Getting to Know PCOS, One of the Causes of Difficulty in Getting Pregnant
Some women have more difficulty conceiving than others. One of the causes is hormonal and ovulation disorders such as polycystic ovary syndrome or polycystic ovary syndrome (PCOS).
This syndrome makes it difficult for women to ovulate because the eggs are small and make cycles irregular. However, don't worry because people with PCOS can still get pregnant even though they need special treatment.
On that basis, Pondok Indah Group Hospital held a discussion entitled "PCO Syndrome & Infertility" on Thursday (27/5/2021). With dr. Gita Pratama, Sp.OG-KFER, M.RepSc, a specialist in obstetrics and gynaecology who practices at Pondok Indah IVF Center Hospital, let's get to know this topic more deeply, let's go!
1. Irregular menstruation is a sign that ovulation is not happening
Is your menstrual cycle on time, or is it often late? Said dr. Gita, regular cycles are a reflection of regular ovulation.
Normally, the cycle ranges from 21-35 days. How do we know ovulation is taking place? The signs are firm breasts, increased libido, bloating, a little pain in the lower abdomen until mucus with a texture like egg white comes out of the vagina.
"The suburban period can be known from the menstrual cycle. For example, the menstrual cycle is once every 28 days, then 28 minus 14, that is the day of ovulation," explained Dr. guitar.
2. Usually, PCOS patients have irregular periods and abnormal eggs
PCOS patients often experience delayed menstruation, ranging from a week to months. To overcome this, the doctor will give drugs to induce menstruation.
After being given the drug, blood spots come out. It can even be accompanied by clots or blood, dr. Gita explained.
In addition, when an ultrasound (USG) was performed, the ovaries were abnormal. The eggs produced are small, numerous, and do not enlarge during the periphery.
"Disorders of egg size in the egg will prevent fertilization. As a result, pregnancy does not occur," said Dr. guitar.
The long-term impact of PCOS patients who do not menstruate for more than 2-3 months will experience the risk of thickening of the uterine wall. In addition, endometrial cancer may occur later in life.
3. What are the appropriate steps for dealing with PCOS?
There are at least four main treatments for PCOS, namely lifestyle modification, fertility drug therapy for patients who want to get pregnant, drug therapy to regulate menstruation in patients who are not planning to become pregnant, and drug therapy to improve insulin resistance.
Visceral fat deposits (excess fat in the abdominal cavity) can increase the risk of the syndrome and insulin resistance. This is why people with PCOS must change their diet to be healthier and exercise regularly.
"It is important to maintain normal body weight (BMI) and a waist circumference of less than 80 cm. If it is above 80 cm, there is a risk of obesity," said Dr Gita warned.
Choose carbohydrates with a low glycemic index, such as brown rice and whole-grain bread. Increase fibre at least 25-30 grams per day and healthy fats that omega-3 from sea fish or avocados contain. Don't forget to do at least 250 minutes of moderate-intensity exercise per week.
In terms of drugs, which is given is metformin about 500-2,000 mg per day. The goal is to increase the body's ability to take insulin and make it regular, explained dr. Guitar.
Medications to trigger ovulation are also given, such as clomiphene citrate, letrozole, to injections of the hormone FSH (gonadotropin). If it still doesn't work, and in vitro fertilization (IVF) program is highly recommended.
What if you have menstrual disorders, frequent bleeding, and bleeding? The doctor will suggest hormonal drugs such as birth control pills to make your periods regular.
"The birth control pill can reduce the risk of thickening the uterine wall, reduce excess androgen hormones, to reduce acne. However, hormonal drugs should not be given to certain patients, such as hypertension patients," he concluded.