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PCOS Treatment in Singapore
Polycystic Ovarian Syndrome, known as PCOS, is a hormonal disorder prevalent in women of reproductive age. It causes enlarged ovaries with small cysts on the outer edges. It is characterised by prolonged or infrequent menstrual periods or excess androgen levels.
PCOS is associated with an array of health issues, including infertility, metabolic syndrome, type 2 diabetes, obesity, and heart disease.
Dr Daphne Lee
MBBS
MRCP(UK)
FAMS
Symptoms
Symptoms vary among individuals with PCOS. Common symptoms include:
- Irregular Menstrual Cycles: This is one of the most common signs of PCOS, where women experience infrequent, irregular, or prolonged menstrual periods.
- Excess Levels of Androgen: Elevated levels of male hormones may result in physical signs such as excess facial and body hair (hirsutism), severe acne, and male-pattern baldness.
- Larger Ovaries with Many Small Follicles: Enlarged ovaries containing numerous small follicles may be identified through an ultrasound. This symptom is not present in all women with PCOS.
- Weight Gain: Many women with PCOS are overweight or obese.
- Changes in Skin Condition: This includes acne, skin tags, and darkening of the skin, particularly in the neck, groin, and underneath the breasts.
- Hair Thinning: Women may experience thinning hair on the scalp in a pattern similar to that of men.
Causes
Polycystic Ovarian Syndrome (PCOS) is a complex endocrine disorder, and its exact cause is not yet fully understood. Studies suggest a link to the following factors:
Genetic Predisposition
There is evidence suggesting a hereditary component in PCOS. Women with a family history of PCOS are more likely to develop the condition. Specific genes associated with insulin resistance, hormone regulation, and inflammation are being studied for their role in PCOS development.
Insulin Resistance
An aspect of the pathophysiology of PCOS is insulin resistance. High levels of insulin in the bloodstream can lead to excess production of androgens by the ovaries. Elevated androgen levels are a sign of PCOS and contribute to the disruption of normal ovarian function.
Hormonal Imbalances
PCOS is characterised by an imbalance of hormones. Apart from increased androgens, there is often an altered ratio of female hormones which can impede normal ovulation.
Inflammation
Chronic low-grade inflammation has been observed in women with PCOS. This inflammation can stimulate polycystic ovaries to produce androgens, which can exacerbate insulin resistance and hormonal imbalance, creating a cyclic effect.
Complications
PCOS is not limited to ovarian health and can lead to several complications impacting overall well-being.
- Infertility: PCOS is a major cause of infertility, due to the irregular ovulation or absence of ovulation.
- Metabolic Syndrome: This includes conditions such as high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels that increase heart disease risk.
- Type 2 Diabetes and Prediabetes: Women with PCOS are at a higher risk of developing diabetes due to insulin resistance.
- Sleep Apnoea: Repeated pauses in breathing during sleep are common in women with PCOS, particularly in those with obesity.
- Endometrial Cancer: Irregular menstrual cycles and the absence of ovulation can lead to the thickening of the uterine lining, increasing the risk of endometrial cancer.
Diagnosis
A combination of clinical evaluation and specific tests are used to diagnose PCOS.
- Medical History: A thorough review of menstrual cycles, symptoms, and medical history, including family history of PCOS or related health issues.
- Physical Examination: A physical exam to check for signs of PCOS, such as excess hair growth, acne, and skin discolouration.
- Blood Tests: These tests check for higher levels of androgens and other hormones, insulin resistance, and glucose tolerance.
- Pelvic Ultrasound: A sonogram assesses the ovaries’ appearance and the uterine lining’s thickness.
Treatment Options
The treatment of PCOS involves a personalised approach, primarily aimed at managing endocrine imbalances and managing the specific symptoms and health risks associated with the condition.
Insulin-Sensitising Medications
Medications such as metformin are used to improve insulin sensitivity in women with PCOS. By reducing insulin resistance, these medications can help lower androgen levels and restore regular ovulation and menstrual cycles.
Hormonal Treatments
Birth control pills containing a combination of oestrogen and progestin can help regulate menstrual cycles, reduce androgen levels, and alleviate symptoms like acne and excess hair growth. In certain cases, other hormonal medications may be recommended for specific symptoms.
Ovulation Induction
For women with PCOS who are trying to conceive, medications that stimulate ovulation, such as clomiphene citrate or letrozole, may be prescribed. These treatments aim to induce the release of an egg to facilitate conception.
Dr Daphne Lee
MBBS
MRCP(UK)
FAMS
Dr Daphne Lee has special interests in the comprehensive management & treatment of diabetes, adrenal and pituitary conditions.
Qualifications
- MBBS (National University of Singapore, Singapore) 2006
- MRCP (Royal College of Physicians, United Kingdom)
- Fellow, Academy of Medicine, Singapore (FAMS)
- Registered with Specialist Accreditation Board (SAB)
- Registered with Singapore Medical Council (SMC)
Before private practice, Dr Daphne Lee was a consultant endocrinologist at Khoo Teck Puat Hospital. During her time there, she also ran the pituitary and adrenal clinics.
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Mount Elizabeth Novena Specialist Center
38 Irrawaddy Road, #07 - 63,
Singapore 329563
Gleneagles Medical Centre
6 Napier Road, #03 - 10,
Singapore 258499
Frequently Asked Questions (FAQ)
Can Women with PCOS Get Pregnant?
While PCOS is one of the leading causes of infertility due to its impact on ovulation, many women with PCOS can and do become pregnant. Consulting an endocrinology specialist can provide tailored guidance and treatment options to improve fertility in women with PCOS.
Can Lifestyle Changes Help with PCOS?
Lifestyle modifications, including diet, exercise, and weight management, play a role in managing PCOS. These changes can improve the body’s sensitivity to insulin, help regulate menstrual cycles, and reduce symptoms such as weight gain, acne, and excess hair growth. Reach out to our endocrinologist to receive personalised guidance based on your specific condition.
What Happens if PCOS is Left Untreated?
If left untreated, PCOS can lead to various long-term health issues, including type 2 diabetes, cardiovascular problems, and endometrial hyperplasia, which can increase the risk of endometrial cancer. Regular monitoring and appropriate treatment can help mitigate these risks. Individuals with PCOS symptoms should consult with an endocrinology specialist for an accurate diagnosis and management plan.
Can PCOS Ever Be Fully Cured?
Currently, there is no cure for PCOS. The symptoms can be effectively managed, and the associated health risks can be reduced with proper treatment. Management of PCOS typically includes a combination of lifestyle changes, medications, and regular medical follow-up. Individuals with PCOS should maintain an ongoing relationship with their endocrinologist for optimal management of the condition.