Poly Cystic Ovarian Syndrome: The invisible disorder that can wreck your mental health

(Read the article below)

With life becoming increasingly complex each passing day, the modern world has given rise to many health issue and illnesses, out of which the worst to manage are lifestyle disorders. For these are the conditions born out of the way you eat, breath, sleep, react to stressors, basically live your life.

And the problem with all these disorders is that they don’t have a sure-shot fix.

On top of that comes the intricate systems of female bodies. The potential for bad lifestyle practices and stress to mess up these delicate systems is substantial.

But even worse is the mental impact these lifestyle disorders have on the psyche of a female. Living with a lifestyle disorder means micro-managing every aspect of life, or you risk aggravating your physical conditions. And for many that in itself can be an exhausting exercise.

Poly Cystic Ovarian Syndrome is one such disorder whose sufferers are rapidly rising in number in the subcontinent of India, even though it isn’t a new condition.

Italian physician Antonio Vallisneri first described its symptoms in 1721. But it is shocking to see how it still lacks the awareness it deserves among the Indian female population.

Its worldwide prevalence varies from 2.2 per cent to 26 per cent. And, according to latest statistics, in India one in every four young women, among the six hundred and seventy-two million female population, is said to have PCOS.

But still the sufferer of this condition finds it challenging to get a diagnosis in time.

Lack of awareness about this condition is partly due to the stigma associated towards free conversation about female sexual and reproductive health in India. And partly due to the mentality of delaying investigation until symptoms worsen.

The early symptoms of Poly Cystic Ovarian Syndrome can seem very random and non-threatening at first.

Firstly, there are the indicating symptoms: excessive hair growth on the face and body, with balding scalp, severe cystic acne, unstable weight gain leading to obesity, painful and irregular periods, and infertility issues.

Then there is what is going inside your body, the hardcore stuff.

In PCOS many small, fluid-filled sacs grow inside the ovaries. These sacs are actually follicles, each one containing an immature egg. Irregularities in period happens when these eggs never mature enough to trigger ovulation.

The lack of ovulation alters levels of estrogen, progesterone, Follicle-stimulating hormone (FSH), and Luteinizing hormone (LH). Leading to lower levels of female hormones, i.e. Estrogen and progesterone and higher male hormones i.e. androgen.

The presence of extra male hormones in female body disrupt the menstrual cycle.

Giving women with PCOS fewer periods with irregular bleeding.

Although that’s not all that can lead to PCOS.

Blood sugar levels are regulated by insulin hormone, and with many females their bodies become insulin resistant leading to obesity. Basically, that’s when your body doesn't respond to the effects of insulin, so it produces even more of it and you feel hungry and eat more and gain weight.

As luck would have it, your insulin intake also affects your androgen levels, along with putting you on a fast track to diabetes. So, it's a vicious cycle of weight gain and irregulated hormones with PCOS.

Looking at all these problems that are happening to a female’s body, you may think “oh my god, that’s already too much, what more could go wrong?” To answer, still plenty much.

The mental toll living with a condition such as PCOS can be excessively taxing.

From obsessing about the arrival of periods, calculating the days/date when it’s supposed to come, and worrying if it gets late, to rearranging your whole life according to your menstruation in order to feel some sense of control in this unpredictable cycle of fertility struggling with PCOS.

Increased social anxiety over changes in looks and appearance, with thinning hair and increased facial and body hair, or sudden weight gain leading to increase in depression over self-worth associated with one’s appearance. It could even lead to anxiety in the work-life, as in that sector of the world good appearance is worth many rewards and sudden changes to that can lead to undesirability of the candidate.

A study conducted over fifteen years by the University of Oulu, Finland, on 5889 women, asked each participant (who was 31 years old at the beginning of the research) to fill in a questionnaire. The questions all focussed on their life satisfaction and health status (for example, their weight, height and the frequency of their periods), and the results found that the women with PCOS had "poorer quality of life" than whose without the condition – with mental health issues being the most common reason.

Another study by researchers from the Neuroscience and Mental Health Research Institute at Cardiff University, found that PCOS patients were more likely to be diagnosed with mental health disorders including depression, anxiety, bipolar disorder and eating disorders.

But all is not a lost cause in this case. There are several things you can do to help yourself while suffering with the negative mental effects of PCOS.

Firstly, just take your time and listen to what your body is trying to tell you. By that I mean, notice the little things that are happening to your body, don’t just automatically disregard them. First step to feeling better in any situation is self-awareness and then showing kindness to yourself for going through all the issues.

Next is establishing a healthy diet and sleeping schedule. Often, we over-work our bodies due to the demands of life. But learn where your breaking point is and then make yourself consciously stop working before you reach there.

This includes play time and partying too. Recognise the huge role sleep and a good diet plays in keeping both your mind and body working smoothly. Without a good amount of both, you will fall prey to many lifestyle disorders.

Then comes your exercise routine and your mentality towards it. Don’t see gyms and fitness centres as places you go with the motivation to “become skinny, become sexy” or “thin is beautiful” etc. But simply as a place that helps you keep your physical body working in the optimum levels. That includes flexible muscles to keep you moving swiftly, strength in bones to carry your weight, a good place to work to release those feel-good hormones Endorphins.

Don’t just relate importance of exercise with your weight or fat levels.

It is important for PCOS sufferers to reduce weight to improve their condition, but it is far more important for them to adapt a healthy attitude towards exercise and weight loss, or else the thought of it alone can push them further down the depression lane.

Then add practicing patience and meditation into your daily schedule. Just set aside 15-30 minutes each day and do any activity where you find yourself most focused plus also genuinely excited about.

Most common complaint with meditation is that people find it too difficult to “focus their thoughts” or “sit still for that long” or simply unable to “make it work” for them.

But when you think about the whole concept behind meditation, it is to increase your focus power, your patience levels, and make you calmer and happier. It’s all those things you feel when you do something of your genuine liking. You just have to learn to do those things more and maybe along the way find more things that make you feel the same.

Such things could be singing karaoke, or painting in any form, or dancing alone to your own beat, or reading a book, or walking in nature, or even daydreaming, etc.

Next adopt a mentality to get regular health check-ups, as per your financial abilities. If you suspect something is off, it is always better to get it checked earlier than putting it off for later and letting the problem grow.

Lifestyle disorders aren’t issues anyone can quick fix with medicine. Long term changes in your lifestyle is really the only way, as of now, to remedy them. Same is the case with most mental health issues. Time, hopeful attitude and constant efforts are the best ways towards betterment.

Read the stories of these two lovely ladies on how they found out what was going on in their bodies and came to terms with it.

Isha Agarwal

(Aged 22 years)

“I never realised small things could add up and create such a big problem for me. I was just a fresh-out-of-high-school girl, going from my small hometown Jaipur to go study in the big city Mumbai. I had my dreams and ambitions to work for, yes, but I also had to work a lot to adjust myself with that sudden and huge change in my lifestyle. Moving from the ‘sheltered-and-living-with-my-parents’ stage in life to the ‘independent’ living thing, you know. In hindsight, perhaps now I see all those little bad things that kept happening over and over that become my physical and mental health’s undoing.

My eating habits had drastically changed, like I was not eating at home, at all. Outings with friends also increased, and my intake of beer skyrocketed. So, by the end of my second year at uni, I had gained a lot of weight. But my periods were more or less same and I couldn’t feel any symptoms that would’ve made me feel something’s wrong or that I might have ‘PCOD’.

My insecurities regarding my body started when I saw my belly fat increase. Like, my whole life my body has pretty much been proportionated, even with weight fluctuations, and I’m okay with it. But this time it was different and that stressed me out.

And my stress increased quadruple times during my final year. I moved into a flat-share situation and found myself struggling to adjust with that change. Then stuff at uni also got stressful, final exams and all. And at the same time, I was facing problems in my love-life also.

So by the end of it, I started feeling a lot of negativity around me. Nothing would make me happy, and I wasn’t able to sleep, I started eating at odd hours, and just didn’t feel like engaging with friends or going out anymore. Everything felt too hard to manage.

Around the same time, I started getting problems with my periods also. My PMS symptoms worsened, and my periods used to get delayed by a week or so. I would also get heavy bleeding and such severe mood swings that for almost 15 days a month I would be crying my eyeballs out for one reason or the other.

All this drove me to stop eating only, as in I used to eat less and skip meals. And side by side I was also getting excessive scalp hair fall and hair growth on my legs and other parts of my body. But I didn’t know any better at that time, so I just chalked it down to random body stuff.

I remember taking a trip with friends in around April 2019, and I went to the resort, woke up after one night of partying and found myself unable to fit into any of my clothes, and with such severe bloating and depression, that I had a mental breakdown. And then I got my period shortly after.

So this time, I was totally sure that something was off with my body and feeling this way was not normal. I confided what was happening to me to a close friend and she told me how she also went through similar issues and found out after much medical investigations that she had PCOD. I spoke to another of my cousins, who had silently suffered from the same issues for years and only recently got diagnosed with PCOD even though her symptoms were textbook.

She took me to see a Gynaecologist, and that’s when I finally found out why I was going through all this hell.

Fast-forward to one and a half year from that trip, I have now moved back to my parents’ home, and with much adjustments and proper diet and regular exercise, I’ve done a full 180 to my lifestyle habits.

I just wish someone had told me earlier, that all that I was going through was not normal. And that I should get a check-up. Or that I myself had not taken so long to take my symptoms seriously and fixed my life.

[Earlier] I was miserable for a whole month, good for a week, and then miserable again. Now that has changed and become like two-four days of misery and then good to go for the rest [of the month].”

Akriti Haldia-Nowal

(Aged 29 years)

“I got married young, and ours was a love marriage so we weren’t bothered much about the concerns of conceiving children and all. At twenty-three I got married and by twenty-four I got pregnant and had my baby by the time I was twenty-five.

It all happened so fast that no body stopped to think there might be some hormonal imbalance going in my body. The fact that, by chance, I also had a complication free pregnancy and gave birth to my daughter smoothly, also never alerted me.

It was only last November/December I started to suspect something was off with my body when I started feeling faintish, weak and gaining weight. Despite the fact that I religiously exercise daily and have been exercising in one form or the other ever since I hit puberty.

So I went to consult my family doctor, who also delivered my first child, and she told me to get some tests done. I thought I might’ve gotten low blood pressure or thyroid but turns out, my doctor wrote me tests for PCOD.

I didn’t know what it meant at the time, and so I didn’t suspect all the things that were creating pains in my life, like losing my temper more easily before ‘that time of the month’ and having a 35 day cycle, basically delayed [menstrual] cycles were actually part of a problem. I just thought that’s the way my body went through it.

But then my test results came in and showed my LH and FSH hormones were too high. When I consulted my doctor again with these results, she said she always knew I had PCOD but since I never showed or complained about any of its symptoms, and also had a normal first pregnancy, it didn’t seem a big deal.

But it became a big deal to me now, because my family had started asking me and my husband questions like ‘when are you giving us another baby to play with?’.

Now how could I explain it to them what I was suffering from, or that my situations had become so severe that I had to take hormonal medicines to treat it. And I couldn’t have a baby even if I wanted to have one right now. Which I didn’t.

Social and family boundations created such pressures on my head that for a bit I just couldn’t even focus on my own health. All that mattered was getting an answer to their question of ‘when I’m having another child?’.

But after calming my heart, and a good discussion with my husband, I got back to realising the priorities of my life as of now. And that were getting treatment for my PCOD and focusing on healing my body which had been suffering probably ever since I was in my late teens.

It’s still very difficult living in this society knowing that as long as I can conceive easily, no one, not even my doctor thinks it is important to tell me what’s going on in my body. Even when they knew it all along. All because I never made any complaints about the bodily symptoms.”

NOTE: Created as part of class course-work at university; so its main focus was on the feature writing and producing effective magazine layout instead of ensuring use copyright free images.