Tuesday, 8 March 2016

Polycystic Ovary Syndrome (PCOS): The ‘Silent Disorder’ in Kashmiri Women

By: Raashid Mumtaz

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Polycystic ovary syndrome (PCOS) or Hyper androgenic anovulation, an endocrine disorder which causes infertility among women, is nowadays common in Kashmiri women.

The number of patients diagnosed with PCOS is adding day by day in Kashmir. Women find it hard to cope with such a problem. Unmarried girls fear marriage, which has led to one of the causes of late marriage. Irony is that PCOS has led to late marriage and late marriage has led to PCOS. Married women with PCOS often faces humiliation, like if they have done a crime which leads to post Traumatic Stress Disorder (PSTD), which makes this problem even more worse and directly affects the birth of child.

Various studies have been conducted in the Kashmir which actually puts the percentage of women suffering from PCOS anywhere between 5 -10%.

A study carried out by SKIMS Soura, on 112 women diagnosed with PCOS to decipher the prevalence of psychiatric disorders among women with PCOS.

The main findings were high rates of depression and anxiety disorders like Generalized Anxiety Disorder (GAD) and Obsessive Compulsive Disorder (OCD) among 52% of them. This suggests the significant relation between Stress and PCOS.

This might scare you, but its true, one among the five women has this disorder. The worst part of this is that it’s incurable although treatable.

The most recent Indian National Family Health Survey (NFHS) indicates that at least 60% of Kashmiri married Women report one (PCOS) or more reproductive health problems which is significantly higher in comparison to the national average of 40%. Why it occurs in Kashmiri women?

Studies on PCOS in Kashmir have identified stress, as one of the major causable factor for the emergence of PCOS in Kashmir.

Another cause of Infertility in Kashmiri women due to PCOS is late marriage. Women now like to pursue higher education or Employment than Marriage because of economic instability or insecurity which often gives place to anxiety thus affecting the reproductive life of women.

Nowadays, school going girls are also diagnosed with PCOS; the reason may be because of throat-cut competition in the class which often disturbs their psychological health and nowadays, parents put much pressure on their wards which often proves harmful for them.

If students fail to secure first position in exams, they often face wrath from their parents; they are humiliated, which in turn disturbs their mental state and reproductive health and some usually end up with suicide. Thus stress is actually a function of the demand placed on us and our ability to meet them.

Kashmir as a conflict zone is also related to the infertility due to the conflict induced stress. Every time we witness killings, tortures, explosions, rumours which affect our life especially of women. Women suffering from depressive disorder should seek psychiatristric help rather than medical intervention so that actual problem would not get overlooked.

Recent study has revealed that 70% of the PCOS diagnosed patients are obese which is one of the physiopathological feature in patients with PCOS, the other being Insulin resistance.

During Stress Glucocorticoids, especially cortisol, the primary stress hormone gets elevated which increases the insulin resistance and affects the fat and protein metabolism and hence results to condition known as obesity. LH/FSH level gets disturbed which results in hyperandrogenism and a halt in the follicle development. Increase in Androgen level cause intense masculinizing effects throughout the body. Women develop virile characteristics, including growth of a beard, a much deeper voice, occasionally baldness. In less severe cases, it may cause irregular menstrual cycles. However, when activated by Stress, Pituitary gland produces increases amount of Prolactin hormone which in turn could cause galactorrhea (Production and Spontaneous flow of breast milk) and Infertility. As it is incurable so it’s important to take control of the situation and make mandatory changes in your lifestyle like regular exercise.

So get off that chair, you can break the cycle of Insulin resistance by daily workout. Medical experts are of the opinion that foods with low Glycaemic index (GI) should be preferred for consumption like vegetables, Fruits etc.

(Author is an MSc Student at the Department of Clinical Biochemistry, University of Kashmir.)



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