Physical Challenges Operating in Secret – the intimate health issues nobody cares about

Here at Inspirited Minds we try our best to explore interesting and diverse topics, and this month’s chosen theme is no different. This month we are taking a closer look at health issues (female edition). The reasons for this are three-fold:

1     We know that the link between physical and mental health is intricate and becoming more relevant in the current age, making an individual’s physical health a key topic when considering their mental health. We hope that each of our articles this month will prove to be excellent examples of this interaction between the physical and the mental.

2     Often-times in our cultures, the woman’s health remains secondary, untouched, or ignored – especially by the men in their lives, whether they be their father, brother, or husband. This is our endeavour to shed light on relevant and important women’s health issues as well as showcase how men can play a role in this, either by being supportive or in other ways

3     Knowing about these issues can hopefully help members of our communities take a closer look at their health and wellbeing, and understand any unexplained experiences they may be going through. It is difficult to accept having a shortcoming or a health issue that may not have a clear-cut cure, but understanding them makes the process of acceptance easier and the process of managing them or recovering even better.

So, with these reasons in mind, we decided to delve into this deep and multi-layered theme of women’s health issues. Throughout the course of this month we will hope to cover topics such as infertility, physical appearance, menopause, learning difficulties and polycystic ovarian syndrome (PCOS). Now some of these topics, like learning difficulties and physical appearance issues, may also be experienced by males, so please do stick around guys – you may glean something new and interesting.

This week we’re going to look at polycystic ovarian syndrome or PCOS, which is a very widespread female condition affecting between 2-30% of women of post-pubertal age (i.e. 16-44 years of age). PCOS is a genetically complex endocrine disorder defined by a set of commonly occurring symptoms, and being an endocrine disorder means it affects the endocrine system – a collection of glands throughout our body that produces a range of different hormones which regulate, amongst other things, our metabolism, mood functions, reproductive cycles and circadian rhythm.

The list of symptoms for PCOS is long, so here are but a few of the common ones:

• Hyperandrogenism: Elevated levels of androgens or masculinizing hormones are a classic symptom of PCOS and are present in most cases, in the form of acne, hyper-menorrhea (see below), hirsutism (see below), and androgenic alopecia (thinning of the hair or increased hair loss). High levels of testosterone and androstenedione hormones circulating in the blood denote hyperandrogenism.
• Irregular menstrual cycles: Most women may experience oligomenorrhea, which is fewer than 9 menstrual periods in a year, or amenorrhea, which is no menstrual periods for 3 or more consecutive months. Some women may also experience both or have other menstrual disorders, such as heavy bleeding (hyper-menorrhea).
• Hirsutism: This is the increased growth of hair around certain body parts, such as the face, chin, underarms, chest, and gonadal regions. This is usually because of excess male hormones within the female body.
• Metabolic syndrome: A tendency to gain weight and suffer from obesity, or difficulty in losing weight is also common in PCOS. Research has shown this to be related to metabolic disturbances, mainly insulin resistance. This is when the amount of insulin produced by the body to regulate blood sugar is not properly used or metabolised because the body is not responsive to the insulin as it should be. This leads the body to overproduce insulin, which in-turn produces more androgens.
• Skin conditions: In PCOS, the skin can appear to darken and become oily in patches around the body, particularly around the neck creases, underneath the breasts and around the gonadal area. Small skin tags, which are small excess flaps of skin, can also develop around the neck and armpit area.
• Infertility: Women with PCOS have reduced fertility, mostly due to chronic anovulation (lack of ovulation of the ovarian egg), and those women that successfully conceive might suffer from pregnancy-related complications and an increased risk of miscarriage.
• Ovarian cysts: Many women who have PCOS do not have the actual cysts in their ovaries, but just present with irregular hormone levels. There are women who have multiple cysts in their ovaries of various sizes that can usually be removed by surgery, but research has shown that removing the cysts does little to alleviate the other symptoms of the syndrome.
• Mood changes: Having PCOS can cause rapid mood swings that are usually related to low energy levels and imbalanced hormones. Women can also experience increased stress, fatigue, insomnia and sleep disorders, depression and anxiety.

We know this is quite a hefty list, but bear in mind that every individual is unique – therefore every woman will experience a differently unique and diverse combination of symptoms. Keeping the biological and medical aspects of PCOS aside, this syndrome is intimately related to mental health. In addition to mood changes and psychological stress-related issues, women with this syndrome are more prone to suffer from eating disorders, recreational drug-related issues, psycho-sexual dysfunctions, low self-esteem and insecurity, and high levels of emotional distress (Veltman-Verhulst et al., 2012). Not to mention the challenging emotion and psychological distress arising because of the intimate symptoms of this disease like obesity and acne, that can challenge a woman’s identity and body image within society.

This is not to say that all hope is lost! Even though PCOS has no cure, its symptoms can be managed and looked after, allowing the woman to live a long and healthy life – even with a big happy family of her own if she would want. With a balanced mix of lifestyle changes, medical treatments, and a disciplined and organised approach to one’s health, even women with severe PCOS have become healthy and happy. Believe us when we say – it’s difficult. It’s difficult to accept that it’s happening. It’s difficult to get on top of it and stop allowing it to control you. It’s difficult to create a conducive environment around yourself with supportive individuals and strict lifestyle choices. It’s difficult knowing that people in your life and in your community will not understand or believe your extra weight or extra hair or extra acne. It’s difficult – but not impossible.

So those of you experiencing PCOS, or anyone of you who knows someone experiencing PCOS – be supportive, mindful and understanding. Making regular comments about one’s weight or skin, no-matter how well-intentioned, can be unhelpful and alienating. Remember that anyone could be experiencing something personal and intimate, whether its PCOS or something else, it could be your friend, sister, wife, mother or daughter.

If you want to know more about PCOS and support groups for women experiencing PCOS, check out: PCOS UK, Wellness Muslimah, Verity, PCOS Awareness Association, Soul Cysters, and PCOS Diet Support.

Do you have any accounts of PCOS you would like to share in the comments below?