Little-known condition that foils motherhood
● Childless at the age of 33, Marion Stevens found herself in a fertility clinic, where she was diagnosed with polycystic ovary syndrome (PCOS), a hormonal disorder that causes a woman to make too few of the hormones needed to ovulate.
It took her two more years to fall pregnant after a reproductive biologist changed her diet and put her on a contraceptive pill, one of the only treatments for a disorder that is linked to numerous other health conditions, including insulin resistance, obesity, nonalcoholic fatty liver disease, diabetes and even depression.
Even though PCOS affects up to 15% of women of child-bearing age, it is hardly talked about. And a campaign to change that suffered a blow last weekend when physician and radio personality Dr Sindi van Zyl died of Covid-19 complications.
Dr Sindi often spoke publicly about her struggles with PCOS and encouraged women to normalise conversations around health problems and not feel isolated and ashamed.
In the aftermath of Dr Sindi’s two-month battle for survival in the intensive care unit of a Johannesburg hospital, a new UK study has found that women with PCOS have a 51% increased risk of contracting Covid-19 than their peers.
But Stevens, a Cape Town midwife and reproductive health policy expert, said this knowledge may fall on fallow ground because most women — particularly those who rely on public health care — have no knowledge of the syndrome.
“As it is generally not widely diagnosed in the public sector, the main response is through treating noncommunicable diseases and chronic diseases of lifestyle such as diabetes and obesity,” she said.
“The physical manifestations of PCOS are not generally treated and there is shame and stigma attached to some of these features.”
Stevens said many women on outdated contraceptives had become used to irregular periods and weight gain. This resulted in PCOS remaining undiagnosed.
“Being large is also viewed as attractive and not a health risk,” she said.
A Centurion gynaecologist and fertility specialist, Dr Qinisile Diale, said PCOS remained “vastly” undiagnosed, partly because other endocrine, ovulatory and androgen-excess disorders have to be ruled out before a PCOS diagnosis is confirmed.
Diale said many women focused only on the noticeable effects of the condition and were “unaware of the submarine-like major health complications of PCOS such as obesity, diabetes and hypertension”.
Exercise, healthy eating and weight loss were some of the best ways to minimise the syndrome’s effects, she said. “Even a 10% weight reduction can trigger normal ovulation and make a difference in fertility.”
Dr Zane Stevens of the Cape Institute of Endocrinology said the main link to Covid19 was underlying obesity, diabetes, hypertension and cardiovascular disease, “all of which are risk factors to severe disease”.
Johannesburg psychiatrist Dr Antoinette Miric said about two-thirds of women with PCOS are overweight.
A Cape Town gynaecologist, Dr Peter de Jong, said awareness was improving, with many women empowering themselves with information, mostly from the internet.
“Many are not surprised, having googled their symptoms already before seeing a specialist.” He said the best preventative measures against PCOS were eliminating junk and unhealthy foods, avoiding smoking and doing moderate exercises.