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PCOS – breaking the stereotype

PCOS - breaking the stereotype

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There is so much noise around women’s health. Specifically, PCOS and most of it seems to be scientifically incorrect. PCOS is one of the most common endocrine disorders in women, affecting one in four women of reproductive age, which is 25% of the entire female population, so it is only fair to bust the myths around it. Before we debunk the misconceptions, here’s a little about PCOS.

A little about PCOS

Polycystic Ovary Syndrome or PCOS is an endocrine disorder that affects the way a woman’s ovary works. Women who suffer from PCOS either have an irregular period, excess production of male hormone or polycystic ovaries (where there are multiple cysts on the ovary). The excess androgen and cysyts in the ovaries prevent ovaries from releasing eggs every month. However, the exact cause of PCOS is still unknown.

Let’s go on and bust the myths around it because separating myth from fact can help you live a healthier life with PCOS. 

Myth #1: Having polycystic ovary syndrome means you have cysts in your ovaries

This is untrue. The name of the disorder is very misleading. If you have PCOS, it doesn’t mean you have cysts in your ovaries and having cysts in your ovaries doesn’t mean you have PCOS.

To be diagnosed with PCOS, you need to have at least 2 of the following symptoms:

Let’s go on and bust the myths around it because separating myth from fact can help you live a healthier life with PCOS. 

Myth #1: Having polycystic ovary syndrome means you have cysts in your ovaries

This is untrue. The name of the disorder is very misleading. If you have PCOS, it doesn’t mean you have cysts in your ovaries and having cysts in your ovaries doesn’t mean you have PCOS.

To be diagnosed with PCOS, you need to have at least 2 of the following symptoms:

Let’s go on and bust the myths around it because separating myth from fact can help you live a healthier life with PCOS. 

Myth #1: Having polycystic ovary syndrome means you have cysts in your ovaries

This is untrue. The name of the disorder is very misleading. If you have PCOS, it doesn’t mean you have cysts in your ovaries and having cysts in your ovaries doesn’t mean you have PCOS.

To be diagnosed with PCOS, you need to have at least 2 of the following symptoms:

Excess androgen – elevated male hormones levels may result in physical signs, such as excess facial and body hair (hirsutism) and occasionally, severe acne and male-pattern baldness.

Irregular periods – this is when you have less than nine periods a year with more than 35 days in between your periods. 

Multiple cysts in your ovaries – your ovaries can be enlarged with tiny follicles that trap the eggs, preventing them from being released every month, causing the ovaries not to function properly. 

So, having just cysts in your ovaries doesn’t necessarily mean you have PCOS. 

If you have any of the above symptoms and would like to get professional advice, you can consult a gynaecologist from the comfort of your home via oDoc.

Myth #2: You can’t get pregnant if you have PCOS

INCORRECT! YOU CAN GET PREGNANT EVEN IF YOU HAVE PCOS. 

PCOS is a common cause of  infertility due to the irregular release of eggs from the ovaries and the hormonal imbalance which interferes with fertilisation, BUT this isn’t the case for everyone. You can still get pregnant both naturally and after fertility treatment. Many medications can stimulate ovulation which is the leading cause of infertility. Women with PCOS who want to start a family can try different fertility treatments. Have a sit down with your gynaecologist to understand your body and treatment options better.

Myth #2: You can’t get pregnant if you have PCOS

INCORRECT! YOU CAN GET PREGNANT EVEN IF YOU HAVE PCOS.

PCOS is a common cause of  infertility due to the irregular release of eggs from the ovaries and the hormonal imbalance which interferes with fertilisation, 

BUT this isn’t the case for everyone. You can still get pregnant both naturally and after fertility treatment. Many medications can stimulate ovulation which is the leading cause of infertility. Women with PCOS who want to start a family can try different fertility treatments. Have a sit down with your gynaecologist to understand your body and treatment options better.

Myth #2: You can’t get pregnant if you have PCOS

INCORRECT! YOU CAN GET PREGNANT EVEN IF YOU HAVE PCOS. 

PCOS is a common cause of  infertility due to the irregular release of eggs from the ovaries and the hormonal imbalance which interferes with fertilisation, BUT this isn’t the case for everyone. You can still get pregnant both naturally and after fertility treatment. Many medications can stimulate ovulation which is the leading cause of infertility. Women with PCOS who want to start a family can try different fertility treatments. Have a sit down with your gynaecologist to understand your body and treatment options better.

Myth #3: You can only get PCOS if you are obese or overweight

Again, nope. This is not true. PCOS is more common in overweight women than lean women, and obesity can worsen the symptoms, but it can affect women of any body type and size.

One of the causes of PCOS is excess insulin in your body. This happens due to your cells forming a resistance to insulin which causes your blood sugar level to increase, and your body might produce more insulin to tackle it. Excess insulin causes more androgen to be produced, which causes difficulty with ovulation. 

The body’s inability to use insulin properly can lead to weight gain. That’s why getting into the habit of eating healthy and exercising regularly is recommended as part of most women’s treatment plan.

Myth #3: You can only get PCOS if you are obese or overweight

Again, nope. This is not true. PCOS is more common in overweight women than lean women, and obesity can worsen the symptoms, but it can affect women of any body type and size.

One of the causes of PCOS is excess insulin in your body. This happens due to your cells forming a resistance to insulin which causes your blood sugar level to increase, and your body might produce more insulin to tackle it. Excess insulin causes more androgen to be produced, which causes difficulty with ovulation. 

The body’s inability to use insulin properly can lead to weight gain. That’s why getting into the habit of eating healthy and exercising regularly is recommended as part of most women’s treatment plan.

Myth #3: You can only get PCOS if you are obese or overweight

Again, nope. This is not true. PCOS is more common in overweight women than lean women, and obesity can worsen the symptoms, but it can affect women of any body type and size.

One of the causes of PCOS is excess insulin in your body. This happens due to your cells forming a resistance to insulin which causes your blood sugar level to increase, and your body might produce more insulin to tackle it. Excess insulin causes more androgen to be produced, which causes difficulty with ovulation. 

The body’s inability to use insulin properly can lead to weight gain. That’s why getting into the habit of eating healthy and exercising regularly is recommended as part of most women’s treatment plan.

Myth 4: Losing weight is how you get rid of PCOS

Unfortunately, there is no cure for PCOS, so losing weight will not make PCOS go away, but it can help manage many of the symptoms. It is said that 10% reduction in body weight can reduce clinical symtoms by 80-90%. Losing weight will help with balancing the hormones. Lifestyle changes, such as healthy eating and regular exercise, improve the way your body uses insulin and, therefore, regulates your hormone levels better, thus helping your symptoms.

Myth 4: Losing weight is how you get rid of PCOS

Unfortunately, there is no cure for PCOS, so losing weight will not make PCOS go away, but it can help manage many of the symptoms. It is said that 10% reduction in body weight can reduce clinical symtoms by 80-90%. Losing weight will help with balancing the hormones. 

Lifestyle changes, such as healthy eating and regular exercise, improve the way your body uses insulin and, therefore, regulates your hormone levels better, thus helping your symptoms.

Myth 4: Losing weight is how you get rid of PCOS

Unfortunately, there is no cure for PCOS, so losing weight will not make PCOS go away, but it can help manage many of the symptoms. It is said that 10% reduction in body weight can reduce clinical symtoms by 80-90%. Losing weight will help with balancing the hormones. Lifestyle changes, such as healthy eating and regular exercise, improve the way your body uses insulin and, therefore, regulates your hormone levels better, thus helping your symptoms.

Myth 5: Women with PCOS do not need to use contraception

If you are not planning on getting pregnant, then you should always use contraception during sex. As mentioned above, ovulation is irregular when you have PCOS, so you never know when the egg will be released. So if you want to avoid unplanned pregnancies, always use a form of contraception.

Myth 5: Women with PCOS do not need to use contraception

If you are not planning on getting pregnant, then you should always use contraception during sex. As mentioned above, ovulation is irregular when you have PCOS, so you never know when the egg will be released. So if you want to avoid unplanned pregnancies, always use a form of contraception.

Myth 5: Women with PCOS do not need to use contraception

If you are not planning on getting pregnant, then you should always use contraception during sex. As mentioned above, ovulation is irregular when you have PCOS, so you never know when the egg will be released. So if you want to avoid unplanned pregnancies, always use a form of contraception.

Myth 6: Irregular periods = PCOS

No! Having PCOS may mean that you might have irregular periods but there are various other factors which can lead to irregular periods such as stress, extreme dieting and other endocrine disorders. Regular periods range between 3-7 days and occur every 21-35 days. Anything longer than this can be considered irregular. If you are experiencing irregular periods, speak to a doctor to get more information.

Myth 6: Irregular periods = PCOS

No! Having PCOS may mean that you might have irregular periods but there are various other factors which can lead to irregular periods such as stress, extreme dieting and other endocrine disorders. Regular periods range between 3-7 days and occur every 21-35 days. Anything longer than this can be considered irregular. If you are experiencing irregular periods, speak to a doctor to get more information.

Myth 6: Irregular periods = PCOS

No! Having PCOS may mean that you might have irregular periods but there are various other factors which can lead to irregular periods such as stress, extreme dieting and other endocrine disorders. Regular periods range between 3-7 days and occur every 21-35 days. Anything longer than this can be considered irregular. If you are experiencing irregular periods, speak to a doctor to get more information.

These are just a few of the misconceptions about PCOS. If you want more information or are experiencing any of the symptoms mentioned in this blog, please seek medical advice from an SLMC registered gynaecologist or GP via oDoc. Do not self-diagnose or self-treat PCOS. 

Checked by Dr. Haroon Thowfeek and Dr. Mohamed Rishard

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Let’s Talk About HPV

Let’s Talk About HPV

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In Sri Lanka, sexual health is a topic rarely spoken about in the open. The taboo and social stigma surrounding this subject may inadvertently lead to sexually active Sri Lankans unaware of how to maintain a healthy sex life. Practicing safe sex is central to this as well as reducing the spread of sexually transmitted diseases (STDs), such as HPV.  

Perhaps you’ve heard about HPV but have been hesitant to ask about it with your loved ones or your doctor. Perhaps you’re sexually active and would like to know how to be safe with your partner, and having an understanding of HPV is one such way to do that.

Well, let’s talk about it!

What is HPV?

The human papillomavirus (HPV) is one of the most sexually transmitted infections in the world today. There are more than 150 different strains of HPV. Depending on the type of strain, HPV can cause warts anywhere on the body. Warts appearing on your genitals is very common. Up to 80% of sexually active adults will get an HPV infection of the genital area at some point in their lives, although many who carry the virus don’t even know it. 

You don’t need to panic if you find a wart on your body since the vast majority of warts are benign and non-threatening but speaking to a VOG doctor will ease your concerns. For a small number of women, certain strains of HPV can cause changes in the cervix that can become cancerous if not treated.

How do you get HPV?

HPV is spread by direct skin contact through vaginal, anal and oral sex with a partner who already has a genital HPV infection. Non-genital HPV infections can occur through skin to skin contact, such as shaking the hand of someone who has a wart on their finger.

What are the symptoms of HPV?

Symptoms of HPV, if they arise, typically appear in the form of a cauliflower-like growth called genital warts. They can also appear flat. Warts can be found around the vagina, anus, mouth and throat as well as the penis and groin. Symptoms usually take weeks or even months to develop after initial exposure. 

Non-genital warts can be found on the rest of the body, especially hands, face, neck, chest, and soles of feet. Some warts can be inside your body, therefore, impossible for you to notice. And in some cases, there might not be any symptoms at all.

How can your doctor diagnose HPV?

Your doctor can diagnose warts by examining the area. Most of the time, warts don’t need to be biopsied unless the doctor is concerned that the warts could be cancerous. A biopsy entails removing a small piece of tissue and examining under a microscope. 

If it’s possible that you have genital warts, your doctor will ask you about your sexual activity. 

  • For women, your VOG doctor will do a pelvic exam and pap smear. This includes removing cells from the cervix to test whether the cells are cancerous. An HPV test, which checks for the actual virus, can also be performed as well. 
  • For men, a physical exam can be performed. 

In the unlikely event that cancer is diagnosed, please speak to a doctor to further discuss the course of treatment.

How do you treat HPV?

Most warts can be treated at home with topical creams prescribed by the doctor. Other long-lasting methods of wart removal include:

  • Cryotherapy (freezing)
  • Cautery (burning)
  • Surgically removing the wart

In some cases, the wart may return. Therefore, you should take preventative measures to reduce the likelihood of getting an HPV infection.

How do you prevent an HPV infection?

Taking preventative measures is of critical importance when it comes to reducing your risk of infection or further spread of the virus. 

Practicing safe sex can greatly reduce the likelihood of getting an infection. This includes maintaining a low number of partners as well as the consistent use of condoms. 

The Centers of Disease Control and Prevention (CDC) recommends all children to be vaccinated before they become sexually active to prevent infection of high-risk strains of HPV. 

For all the ladies out there, an important preventative measure that you can take is visiting your VOG doctor on an annual basis for your routine check up. Your doctor may perform a pelvic exam to make sure everything is normal in your vagina, vulva, uterus, cervix, rectum, ovaries and fallopian tubes. Your VOG doctor might suggest performing a pap smear as well. Pap smears are important as it involves examining cells from the cervix under a microscope to identify any abnormal cervical changes such as precancerous cells. 

We hope you have a better understanding of HPVs now but if you have more questions or are concerned about other issues related to sexual health, you can get in touch with sexual health and VOG doctors on oDoc.

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Let’s talk about UTIs

Let’s talk about UTIs

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Chances are if you are a woman reading this, you’ve suffered from a urine tract infection (“UTI”) at some point in your life. Whether it has crept up on you or was caused by sex or other irritation, the constant urge to urinate, the pain and discomfort in the lower abdomen and seeing blood in the urine is enough to make anyone pretty miserable.

What is a UTI

Mayo Clinic defines a UTI as “an infection of any part of your urinary system (kidneys, ureters, bladder and urethra)”. More than half of all women are expected to suffer from a UTI at least once in their lifetimes and for some women, it can be a recurring, painful battle.     

Women are more prone to these bacterial infections as we have a shorter urinary tract compared to men so bacteria and toxins can cause trouble easily. An infection can start off in the bladder (cystitis) and move up to the kidneys & ureter (uretheritis).

What are the most common symptoms of a UTI?

UTI infection symptoms include the constant urge to pee, a burning sensation when peeing, passing small (to no) amounts of urine, cloudy urine (sometimes rosey coloured with blood) and pelvic pain. 

Older people with UTIs can present with confusion whilst in young children, it often manifests as fever and/or wetting themselves.

Why they occur

  • There are numerous reasons why these infections occur but the most common is human anatomy: the female urinary tract is short, the space between the anus and the urethra is shorter than it is for a male and therefore the distance gut bacteria have to travel to enter the bladder is shorter. 
  • Sex could lead to UTIs due to bacteria from the genital area entering the urinary tract.
  • It’s sometimes found to be a predisposition caused by genetics where females in certain families are more prone to UTIs.
  • Dehydration and limited water intake results in poor flushing of urine from the bladder causing bacterial build up.
  • Material of underwear makes a difference where nylon, spandex and lycra materials reduce the breathability in the area.
  • Hygiene is an important factor where wiping from back to front has caused E.Coli (bacteria) to enter from the gut/anus to the urethra.
  • Pregnancy often causes UTIs as the growing foetus puts pressure on the bladder and urethra causing urine to leak. During pregnancy, a woman’s urethra expands resulting in increased bladder volume but reduced muscle tone causing urine to become more “still” and allowing bacterial growth.

When to contact a doctor

If you experience or are experiencing UTI symptoms, contact an on demand family doctor/GP on oDoc to obtain immediate medical advice and treatment.

How are UTIs treated

Your doctor would generally prescribe you a course of antibiotics to treat the infection. It is vital that you continue to take the antibiotics even after your symptoms subside so as to not build antibiotic resistance to the drug.

Your doctor may request a urine test to ascertain the type of bacteria and match treatment. You can conduct the test from the comfort of your own home via oDoc’s oLabs mobile lab service.

How to prevent a UTI

Anyone who’s experienced a UTI probably never wants to experience one again!

Follow these preventative steps to keep UTIs at bay:

  • Make sure to not hold your pee in, if you need to go, go!
  • Pee before AND after sex to ensure bacteria are flushed out of the system.
  • Avoid wiping back to front.
  • Drink water, especially if you are only in the fledgling state of a UTI. Avoid caffeine and alcohol but gulp down litres of water to flush out the bladder.
  • Although the science is out on this one, Cranberry juice and supplements are said to help ease symptoms and prevent UTIs.
  • Wear cotton underwear, especially given this tropical Sri Lankan climate.

Whilst we may never be able to fully protect ourselves from contracting a UTI, following these simple steps can significantly reduce our chances. If you do develop one or are currently suffering from one, speak to a Sri Lanka Medical Council registered GP or family doctor on oDoc and obtain medical advice, treatment and ultimately, relief!

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Sources

  • Medina, M et al. (2019). An introduction to the epidemiology and burden of urinary tract infections. Thev Adv Urol, 11.
  • Foxman, B., (2003) Epidemiology of urinary tract infections: Incidence, morbidity, and economic costs., Elsevier.,49:53-70.
  • Hisano, M. et al (2012). Cranberries and lower urinary tract infection prevention., Clinics 67:661-667
  • Mayo Clinic, Urinary Tract Infections.
  • Platte, R. (2019) Urinary Tract Infections in Pregnancy., Medscape

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