LIVING WITH POLYCYSTIC OVARIAN SYNDROME

During my early teens, as an eleven years old girl, I was introduced into womanhood, the beginning of menstruation. Every girl looked forward to this moment especially when her peers are already experiencing it. As a conservative Muslim, you get to learn about puberty if not in school during sex education, from Islamic school where you are thought what it is and how to take care of yourself during this period, what you should be doing and what you shouldn’t. sadly enough, you don’t get to hear parents, I mean mothers to be precise, talk about this with you. They only react and frighten you about what menstruation implies only after you experience it for the first time.

After a few years of becoming a woman due to the monthly vaginal bleeding every woman experienced, I began to notice that I wasn’t a normal woman. At the age of sixteen I realized that I did not bleed often, months past and it didn’t come. I started to gain weight, which I thought was normal perhaps I was “growing up”. At the age of seventeen, it became distressing and exciting at the same time, I would think to myself, why don’t I menstruate like my elder sisters do monthly? All the while nobody knew about this. It was exciting because I forgot how menstruation could be painful with all the premenstrual syndrome associated with this process. My distress outweighed my excitement and I decided to open my mouth. I told my female family members, the ones experiencing it of course, which means my mother got to know about it. Her first response was she had never experienced such ever since she started menstruating as a teenager up until now. My elder sisters also had never experienced what I was experiencing. It was abnormal, as such I decided to see a doctor at the age of eighteen to complain about my mysterious periods. With no laboratory tests conducted or any physical examination, he concluded that it happened to some women, even those that were older than myself, he tried to explain to me that it could be that I wasn’t mature enough. He talked about how he thought my hypothalamus was not fully developed and could be the reason why I had this hormonal imbalance that prevented my monthly periods. Don’t worry it will become regular he assured me.

Let me not forget to add that the monthly vaginal bleeding was not completely off, it was irregular, it could take three months to see the next one. Having less than nine periods for a whole year, at most six to seven. I took the doctor’s advice and believed I was just fine maybe my brain was not well developed after all. Until I was nineteen, I fell ill and was taken to the hospital, and during consultation the doctor asked me when last I saw my period, my response was three months back. He exclaimed, how old are you? I answered nineteen, are you married? at this point I became embarrassed because my father was standing right next to me. No, I answered with my face looking at the tiled floor. He asked, are you sexually active? at this point I told him, I had been like this for the past three years. So he said to me, this is not normal, I mean if you were fourteen years old, it could be considered totally normal but at nineteen, I advise you see a gynecologist if it persist at twenty. I was very ashamed to talk about my experience with friends, so I never spoke about it with any of them. It felt bad, especially when they complained about menstrual cramps, I did not want to hear any of it. It felt like I was lesser of a girl.

My mother later told me that I was totally fine and normal. She told me she had a friend who was like me and yet she had five beautiful kids. What my mother said gave me a glimpse of hope perhaps, I was just like her friend. But she kept on asking and sought for remedies for my “normal” menstruation. That’s how the idea of scent leaf juice came along. I would take it every morning before breakfast, the first time I tried it, I think it coincided with my next cycle and I had a period that month but after that it never came due to my recent “juice” consumption. Early this year, I decided to see another doctor because it became one of my unsolved mysteries, I needed to get to the bottom of this. I just knew I wasn’t normal probably because I started to research and that is when I first came across the term polycystic ovarian syndrome. I read through it and what I learnt about the symptoms of this condition made me believe that I suffered from this condition because I had observed some of these changes with my body. But I needed a doctor, a specialist to diagnose me, to get possibly a second opinion from another specialist. Before I finally got to see a specialist, I sought the opinion of three other doctors.

The first doctor requested an abdominal ultrasound scan be done with several laboratory test including a PT test, urinalysis and a FBC blood test. Which I all did, and which all indicated I was normal. On seeing my ultrasound scan, the second doctor told me my ovaries were fine and suggested I got a hormonal assay done on LH and FSH hormones. He told me the test were quite expensive but I had it done anyway. After two weeks I got the result which showed normal FSH Levels and abnormally high levels of LH. When I took my test result, I met another doctor and this time it was a female doctor, I felt free because she was a woman she should understand better what I was going through. She read through my medical history and she thought it was time I was referred to a specialist, a gynecologist.

My first appointment with a gynecologist was a frustrating one. I had to wait for hours before I finally got to see her, it was a long queue. When I gave her a brief history about my menstrual mystery and why I came, she decided to ask me some personal question:

Gynecologist: how old are you?

Me: twenty years’ old

Gynecologist: when did you start menstruating?

Me: at eleven

Gynecologist: have you gained weight over the past few years?

Me: yes

Gynecologist: has anyone in your family experienced what you are experiencing?

Me: none that I know of

Gynecologist: have you noticed any facial or increased body hair growth?

Me: yes, around my chin

Gynecologist: do you have a family history of heart disease or diabetes?

Me: none that I know of

Gynecologist: do you have any married sister with fertility problems?

Me: no

Gynecologist: are you planning to get married

Me: no

At this point we both started laughing, because I said no with all confidence and she said to me,” you shouldn’t say no, you should say not soon, because we all plan to marry one day, don’t we?”

She later suggested I go for another hormonal assay, this time progestogen and testosterone levels should be ascertained. Also, my blood sugar level, with two hours postprandial and fasting blood sugar tests. She also had quick physical lower abdominal examination. After she palpated several areas and asked if I felt any pain which I responded with a no throughout the examination, she asked me to return with my test results but she told me she thought I suffered from PCOS but she needed a confirmatory test. I presented the results of my test after a week and this time I met another gynecologist, she was very friendly just like the first one. She concluded on looking at my test result that I am indeed suffering from PCOS, although progestogen was normal, she mentioned that free testosterone was elevated and is responsible for the facial hairs(hirsutism). She decided to put me on combination pills which I had refused when the first specialist offered to prescribe it for three cycles. Now I had to comply because it had concluded that I had PCOS.

What is polycystic ovarian syndrome?

Polycystic ovarian syndrome(PCOS) is a hormonal disorder common among women of reproductive age. It is estimated that one in every ten women of reproductive age suffer from this condition worldwide. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone(androgen) levels. The ovaries may develop numerous small collection of fluid(follicles) and fail to regularly release egg. The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce risk of long term complications such as type 2 diabetes and heart diseases.

What are the signs and symptoms of this condition?

PCOS often develop around the time of first menstrual period during puberty. Sometimes PCOS develops later, in response to substantial weight gain. Signs and symptoms of this condition vary from woman to woman but, one should consult a doctor when you experience at least two of these sign

Irregular periods; infrequent, irregular or prolonged menstrual cycles are common signs. A term referred to as oligoamennorrhea and in some cases amenorrhea when period ceases completely. Fewer than nine periods in a year, more than thirty-five days between periods and for some people abnormally heavy periods.
Excess androgen; elevated levels of male hormone may result in physical signs such as excess facial(hirsutism) and body hair and occasionally severe acne and male pattern baldness
Polycystic ovaries; your ovaries might be enlarged and contain follicles that surround eggs, as a result the ovaries might fail to function regularly. This can only be observed with a lower abdominal ultrasound scan
When do you get worried?

Seek medical consultation when you have concerns about your menstrual periods, if you are experiencing infertility or if you have signs of excess androgen such as worsening hirsutism (facial hair growth), acne and male pattern baldness.

What are the causes of PCOS?

Excess androgen
Heredity
Low-grade inflammation
Excess insulin
If not diagnosed and managed, what happens?

Some of the long term complication of PCOS includes;

Infertility
Gestational diabetes or pregnancy induced high blood sugar
Miscarriage or premature birth
Metabolic syndrome; a cluster of conditions including high blood pressure, high blood sugar and abnormal cholesterol or triglycerides level that significantly increase risk of cardiovascular diseases, type 2 diabetes, sleep apnea, depression, anxiety and eating disorders, cancer of the uterine lining (endometrial cancer
At this point, I would like to mention why I made the decision to see different doctors and eventually a gynecologist. Once, during a lecture on women’s health, we discussed PCOS. It felt like she was talking to me most of the things my lecturer said that day felt like this lecture was for me, although I had started making research and had come across PCOS before, but she made it a little clearer to me. She mentioned symptoms, causes, complications and obviously treatment options, I mean that is why I am in pharmacy school right! I got very disturbed and depressed and I decide it was time to face my reality, I was not normal.

Why am I sharing this story?

It is definitely not easy to tell your personal story and experiences especially if it has to do with your health but you might just save someone, you might make someone out there feel they are not alone. I am sure that there are many of me out there and many a times people live with this condition undiagnosed. Some result to fetish and spiritual consultations probably because they’ve been considered infertile, you might just be suffering from PCOS.

I appeal to anyone who gets the chance to read this article, you should try and forward this message. For those who are experiencing some of the above listed signs, do not feel shy or lose yourself, do not get depressed because you’re developing facial hair, severe acne or male pattern baldness. You might be suffering from PCOS, all you need to do is see a doctor to talk about your health, you might save yourself from future complications of this condition.

PCOS HAS NO KNOWN CURE BUT CAN BE MANAGED EFFECTIVELY, LIFESTYLE CHANGES INCLUDING WEIGHT LOSS, DIETARY CHANGES AND DRUG MANAGEMENT LIKE THE USE OF COMBINED ORAL CONTRACEPTIVE PILLS TO LOWER ANDROGEN LEVELS.

A LADY SEEKING TO MAKE IMPACT
http://insightfulobserver.com.ng/blog/2018/12/23/living-with-polycystic-ovarian-syndrome-my-story/

Cc:
Dominique, sissy3