to 20% of women during their reproductive age<a href="#accordion">[1]</a>. This syndrome presents a combination of symptoms, including anovulation (lack of ovulation), polycystic ovaries, hyperandrogenism (elevated androgen levels), hirsutism (excess hair growth), abdominal obesity, insulin resistance, and increased body mass index (BMI) and waist to hip ratio (WHR).

While PCOS is prevalent, its exact cause remains unclear. Researchers have identified genetic, environmental, nutritional, and metabolic factors as potential causes, but the full picture is yet to be painted. 
&nbsp;

Understanding The Difference Between PCOS And Endometriosis

Though endometriosis and PCOS might sound a bit complex, fear not, as we&#39;re here to break it down for you in simple terms. Let&#39;s explore the similar symptoms and key differences, so you can be better informed about these conditions and their impact on your health. 
&nbsp;

<h5>Similar Symptoms</h5>

Both endometriosis and PCOS can make us feel like our bodies are playing a game of twister with our health. Here are some symptoms that might be familiar for both conditions:

<ul>
	<li>Painful Periods</li>
	<li>Irregular Periods - If your period occurs more frequently than every 21 days or less often than 35 days, PCOS or endometriosis might be to blame.</li>
	<li>Fertility Challenges - If you&#39;ve been struggling to conceive, both endometriosis and PCOS can play a role in making that journey bumpier.</li>
	<li>Pelvic Pain - A persistent pain in your pelvic region can be a signal that something is amiss, which might be caused by either condition. 
	&nbsp;</li>
</ul>

<h5>Differentiating Features</h5>

While there are some similarities, endometriosis and PCOS have their distinct traits that set them apart. Here&#39;s how you can tell the difference: 
&nbsp;

<ol>
	<li>Endometriosis</li>
</ol>

<ul>
	<li>Ectopic Tissue - In endometriosis, the lining of your uterus decides to go on an adventure, growing outside the uterus on ovaries, fallopian tubes, or other places.</li>
	<li>Pain During Intercourse - Pain during sexual intercourse can be a common feature of endometriosis.</li>
	<li>Fertility Troubles - Endometriosis can lead to the formation of scar tissues and adhesions, which can make it harder for eggs to meet sperm. 
	&nbsp;</li>
</ul>

<ol start="2">
	<li>PCOS</li>
</ol>

<ul>
	<li>Cysts On Ovaries - In PCOS, your ovaries might become a little crowded with tiny cysts, affecting their normal function.</li>
	<li>Hormonal Havoc - PCOS can cause a hormonal roller coaster, leading to excess androgen levels (male hormones) and insulin resistance.</li>
	<li>Hirsutism And Acne - You might notice excess hair growth (hirsutism) or acne due to hormonal imbalances with PCOS. 
	&nbsp;</li>
</ul>

Getting a proper diagnosis is the first step in tackling these conditions. If you&#39;re experiencing any of these symptoms, don&#39;t hesitate to talk to a healthcare professional. They can perform a physical exam, run some tests, and ask about your medical history to figure out what&#39;s going on.

Remember, you&#39;re not alone. Both endometriosis and PCOS are more common than you might think, and many women deal with them every day. Finding a supportive community, sharing experiences, and seeking medical guidance can make this journey a lot easier. 
&nbsp;

Endometriosis and PCOS might share some symptoms, but they are distinct conditions with their own set of features. Painful periods, fertility challenges, and pelvic pain are common themes, but the presence of ectopic tissue and ovarian cysts can help differentiate between the two. If you suspect you might be dealing with either of these conditions, don&#39;t hesitate to seek help and find the support you need. Understanding your body and taking proactive steps can help you better manage your health and well-being, paving the way for a happier and healthier life. 
&nbsp;

[1] Sadeghi MR. Polycystic Ovarian Syndrome and Endometriosis as Two Evil Extremes of Health Continuum. J Reprod Infertil. 2022;23(1):1-2. doi:10.18502/jri.v23i1.8445

Role Of Period Tracker Apps For Managing PCOS

Let&#39;s embark on a journey to understand how these apps work their magic and how they fit into your PCOS management toolkit. 
&nbsp;

Understanding the role of period tracker apps for managing PCOS

<a href="https://merisehat.pk/disease/polycystic-ovary-syndrome-pcos">Polycystic ovary syndrome (PCOS)</a> is a hormonal disorder affecting women, often leading to infertility and various health complications. Traditional management methods have proven effective but can be enhanced by modern technology. Period tracker apps offer a convenient and accessible way to monitor menstrual cycles and reproductive health. However, their accuracy and suitability for managing PCOS need to be carefully considered. 
&nbsp;

Period tracker apps, such as Clue and Flo, are popular tools that allow users to record menstrual cycle length, symptoms, and mood changes. These apps provide insights into unique patterns and reproductive health. Some apps offer additional features, such as tracking sexual behavior and contraception usage. 
&nbsp;

Period tracker apps can assist in managing PCOS by helping users track irregular cycles, ovulation patterns, and symptom changes. They provide a visual representation of data, aiding in identifying abnormalities and potential issues. Some apps even offer risk assessment features for PCOS, though caution is advised regarding their accuracy.

Recently, researchers at Northwestern University conducted a study using the Flo period tracking app to analyze symptoms of PCOS in women from different countries<a href="#accordion">[1]</a>. The study revealed that common traits of PCOS may extend beyond the current diagnostic criteria, known as the Rotterdam criteria. Bloating, facial hirsutism, irregular cycles, hyperpigmentation, and baldness were frequently reported symptoms that were broader than those included in the diagnostic criteria. 
&nbsp;

Bloating emerged as a significant predictor of PCOS, followed by high glucose levels and high cholesterol combined with high glucose. The study involved users from the United States, the United Kingdom, India, the Philippines, and Australia. Among women with a PCOS diagnosis, bloating was the most commonly reported symptom across these countries, and high glucose levels and cholesterol were also prominent predictors.

Put simply, the study provides evidence of the variability of PCOS symptoms across different parts of the world. Moreover, it highlights the potential of period tracking apps, like Flo, to provide insights into PCOS symptomatology and contribute to better understanding and management of the condition on a global scale. 
&nbsp;

Many period tracker apps struggle to accurately predict ovulation and cycles for women with irregular periods, which is common in PCOS. These apps may not consider factors like stress, diet, or medications affecting cycle regularity. Thus, relying solely on app predictions for PCOS management may be inadequate.

Period-tracking apps like Flo and Clue have introduced health tools that assess a woman&#39;s risk of polycystic ovary syndrome (PCOS), a hormonal imbalance. These apps use data collected from users to predict the likelihood of PCOS based on symptoms and provide recommendations to consult a doctor. However, these tools haven&#39;t been thoroughly tested for accuracy or potential consequences, leading to concerns about overdiagnosis. 
&nbsp;

While these apps aim to help users by providing insights into their health, experts caution that without proper clinical validation, the risk of misdiagnosis and undue anxiety is present. These tools are part of a larger trend in digital health apps that attempt to go beyond data tracking and venture into medical predictions.

Unlike medications or medical devices, these apps often don&#39;t need approval from health authorities if they don&#39;t claim to diagnose or treat diseases. This raises concerns about their effectiveness and accuracy. 
&nbsp;

Flo and Clue, with millions of users, have developed their assessment tools in collaboration with medical experts and following guidelines. However, the assessment results provided by these apps are not definitive diagnoses and should not replace professional medical advice.

The potential issues with these tools include overdiagnosis, misinterpretation of symptoms, and an incomplete understanding of individual context. For instance, one user mentioned that the app suggested she might have PCOS due to a change in her menstrual cycle, which was actually due to a switch in birth control pills<a href="#accordion">[2]</a>.

In conclusion, period-tracking apps like Flo and Clue offer new tools to assess the risk of PCOS. However, the accuracy and reliability of these tools are currently uncertain, and users should approach their results with caution<a href="#accordion">[3]</a>. It&#39;s important to consult a healthcare professional for a proper diagnosis and treatment plan. 
&nbsp;

Despite limitations, period tracker apps offer benefits. They empower users to understand their bodies, track ovulation, and communicate effectively with healthcare providers. Apps with risk assessment features can raise awareness about PCOS symptoms, prompting women to seek medical advice.

While these apps are not a replacement for professional medical advice, they offer a convenient way to stay informed and engaged in one&#39;s health journey. Women with PCOS should consider using period tracker apps as part of a holistic approach to managing their condition, alongside regular consultations with healthcare providers. 
&nbsp;

[1] Negris O, Brown D, Galic I, Zhaunova L, Klepchukova A, Jain T. SUN-LB3 Relationship Between BMI and PCOS Symptoms Among Flo App Users in the United States. J Endocr Soc. 2020;4(Suppl 1):SUN-LB3. Published 2020 May 8. doi:10.1210/jendso/bvaa046.2175

[2] Singer N. Period-Tracking Apps Say You May Have a Disorder. What if They’re Wrong?. The New York Times.

[3] Hohmann-Marriott BE, Williams TA, Girling JE. The role of menstrual apps in healthcare: provider and patient perspectives. N Z Med J. 2023;136(1570):42-53. Published 2023 Feb 17.

Ismail Munir

Unlocking The Path To Pregnancy: Fertility Tips For Women With PCOS

You may wonder about your chances of getting pregnant and whether you can even get pregnant at all. No need to fret! This article will arm you with the right knowledge and tips that can help increase your chances of conceiving faster. But first, what even is PCOS?

Disclaimer: This article is not intended to replace a doctor&rsquo;s advice. Always consult a healthcare professional before starting any medication or making any changes to your lifestyle. 
&nbsp;

PCOS is a hormonal disorder that affects millions of women worldwide. With an overall prevalence of 5-15%, it is considered the most common endocrine disorder in women and is a common cause of <a href="https://merisehat.pk/disease/infertility-in-women">infertility</a><a href="#accordion">[1]</a>. The prevalence is much higher in South Asia, especially in Pakistan where 52% of women are affected by PCOS<a href="#accordion">[2]</a>. 
&nbsp;

The endocrine disorder occurs when the ovaries produce an excessive amount of androgens (male hormones) and develop small cysts, causing an imbalance in the reproductive system. While the exact cause remains a bit of a medical enigma, it is essential to know that it can be managed with the right approach. 
&nbsp;

Understanding Fertility Tips For Women with PCOS

The hormonal imbalances disrupt the regular ovulation process, leading to irregular or absent menstrual periods. Without ovulation, the chances of conceiving decrease significantly. Additionally, elevated androgen levels can interfere with the maturation of eggs and hinder their release, making pregnancy more challenging. 
&nbsp;

Absolutely! Having PCOS does not mean your dreams of motherhood are out of reach. Several women with PCOS have had successful pregnancies. With the right knowledge and strategies, you can enhance your fertility and increase your chances of becoming pregnant. 
&nbsp;

While each woman&#39;s journey is unique, several lifestyle changes and medical interventions can boost fertility. The following tips can help increase your chances of conceiving<a href="#accordion">[1][3]</a>. Let&rsquo;s check them out! 
&nbsp;

<h5>Lifestyle Changes</h5>

The first-line treatment recommended for women with PCOS is lifestyle changes that promote weight loss. A healthy diet and regular physical activity help reduce insulin resistance (IR) and hyperandrogenism, optimizing hormonal balance and improving cardiovascular health. Weight loss of as little as 5% from initial body weight can restore regular menstrual cycles and improve response to fertility medications.

<ul>
	<li>Diet: Diet plays a crucial role in managing PCOS symptoms and fertility. An anti-inflammatory diet can help balance hormones and blood sugar, and promote weight loss if needed. Include fruits, vegetables, omega-3-rich fish, herbs, spices, unsaturated fats, and beans in your diet, while limiting red meat and sugar.</li>
	<li>Exercise Regularly: Physical activity can aid in weight management, reduce insulin resistance, and improve overall well-being. 
	&nbsp;</li>
</ul>

<h5>De-Stress</h5>

Balanced hormones and nurtured adrenals are vital for fertility, and stress can negatively impact them. Engage in activities that help reduce stress, such as meditation, massage, yoga, exercise, spending time with animals, or socializing with loved ones. 
&nbsp;

<h5>Track Your Menstrual Cycle</h5>

Tracking your menstrual cycle allows you to identify ovulation and your fertile window, increasing the chances of conceiving. Use an ovulation calendar or app to pinpoint the best times for baby-making. 
&nbsp;

<h5>Reverse Any Insulin Resistance</h5>

Insulin resistance is a common issue for women with PCOS, affecting blood sugar and insulin levels, which can hinder conception. While Metformin is a prescribed option, consider starting with dietary changes. Eliminate sugar and refined carbs, and focus on protein, fiber, and healthy fats. Additionally, Myo-inositol has shown promise in treating insulin resistance for some women with PCOS. 
&nbsp;

<h5>Metformin</h5>

Metformin, an insulin sensitizer, can be used alone or in combination with other medications for ovulation induction. It lowers androgen production in the ovary and may have an ovulation-stimulating effect. 
&nbsp;

<h5>Ovulation Induction</h5>

Since 70% of women with PCOS have ovulation problems, ovulation induction becomes a cornerstone of treatment. Selective estrogen receptor modulators (SERMs) like clomiphene citrate (CC) or aromatase inhibitors like letrozole are commonly used to induce ovulation. CC acts as an anti-estrogen, stimulating the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), whereas letrozole inhibits estrogen conversion and enhances follicular sensitivity to FSH. 
&nbsp;

<h5>Gonadotropins</h5>

In women who do not respond to CC or letrozole, gonadotropins (FSH or human menopausal gonadotropin) can be used for ovulation induction. However, they carry a higher risk of ovarian hyperstimulation syndrome (OHSS) and multiple pregnancies. 
&nbsp;

<h5>Assisted Reproductive Technologies (ART)</h5>

ART, such as in vitro fertilization (IVF) or in vitro maturation (IVM), may be considered if other treatments fail or if there are other infertility factors. In high responders with PCOS, a &quot;freeze-all&quot; strategy may be employed to reduce the risk of OHSS. 
&nbsp;

<h5>Laparoscopic Ovarian Drilling (LOD)</h5>

LOD is a minimally invasive surgical approach that can be considered for ovulation induction in women with PCOS who are resistant to pharmacological treatments. 
&nbsp;

<h5>Bariatric Surgery</h5>

For overweight or obese women with PCOS, bariatric surgery may be an option to improve fertility and other associated symptoms. However, it should be considered experimental, and the risks and benefits should be carefully evaluated. 
&nbsp;

<h5>Start Taking Supplements</h5>

Consider adding a myoinositol supplement to your daily routine. Certain vitamins and minerals, like folic acid, vitamin B6, vitamin D, and more, can also aid fertility. Consult your doctor for personalized recommendations. 
&nbsp;

<h5>Alternative Therapies</h5>

Acupuncture and Chinese Herbal Medicine have limited evidence in enhancing fertility outcomes in women with PCOS. According to research, acupuncture appears to influence insulin signaling, reduce inflammation, and affect adipose tissue functions, thus improving metabolic dysfunction in PCOS patients. Furthermore, acupuncture may regulate the ovarian response to gonadotropins and restore neurogenic ovarian regulation. However, further research is needed to fully understand the effect of acupuncture on PCOS-related infertility<a href="#accordion">[4]</a>. 
&nbsp;

Polycystic Ovarian Syndrome may present some fertility challenges, but remember, it doesn&#39;t define your ability to become a parent. With a proactive approach, a healthy lifestyle, and the right support, women with PCOS can overcome these hurdles and fulfill their dreams of motherhood. Tracking ovulation and considering fertility medications or treatments if needed can significantly enhance your chances of conceiving. Remember, you have the power to shape your fertility journey and welcome the joy of parenthood with open arms. Stay hopeful, stay positive, and may your dreams of becoming a mother soon become a beautiful reality. 
&nbsp;

[1] Cunha A, Póvoa AM. Infertility management in women with polycystic ovary syndrome: a review. Porto Biomed J. 2021;6(1):e116. Published 2021 Jan 26. doi:10.1097/j.pbj.0000000000000116

[2] Azhar A, Abid F, Rehman R. Polycystic Ovary Syndrome, Subfertility and Vitamin D Deficiency. J Coll Physicians Surg Pak. 2020;30(5):545-546. doi:10.29271/jcpsp.2020.05.545

[3] Iftikhar N. How to Get Pregnant with Polycystic Ovary Syndrome (PCOS). Healthline

[4] Ye Y, Zhou CC, Hu HQ, Fukuzawa I, Zhang HL. Underlying mechanisms of acupuncture therapy on polycystic ovary syndrome: Evidences from animal and clinical studies. Front Endocrinol (Lausanne). 2022;13:1035929. Published 2022 Oct 24. doi:10.3389/fendo.2022.1035929

Prediabetes And Pregnancy - All You Need To Know

Diabetes mellitus is considered the most prevalent of them all, affecting more than 530 million adults globally<a href="#accordion">[1]</a>. The insidious condition affected an estimated 26.7% of Pakistani adults in 2022[2]. Unfortunately, these numbers have shown a sharp increase over the years, and show no signs of slowing down. According to the projections by the International Diabetes Federation (IDF), global prevalence is predicted to rise to 643 million by 2030<a href="#accordion">[1]</a>. 
&nbsp;

Think things can&rsquo;t get any worse than that? Enter prediabetes, the precursor to diabetes. Currently, around 319 million people worldwide are dealing with prediabetes, and that number is expected to swell to an unfortunate 441 million by 2045. This means even more people are at risk of crossing over into full-blown diabetes territory<a href="#accordion">[3]</a>.

Now, imagine this scenario getting even trickier: you&#39;re pregnant. That&#39;s when things get even more complex.<a href="https://merisehat.pk/disease/pcos-and-pregnancy-common-faqs"> Pregnancy </a>has a unique way of magnifying health issues, and when prediabetes enters the picture, it&#39;s like a double challenge. This article dives headfirst into the fascinating world where prediabetes and pregnancy meet. But first, what is prediabetes? 
&nbsp;

Understanding The Impact of Prediabetes on Pregnancy

Prediabetes is like a whispered caution from our bodies, a stage that sits right on the turning point between normal blood sugar levels and full-fledged diabetes. It is characterized by blood sugar levels that are higher than the ideal range for a healthy individual, yet not quite high enough to be classified as diabetes.

There are varying definitions and diagnostic criteria for prediabetes. The WHO defines prediabetes in terms of fasting plasma glucose. A fasting blood sugar level between 6.1 mmol/L (110 mg/dL) and 6.9 mmol/L (125 mg/dL) indicates prediabetes. Similarly, during an oral glucose tolerance test, a blood sugar reading between 7.8 mmol/L (140 mg/dL) and 11.0 mmol/L (199 mg/dL) two hours after consuming a glucose-rich solution also falls within the prediabetes range<a href="#accordion">[4]</a>. 
&nbsp;

In Pakistan, the prevalence of prediabetes is estimated to be around 11.4%, with women being affected more than men<a href="#accordion">[5]</a>.

Many people feel a sense of impending doom when they receive a prediabetes diagnosis. Fortunately, prediabetes does not mean a guaranteed transition to type 2 diabetes. Instead, think of prediabetes as a pivotal juncture, a crucial opportunity to take charge of your health. While you may not have fully crossed into diabetes territory, your body is sending a clear signal that it&#39;s time to make some positive changes.

But what if you&rsquo;re pregnant? Is prediabetes still reversible? Can prediabetes alter the course of your pregnancy or increase the risk of gestational diabetes? Questions, questions, and more questions! 
&nbsp;

Research suggests that prediabetes, characterized by elevated blood sugar levels, can exert a significant impact on fertility, both in men and women<a href="#accordion">[8]</a>.

For women, prediabetes can disrupt the delicate hormonal balance necessary for a healthy menstrual cycle and ovulation. Irregular or absent menstrual periods, a common consequence of prediabetes, can hinder the ability to conceive. Additionally, elevated blood sugar levels can lead to insulin resistance, which may contribute to anovulation (lack of ovulation) and other fertility challenges<a href="#accordion">[8]</a>. 
&nbsp;

In men, prediabetes can affect sperm quality and function. High blood sugar levels can lead to oxidative stress and inflammation, which may impair sperm production, motility, and morphology. These factors can reduce the chances of successful fertilization and conception<a href="#accordion">[7]</a>.

Addressing prediabetes through lifestyle changes, such as adopting a healthy diet, engaging in regular physical activity, and managing stress, not only reduces the risk of developing type 2 diabetes but also plays a vital role in promoting fertility and optimizing reproductive health for both men and women. 
&nbsp;

According to research, women with prediabetes are at high risk for developing gestational diabetes during pregnancy<a href="#accordion">[9]</a>. Furthermore, prediabetes in early pregnancy is linked to an increased risk of adverse pregnancy outcomes<a href="#accordion">[10]</a>. Therefore, experts recommend early diabetic screening for women with prediabetes. 
&nbsp;

A 2015 study assessed the benefits of early treatment on women with prediabetes during pregnancy. The study participants either received routine care or treatment for GDM with dietary intervention and insulin as needed. While the treatment and control groups had no difference in the primary outcome (positive glucose tolerance test), the early treatment did lead to lower A1C levels in women with prediabetes. Furthermore, in non-obese women, the treatment reduced the rate of gestational diabetes<a href="#accordion">[11]</a>. 
&nbsp;

While a complete reversal of prediabetes during pregnancy may be challenging, adopting a healthy lifestyle can help manage blood sugar levels effectively. Making positive changes in diet, exercise, and overall wellness can contribute to improved insulin sensitivity and may prevent the progression of prediabetes to type 2 diabetes. Moreover, some patients may be prescribed metformin. Especially, people who are obese or women with a history of gestational diabetes<a href="#accordion">[6]</a>. 
&nbsp;

By actively managing prediabetes through healthy lifestyle choices, pregnant women can optimize their health and the health of their developing child. With vigilant monitoring, personalized healthcare guidance, and a commitment to well-being, expectant mothers can navigate this complex intersection with confidence and the promise of a healthier future. 
&nbsp;

Remember, if you find out you&rsquo;re prediabetic, seek the help of a nutritionist that can help create a healthy diet and exercise plan for you so you can have a healthy pregnancy.&nbsp; 
&nbsp;

[1] IDF Diabetes Atlas. International Diabetes Federation.

[2] Azeem S, Khan U, Liaquat A. The increasing rate of diabetes in Pakistan: A silent killer. Ann Med Surg (Lond). 2022;79:103901. Published 2022 Jun 3. doi:10.1016/j.amsu.2022.103901

[3] Ampeire, I.P., Kawugezi, P.C. & Mulogo, E.M. Prevalence of prediabetes and associated factors among community members in rural Isingiro district. BMC Public Health 23, 958 (2023). DOI:10.1186/s12889-023-15802-9

[4] Bansal N. Prediabetes diagnosis and treatment: A review. World J Diabetes. 2015;6(2):296-303. doi:10.4239/wjd.v6.i2.296

[5] Akhtar S, Nasir JA, Abbas T, Sarwar A. Diabetes in Pakistan: A systematic review and meta-analysis. Pak J Med Sci. 2019;35(4):1173-1178. doi:10.12669/pjms.35.4.194

[6] Insulin Resistance & Prediabetes. National Institute of Health.

[7] Boeri L, Capogrosso P, Ventimiglia E, et al. Undiagnosed prediabetes is highly prevalent in primary infertile men - results from a cross-sectional study. BJU Int. 2019;123(6):1070-1077. doi:10.1111/bju.14558

[8] R Lisa. Fertility, Pre-Diabetes & Diabetes: Everything You Need To Know. illume fertility.

[9] Diabetes Mellitus and Pregnancy. Medscape.

[10] Hughes RCE, Rowan J, Williman J. Prediabetes in pregnancy, can early intervention improve outcomes? A feasibility study for a parallel randomized clinical trial. BMJ Open. 2018;8(3):e018493. Published 2018 Mar 3. doi:10.1136/bmjopen-2017-018493

[11] Osmundson S, Norton M, El-Sayed Y, Faig J, Carter S, Kitzmiller J. 35: Early treatment of women with Prediabetes in pregnancy: A randomized controlled trial. American Journal of Obstetrics and Gynecology. 2015;212(1). doi:10.1016/j.ajog.2014.10.081

Depression And PCOS – What’s The Link?

In addition to irregular or infrequent periods, excessive hair growth, and acne, experiencing PCOS means the person is also prone to developing mental health conditions, particularly depression. 
&nbsp;

Unlike popular belief, <a href="https://merisehat.pk/disease/depression">depression </a>is a serious mental condition that needs proper medical treatment. The emotional toll of PCOS can manifest in different forms of depression in girls and women, including major depressive disorder, seasonal affective disorder, and bipolar depression, affecting their ability to function<a href="#accordion">[2]</a>. 
&nbsp;

Understanding The Link Between Depression And PCOS

Depression can be linked to PCOS through various mechanisms, including hormonal imbalances, psychological factors, and the impact of PCOS symptoms on quality of life.

According to studies, 26-40% of women with PCOS also have depression<a href="#accordion">[1][2]</a>. One study, in particular, points out that women with PCOS have higher rates of suicide compared to those without the syndrome<a href="#accordion">[2]</a>. 
&nbsp;

It&#39;s important to note that not all women with PCOS will experience depression, and the relationship between PCOS and depression can vary from person to person. 
&nbsp;

There is evidence to suggest that there may be a bidirectional relationship between PCOS and depression. Here are some ways the two may be linked:

<ul>
	<li>Hormonal Imbalances</li>
</ul>

PCOS is characterized by imbalances in sex hormones, particularly elevated androgens (male hormones), and insulin resistance. These hormonal imbalances can affect mood and emotional well-being, potentially contributing to feelings of depression or anxiety.

An increase in androgens can affect a woman&rsquo;s physical appearance i.e. hair loss, weight gain, acne, and excessive growth of dark and coarse facial hair. These changes negatively impact body image and self-esteem. Besides, associated health risks and challenges, like trying to start a family, could potentially contribute to feelings of depression. 
&nbsp;

The fear that there&rsquo;s something wrong with them or that their appearance doesn&rsquo;t conform to normal standards of beauty is real. It also impacts their relationships with their partner, and they plummet further into depression.

On the other hand, mental health conditions like depression may influence hormonal function in the body. Depression can particularly cause changes in levels of stress hormones like cortisol and cytokines, which can impact the endocrine system<a href="#accordion">[3]</a>. However, while depression might influence hormone levels, it is not a direct cause of PCOS. 
&nbsp;

<ul>
	<li>Irregular Menstrual Cycle</li>
</ul>

This is a common symptom of PCOS. The hormonal imbalance due to PCOS prevents ovulation. As a result, periods may be irregular or absent. Not knowing when the next period is due can be frustrating and stressful.

There&rsquo;s also an emotional factor attached to some women who are unable to conceive. It can prolong or intensify feelings of hopelessness, sadness, lack of motivation, and self-victimization typically associated with depression<a href="#accordion">[3][6]</a>. 
&nbsp;

<ul>
	<li>Metabolic And Inflammatory Factors</li>
</ul>

Some studies suggest that PCOS may be associated with low-grade inflammation and metabolic disturbances, which can have implications for mood and mental health.

It&rsquo;s like a snowball effect from there on. Depression, obesity, and stress all add to inflammation in the body. And then, coming full circle, increased inflammation activity in the immune system contributes to depression<a href="#accordion">[3]</a>. 
&nbsp;

<ul>
	<li>Lifestyle Factors</li>
</ul>

PCOS is associated with an increased risk of certain lifestyle factors, such as sedentary behavior and unhealthy eating habits, which can affect mental health and contribute to depression.

It&rsquo;s pertinent to mention here that even healthy behaviors like exercise can act as stressors in the wrong context. For instance, doing HIIT ( high intensity interval training) when the body is sleep-deprived is a no-no. 
&nbsp;

Treating PCOS can potentially help prevent or reduce the risk of depression in some women. 
&nbsp;

<ul>
	<li>PCOS is characterized by hormonal imbalances. Addressing this issue through medical treatments or lifestyle changes can have a positive impact on mood and emotional health.</li>
	<li>PCOS symptoms, such as irregular menstrual cycles, acne, hirsutism, and weight changes, are known to cause emotional distress, right? Well, managing these symptoms effectively can help improve emotional well-being and reduce feelings of frustration or self-consciousness.</li>
	<li>For women trying to conceive, dealing with ovulation irregularities and providing fertility support can alleviate the emotional burden associated with fertility challenges.</li>
	<li>Adopting a healthy lifestyle, including a balanced diet and regular exercise, can positively affect both physical and mental health. Physical activity, in particular, has been linked to improved mood and reduced risk of depression.</li>
	<li>Educating masses about PCOS and providing access to support networks, such as healthcare professionals, support groups, or online communities, can help women cope with the challenges of living with the condition. 
	&nbsp;</li>
</ul>

Note: It&#39;s important that while treating PCOS can have a positive impact on emotional well-being, it may not entirely prevent depression, especially if there are other underlying factors contributing to the depression. Depression is a complex condition with multiple causes, and it may require separate or additional treatment approaches, such as therapy or medication. 
&nbsp;

If you or someone you know with PCOS is experiencing symptoms of depression or struggling emotionally, it&#39;s essential to seek support from a healthcare provider. They can provide guidance, offer appropriate treatments for both PCOS and depression, and help manage both the physical and emotional aspects of the condition effectively. 
&nbsp;

Treating depression itself does not directly prevent or avoid PCOS. PCOS is primarily a hormonal disorder with a genetic and hormonal basis. While depression or other mental health conditions may influence it, they&rsquo;re not the cause of PCOS. 
&nbsp;

However, addressing and treating depression in women with PCOS can be beneficial for several reasons:

<ul>
	<li>By treating depression, women with PCOS can experience better emotional and mental health, leading to an improved overall quality of life.</li>
	<li>Treating depression can help improve motivation and compliance with PCOS management strategies, such as taking medication, maintaining a healthy lifestyle, and attending regular medical appointments.</li>
	<li>Managing depression can help reduce stress levels, which can have a positive impact on overall health and may indirectly contribute to better management of PCOS.</li>
	<li>Treating depression often involves learning coping skills and strategies to manage emotional challenges. These coping skills can help deal with the emotional impact of living with PCOS and navigating its challenges.</li>
	<li>Seeking treatment for depression can lead to increased social support from healthcare providers, mental health professionals, and support groups (in certain settings). Social support can play a significant role in helping women with PCOS cope with their condition. 
	&nbsp;</li>
</ul>

Note: If you or someone you know has PCOS and is also experiencing symptoms of depression, it&#39;s essential to seek support from healthcare professionals. They can provide guidance and help manage both the physical and emotional aspects of PCOS effectively. Taking care of mental health is an essential part of comprehensive care for individuals with PCOS. 
&nbsp;

The emotional and psychological impact of living with PCOS can be significant, and depression can adversely affect a person&#39;s overall well-being and quality of life. 
&nbsp;

Here are some reasons why girls with PCOS should be screened for depression:

<ul>
	<li>Increased Risk</li>
</ul>

Research has shown that women with PCOS have a higher prevalence of depression compared to women without the condition<a href="#accordion">[3]</a>. The hormonal imbalances, challenges related to fertility, and body image concerns associated with PCOS can contribute to emotional distress and an increased risk of mood disorders like depression. 
&nbsp;

<ul>
	<li>Emotional Impact</li>
</ul>

PCOS can affect self-esteem, body image, and overall emotional well-being. The physical symptoms of PCOS may lead to feelings of frustration, embarrassment, or self-consciousness, which can contribute to depression. 
&nbsp;

<ul>
	<li>Fertility Challenges</li>
</ul>

For girls and young women with PCOS, concerns about fertility and difficulties in conceiving may add to emotional stress and increase the risk of depression. 
&nbsp;

<ul>
	<li>Stress Management</li>
</ul>

PCOS can be a chronic condition requiring ongoing management. Stress and coping with the challenges of living with PCOS can impact mental health, making screening for depression important for timely intervention and support.

Regular screening allows for early detection and intervention. Identifying depression early enables healthcare providers to provide appropriate and holistic support, counseling, or treatment to improve emotional well-being. 
&nbsp;

Here are some reasons why girls with depression should be tested for PCOS:

<ul>
	<li>Common Comorbidity</li>
</ul>

Research has shown that there is a higher prevalence of PCOS in individuals with mood disorders like depression. Addressing the potential link between PCOS and depression is essential for understanding the underlying factors contributing to emotional health concerns. 
&nbsp;

<ul>
	<li>Hormonal Imbalances</li>
</ul>

PCOS is characterized by hormonal imbalances that can affect mood and emotional well-being, potentially exacerbating or worsening depressive symptoms. Identifying and addressing PCOS in girls with depression is essential for providing comprehensive healthcare and managing both conditions effectively. 
&nbsp;

<ul>
	<li>Impact On Emotional Health</li>
</ul>

The physical symptoms of PCOS can impact self-esteem and emotional well-being. Treating PCOS can help alleviate these concerns and improve emotional health. 
&nbsp;

<ul>
	<li>Fertility Concerns</li>
</ul>

For girls with depression who may be concerned about their future reproductive health, addressing PCOS can provide clarity and support. 
&nbsp;

<ul>
	<li>Individualized Treatment</li>
</ul>

Knowing whether a girl with depression has PCOS or not allows healthcare providers to tailor treatment plans based on her specific health needs and concerns.

Screening for PCOS in girls with depression typically involves a medical evaluation, blood tests to assess hormone levels, and an assessment of symptoms related to PCOS. If PCOS is identified, appropriate management strategies can be implemented, including lifestyle changes, medication, and counseling if needed. 
&nbsp;

It&#39;s essential to recognize the potential link between PCOS and depression and to address any emotional or mental health concerns that may arise.

Young or old, if you or someone you know with PCOS is experiencing symptoms of depression or struggling emotionally, it&#39;s essential to seek support from a healthcare professional. 
&nbsp;

Treating both the physical symptoms of PCOS and addressing emotional well-being is crucial for managing the condition comprehensively and promoting overall health and quality of life. 
&nbsp;

<ul>
	<li>According to estimates, the prevalence of PCOS is on the rise.</li>
	<li>Depending on the demographics and the diagnostic criteria applied, PCOS affects 5-20% of reproductive-aged women<a href="#accordion">[5]</a>. This includes almost 11% of youth globally<a href="#">[6]</a>.</li>
	<li>The prevalence of PCOS in Pakistan is 52%, with the affected population prone to developing anxiety and depression<a href="#accordion">[9]</a>.</li>
	<li>Females with PCOS are susceptible to multiple conditions, including diabetes, mood disorders, and hypertension. Depression and anxiety are common among 21-35-year-olds with PCOS<a href="#accordion">[9]</a>.</li>
	<li>While depression might influence hormone levels, it is not a direct cause of PCOS.</li>
	<li>There is evidence to suggest that depression is nearly 3-8 times higher in women with PCOS compared to women without it.</li>
	<li>According to a study, depressive symptoms with increasing duration of PCOS significantly reduced quality of life<a href="#accordion">[6]</a>. Depression changes their perspective on PCOS symptoms.</li>
	<li>It&#39;s important to recognize that PCOS and depression are distinct conditions, and having one does not necessarily cause the other. While there is a higher prevalence of depression among women with PCOS, not all women with PCOS will experience depression.</li>
	<li>Various studies show a poor understanding of PCOS and its risk factors among participants<a href="#accordion">[8]</a>. According to research, poor awareness leads to negative outcomes for women<a href="#accordion">[7]</a>.</li>
	<li>Health policymakers should consider conducting awareness campaigns within different academic institutions to promote disease education and lower the stigma attached to it. 
	&nbsp;</li>
</ul>

[1] Moore M. Polycystic ovarian syndrome and depression. Psych Central

[2] Angela Grassi M. The connection between PCOS and depression. Verywell Health.

[3] What is the link between PCOS and depression? what to know. Medical News Today.

[4] What is the link between PCOS and depression? what to know. Medical News Today.

[5] Xing L, Xu J, Wei Y, et al. Depression in polycystic ovary syndrome: Focusing on pathogenesis and treatment. Frontiers.

[6] Peerwani G, Rozi S, Lakhdir MPA, Zuberi N, Asad N. Association of depressive symptoms and quality of life in Pakistani youth (15–24 years) with polycystic ovarian syndrome: A web-based analytical cross-sectional study. Frontiers.

[7] Rizvi M, Islam MA, Aftab MT, et al. Knowledge, attitude, and perceptions about polycystic ovarian syndrome, and its determinants among Pakistani undergraduate students. PloS one. May 25, 2023

[8] Kiran S, Sarwar H, Masih S. The knowledge and awareness on polycystic ovarian syndrome among lady health visitors in Public Health Nursing School Lahore: Knowledge and awareness on pcoss. Pakistan Journal of Health Sciences

[9] Frequency and risk factors for depression and anxiety in patients with polycystic ovary syndrome presenting in a Tertiary Care Hospital Karachi, Pakistan. Obstetrics and Gynecology Research

Understanding Transvaginal Ultrasound For PCOS

Transvaginal ultrasound is a diagnostic imaging technique that uses sound waves to create detailed images of the pelvic region, including the ovaries, uterus, and surrounding structures.

It is commonly used in the diagnosis and management of various gynecological conditions, including PCOS.

The presence of polycystic ovaries is one of the diagnostic criteria for <a href="https://merisehat.pk/disease/novel-drug-targets-discovered-for-pcos-therapy">PCOS</a>. The other two conditions include irregular menstrual cycles and hyperandrogenism. These cysts are small (usually just 8 mm in diameter) and are found right below the surface of the ovaries. A transvaginal ultrasound complements the diagnosis of the condition by providing visual evidence of ovarian morphology. 
&nbsp;

A normal, or external, ultrasound involves the application of a tiny amount of lubricant over the lower stomach and the ultrasound probe resting on top of the abdomen.

Internal ultrasound or transvaginal implies &lsquo;through the vagina.&rsquo; It&rsquo;s more sensitive and accurate than a transabdominal probe for evaluating the pelvis, especially the ovary, to identify the follicle size, number of follicles, stromal changes, and endometrial pathology<a href="#accordion">[4]</a>. 
&nbsp;

While a pelvic ultrasound can be used to examine both male and female pelvis, a transvaginal ultrasound is specifically for females to check the health of pelvic organs, including the cervix, uterus, fallopian tubes, endometrium, ovaries, pelvic cavity, or bladder.

Another difference is that transabdominal sonography is performed with an optimally filled bladder, whereas transvaginal sonography is performed with an empty bladder<a href="#accordion">[3]</a>.

However, personal or cultural barriers mean that transabdominal is often the only modality available, which can result in under- or over-diagnosis of PCOS. 
&nbsp;

Doctors may order one if the individual is experiencing any unpleasant symptoms, like abnormal bleeding or pelvic pain. 
&nbsp;

Transvaginal ultrasound allows the doctor to:

<ul>
	<li>Assess the uterus or ovary</li>
	<li>Identify potential causes of fertility issues</li>
	<li>Confirm signs of pregnancy</li>
	<li>Identify warning signs of early delivery or miscarriage</li>
	<li>Monitor the fetus&rsquo; heartbeat</li>
	<li>Determine how far along the person is in their pregnancy</li>
	<li>Identify conditions, like low-lying placenta</li>
	<li>Identify if an IUD is incorrectly placed</li>
</ul>

Additionally, it can help the doctor plan for surgery<a href="#accordion">[6]</a>. For instance, if there are any abnormal changes in the womb, they may order a biopsy to find out the cause. 
&nbsp;

Transvaginal ultrasound is a valuable tool for diagnosing PCOS based on the presence of certain characteristic features.

<ul>
	<li>Ovarian Morphology: Even though there are ethnic variations, PCOS patients reportedly have a higher number of follicles per ovary<a href="#accordion">[3]</a>. 
	Transvaginal ultrasound allows the visualization of these follicles or multiple small cysts, which can appear as a &quot;string of pearls&quot; pattern on the ultrasound image. The number of follicles on the ovary is counted to yield the antral follicle count, or AFC. 
	 
	A study published recently examined the diagnostic criteria for PCOS and found that transvaginal ultrasound is crucial for identifying the presence of polycystic ovaries<a href="#accordion">[1]</a>. 
	Another study investigated the relationship between ovarian morphology observed through transvaginal ultrasound and hormonal profiles in PCOS. The researchers found that ovarian volume and AFC were significantly correlated with hormonal imbalances<a href="#accordion">[2]</a>. 
	&nbsp;</li>
	<li>Ovulatory Dysfunction: PCOS often involves irregular or absent ovulation. Transvaginal ultrasound can help identify whether follicles are maturing and whether ovulation is occurring normally. 
	&nbsp;</li>
	<li>Ovarian Volume: Transvaginal ultrasound helps measure the ovarian volume. PCOS ovaries often have a larger volume compared to ovaries in individuals without PCOS. 
	&nbsp;</li>
	<li>Ovarian Stromal Hypertrophy: Increased ovarian stromal tissue is commonly observed in PCOS. 
	&nbsp;</li>
	<li>Exclusion Of Other Conditions: It helps rule out other potential causes of similar symptoms, such as ovarian tumors or cysts unrelated to PCOS. 
	&nbsp;</li>
</ul>

Information about the ovaries&#39; appearance and structures helps healthcare professionals develop appropriate treatment strategies, such as fertility treatments, for individuals with PCOS.

It also enables healthcare professionals to monitor the effects of treatment over time. For instance, it can show whether ovarian cysts are shrinking or if follicle development is improving. 
&nbsp;

Ideally, the scan should be performed on Day 2-7 of the menstrual cycle. This is because it will help prevent any growing follicle from modifying ovarian volume or hiding smaller follicles.

In the case of missed, infrequent, or irregular periods, scanning can be done at random or between the second and fifth days after the progesterone-induced bleeding<a href="#accordion">[3]</a>. 
&nbsp;

This includes:

<ul>
	<li>Schedule The Appointment: Call the doctor&#39;s office to schedule the ultrasound. Let them know it&#39;s for checking ovaries and PCOS.</li>
	<li>Inform The Doctor: It&rsquo;s best to tell the doctor about any existing health conditions or medications before the procedure.</li>
	<li>Empty The Bladder: The scan will be performed once the urinary bladder is sufficiently distended. This can make the procedure more comfortable.</li>
	<li>Wear Comfortable Clothing: The patient is asked to undress waist-down for the procedure. Or they can also opt for a hospital gown. Wearing comfortable clothing can help avoid unnecessary hassle.</li>
	<li>During Menstruation: It&rsquo;s also imperative to remove the tampon before the test in case the patient is menstruating and wearing one.</li>
	<li>Ask Questions: Don&#39;t hesitate to ask the doctor or the ultrasound technician if there are any concerns regarding the process. 
	&nbsp;</li>
</ul>

Typically, a transvaginal ultrasound entails:

<ul>
	<li>Privacy And Comfort: The person is taken to a private room. The technician will explain the procedure and make them comfortable.</li>
	<li>Positioning: The individual is asked to lie on an exam table and place their feet in stirrups, similar to a regular pelvic exam, so that their abdomen and pelvis are adequately exposed.</li>
	<li>Insertion Of The Transducer: A small, wand-like device called a transducer will be covered with a protective sheath (condom) and a lubricating gel. The technician will gently insert it 3-4 inches into the vagina.</li>
	<li>Imaging: The transducer emits high-frequency sound waves that bounce off the internal structures, including the ovaries, uterus, and nearby tissues. The scan should be done in both longitudinal and transverse planes. 
	The sound waves create real-time images on a monitor, allowing healthcare professionals to visualize the size, shape, and structures of the ovaries.</li>
	<li>Movement: The technician may move the transducer slightly to get different views of the ovaries.</li>
	<li>Inform About Discomfort: It&rsquo;s okay for patients to ask questions or let the technician know if the procedure makes them feel uncomfortable at any point. 
	&nbsp;</li>
</ul>

The procedure usually takes about 15-60 minutes. It&rsquo;s possible that it causes a bit of pressure or mild discomfort, but generally, it&rsquo;s not painful.

Some healthcare facilities also allow a friend or family member in if it makes the patient more comfortable. 
&nbsp;

A normal result means the pelvic structures are normal<a href="#accordion">[5]</a>.

An abnormal result may be due to many conditions. For girls or women with PCOS, problems include:

<ul>
	<li>Birth defects</li>
	<li>Benign growth (e.g., fibroids or cysts)</li>
	<li>Cancer (uterus, vagina, ovaries, and other pelvic structures)</li>
	<li>Infection (e.g., pelvic inflammatory disease)</li>
	<li>Twisting of the ovaries</li>
	<li>Endometriosis</li>
	<li>Ectopic pregnancy 
	&nbsp;</li>
</ul>

Transvaginal ultrasound is generally considered a safe and routine medical procedure. Unlike traditional X-rays, there is no radiation exposure with this test. 
&nbsp;

However, as with any medical intervention, there are some potential considerations to be aware of:

<ul>
	<li>Discomfort Or Pain: Some individuals may experience mild discomfort, pressure, or a sensation similar to a tampon insertion. However, this discomfort is usually brief and tolerable.</li>
	<li>Infection: While the risk of infection is low, there is a very small possibility of introducing bacteria into the vagina during the procedure. To mitigate this risk, healthcare providers typically follow strict hygiene protocols and use sterilized equipment.</li>
	<li>Vaginal Discharge: Sometimes, vaginal discharge may occur from the lubrication gel. However, it should stop within 24 hours of the exam.</li>
	<li>Vaginal Bleeding: In rare cases, transvaginal ultrasound may cause minor vaginal spotting or bleeding, particularly if the person is pregnant and is experiencing vaginal bleeding or has placenta previa.</li>
	<li>Allergic Reactions: It&#39;s extremely rare, but some individuals may have an allergic reaction to the lubricating gel used on the transducer or the materials of the transducer itself.</li>
	<li>Injury Or Trauma: The transducer is a gentle device, but in very rare instances, it can potentially cause minor injury to the vaginal tissues. Skilled and experienced healthcare professionals minimize this risk.</li>
	<li>Emotional Discomfort: Some individuals may experience emotional discomfort or anxiety due to the invasive nature of the procedure. Healthcare providers should communicate and provide support to address any concerns.</li>
</ul>

It&#39;s important to note that the vast majority of transvaginal ultrasounds are performed without any complications. 
&nbsp;

No, the ultrasound is a diagnostic procedure and doesn&rsquo;t affect fertility. 
&nbsp;

Transvaginal ultrasounds can be performed on both virgins and sexually-active girls and women. The decision to have a transvaginal ultrasound is based more on medical needs and the specific circumstances of each individual than on their sexual activity status.

Note: Trained healthcare professionals will conduct transvaginal ultrasounds. If you have concerns about the procedure or its implications, it is a good idea to discuss your questions with your healthcare provider beforehand. 
&nbsp;

<ul>
	<li>Transvaginal ultrasound is a medical imaging technique used to examine the pelvic region, particularly the ovaries and reproductive organs, in more detail.</li>
	<li>In the context of polycystic ovary syndrome (PCOS), transvaginal ultrasound is commonly employed to help diagnose and assess the condition.</li>
	<li>Besides confirming the presence of polycystic ovaries, a key diagnostic criterion of PCOS, it also helps healthcare professionals distinguish between other conditions with similar symptoms.</li>
	<li>Additionally, transvaginal ultrasound can be used to monitor the response to treatment and assess changes in ovarian morphology over time.</li>
	<li>It can also be used during pregnancy to monitor the progress of the fetus; usually, it&rsquo;s just once during the first trimester. However, it may be done more often if there are some concerns.</li>
	<li>It&rsquo;s recommended to empty the bladder before the procedure, wear comfortable clothing, and let the doctor know if there are any health conditions or concerns.</li>
	<li>Some individuals may feel some pressure or mild discomfort as the transducer is inserted and/or moved around in the vagina. However, it&rsquo;s a quick and routine procedure that&rsquo;s usually not painful.</li>
	<li>The risks of infection, bleeding, or injury during transvaginal ultrasound are minimal but exist. Skilled healthcare providers and adherence to hygiene protocols help mitigate these risks.</li>
</ul>

[1] Didier Dewailly and others, Definition and significance of polycystic ovarian morphology: a task force report from the Androgen Excess and Polycystic Ovary Syndrome Society, Human Reproduction Update, Volume 20, Issue 3, May/June 2014, Pages 334–352

[2] Nylander M, Frøssing S, Bjerre AH, et al. Ovarian morphology in polycystic ovary syndrome: estimates from 2D and 3D ultrasound and magnetic resonance imaging and their correlation to anti-Müllerian hormone. Acta Radiol. 2017;58(8):997-1004. doi:10.1177/0284185116676656