Infrequent Menstruation, PCOS

If PCOS has been confirmed then it is a matter of managing the condition. As you have mentioned that you are married for two years and I can imagine that at some point you will think of starting your family. So I will mention some points in that context as well.

PCOS and irregular Periods

PCOS is a condition that affects 3% to 7% of all women and the classical symptoms are irregular menstrual periods - typically periods delayed for weeks. Often they are heavy as well. And there is a tendency of putting on weight and having excessive hair on face etc (hirsuitism). Since the underlying problem is lack of ovulation, such women can often find it difficult to get pregnant.

In case you ARE NOT trying for a baby

If you are not trying for a baby, all you need to is to give some sort of regularity in the cycles. That generally means giving oral progesterone tables for ten days every 5 to 6 weeks. This of course is over simplification of the treatment. You will need a gynaecologist to help you with starting and monitoring your treatment.

In case you ARE trying for a baby

If you are trying for a baby the answer is ovulation induction. The success rate for doing this is quite good so all reason for feeling positive about it.

Laparoscopic ovarian drilling is a treatment that some gynaecologists recommend, but it is something that many of us find too destructive. It involves drilling holes in your ovary with electro-cautery or laser. It sounded quite logical 30 years ago when it was first done, as the thick ovarian capsule was seen as the main problem. Today some of us think it causes unnecessary loss of ovarian follicles and gives no lasting benefits. Ovulation induction by medicines is preferable any day.

What is PCOS?

Main underlying problem of PCOS is that eggs (follicles) start growing but the normal process of having a single dominant (by 5th day of the cycle) follicle does not happen. Instead many follicles grow up to the size of 10mm or beyond. These follicles locate themselves under the ovarian capsule (periphery) and are seen in ultra sound scans as a pearl necklace. This description should be seen as more euphemistic than romantic and the condition has various other manifestations because of the hormonal imbalance.

Since ovulation doesn’t happen, there is no progesterone secreted in the second half of the cycle. This is what creates irregular periods. The predominant hormone is then estrogen and testosterone or testosterone like hormones (androstenedione, DHEA etc). This causes various unwanted symptoms like facial hair and .. generally, obesity, increased appetite, loss of scalp hair, acne etc. When obesity happens over a long period there are other complications linked with obesity such as hypertension and diabetes.

It is important to note that PCOS being so common is seen in a wide range of manifestations and there is no one single picture that represents it. Unfortunately every girl who is told that she has PCOS will get terribly anxious and that doesn't help at all.

Many a times you will end up reading a list of even further problems and that can worry you a lot. This is the problem of internet wherein to your situation and unless it is interpreted in your circumstances the only thing it will do is cause anxiety.

Managing PCOS

Yoga and weight loss is always helpful, however that is not easy at all times. Losing weight in PCOS is many times more difficult because of the excessive testosterone hormones which gives you a good appetite and increases your muscle mass. But regular exercise is helpful even if there is not enough weight loss as it reduces insulin resistance which has a deeper association to PCOS.