By Evans Matthews
Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age globally, including in Nigeria. Despite its prevalence, many Nigerian women remain unaware or misinformed about the condition, often attributing its symptoms to cultural myths, spiritual beliefs, or unrelated health issues. This article seeks to demystify PCOS for Nigerian women by offering culturally relevant information about its causes, symptoms, diagnosis, treatment, and lifestyle management strategies.
What is PCOS?
PCOS is a hormonal disorder characterized by an imbalance in reproductive hormones, which leads to problems in the ovaries. In women with PCOS, the ovaries may develop numerous small cysts (fluid-filled sacs), and fail to regularly release eggs (ovulation).
The name “polycystic” can be misleading because not every woman with PCOS has ovarian cysts, and not every woman with ovarian cysts has PCOS.
Prevalence and Under diagnosis in Nigeria
Studies estimate that PCOS affects approximately 1 in 10 women worldwide. However, in Nigeria, the condition is often under diagnosed due to:
· Limited awareness among women and healthcare providers
· Social stigma surrounding infertility and menstruation
· Poor access to specialized reproductive healthcare in rural and semi-urban areas
A 2020 study conducted at the University College Hospital (UCH) Ibadan revealed that many young women with PCOS symptoms were unaware of the condition and had not sought medical help due to misinformation or fear of being labeled “barren” or “possessed”.
Causes of PCOS
While the exact cause of PCOS is unknown, several factors may contribute to its development:
1. Insulin Resistance
Many women with PCOS have insulin resistance, which means their bodies do not use insulin effectively. This leads to higher insulin levels, which may increase androgen (male hormone) production.
2. Hormonal Imbalance
Women with PCOS typically have elevated levels of androgens, which can interfere with ovulation, cause acne, and increase body hair growth.
3. Genetics
PCOS tends to run in families. If your mother or sister has PCOS, your risk may be higher.
Symptoms of PCOS
Symptoms can vary from one woman to another and may change over time. Common signs include:
· Irregular periods or missed periods
· Heavy bleeding during menstruation
· Acne and oily skin
· Excess facial and body hair (hirsutism)
· Weight gain or difficulty losing weight
· Thinning scalp hair
· Infertility or difficulty conceiving
· Dark patches of skin (acanthosis nigricans), especially around the neck and armpits
Many Nigerian women may ignore or hide these symptoms due to social pressures or fear of discrimination, especially when related to fertility.
Diagnosis
There is no single test to definitively diagnose PCOS. Diagnosis is typically based on a combination of:
1. Medical history and physical examination
2. Blood tests to measure hormone levels
3. Pelvic ultrasound to check the ovaries and endometrial lining
The widely accepted criteria (Rotterdam criteria) require that a woman has at least two of the following:
· Irregular or absent ovulation
· High androgen levels (tested via blood work or symptoms like hirsutism)
· Polycystic ovaries on ultrasound
Complications of Untreated PCOS
Without proper diagnosis and management, PCOS can lead to serious long-term health problems, such as:
· Infertility
· Type 2 diabetes
· High blood pressure
· Endometrial cancer
· Depression and anxiety
· Sleep apnea
· Heart disease
For Nigerian women, especially those with limited access to preventive care, these complications can go unnoticed until they become life-threatening.
PCOS and Fertility
Infertility is one of the most distressing aspects of PCOS, particularly in Nigeria, where societal expectations often pressure women to conceive soon after marriage. PCOS is one of the leading causes of anovulatory infertility (infertility due to lack of ovulation).
However, having PCOS does not mean a woman cannot get pregnant. Lifestyle changes and medical treatments can significantly improve the chances of ovulation and conception.
Treatment and Management
1. Lifestyle Changes
· Weight Management: Losing just 5–10% of body weight can help regulate menstrual cycles and improve fertility.
· Healthy Diet: Adopt a diet low in refined carbohydrates and sugar (e.g., cut down on white rice, sweetened beverages, and pastries). Include more fruits, vegetables, whole grains, and lean proteins.
· Exercise: Regular physical activity improves insulin sensitivity and helps with weight control.
2. Medications
Birth control pills: To regulate periods and reduce excess androgen symptoms
Metformin: A diabetes medication that improves insulin sensitivity
Clomiphene (Clomid): To stimulate ovulation for women trying to conceive
Anti-androgens: To reduce excess hair growth and acne
3. Natural Remedies
While some women explore herbal remedies, it’s essential to consult a qualified health professional before using them. Popular Nigerian herbal approaches (e.g., agbo) may have unknown effects or interact negatively with medications.
Social and Cultural Barriers in Nigeria
Cultural misconceptions remain one of the biggest obstacles in addressing PCOS in Nigeria:
· Infertility stigma: Women with PCOS often face mockery or rejection in relationships and marriages.
· Blame and superstition: Symptoms like hair growth or acne are sometimes seen as signs of “spiritual attack” or “bad blood.”
· Shame around menstruation: Many women hesitate to discuss irregular periods due to taboo.
Education, support groups, and public health campaigns are essential in breaking these stigmas.
Living with PCOS: Support and Coping
· Seek medical help early: Visit a gynecologist or endocrinologist if you suspect symptoms.
· Track your cycle: Use mobile apps or calendars to monitor changes in menstruation.
· Join support groups: Online or in-person communities can provide emotional support and advice.
· Mental health care: PCOS can cause depression, anxiety, and body image issues. Counseling can help navigate these challenges.
Conclusion
Polycystic Ovary Syndrome is a manageable condition, but awareness is key. For Nigerian women, the journey toward diagnosis and healing is often hindered by cultural misconceptions, lack of access to specialized care, and social pressure. By fostering open discussions, improving healthcare access, and empowering women with accurate information, we can ensure that no woman suffers in silence due to PCOS.
If you or someone you know is struggling with symptoms of PCOS, consult a healthcare provider. Early diagnosis and appropriate management can lead to a healthier, more fulfilling life.
References:
1. Olarinoye, J. K., et al. (2020). “Awareness and Perception of Polycystic Ovary Syndrome among Young Women in Southwestern Nigeria.” Nigerian Journal of Endocrinology and Metabolism.
2. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004). “Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome.” Fertility and Sterility, 81(1), 19-25.
3. Azziz, R., et al. (2016). “Polycystic ovary syndrome.” Nature Reviews Disease Primers, 2, 16057.
4. Mayo Clinic. (2023). “Polycystic ovary syndrome (PCOS) – Symptoms and causes.” https://www.mayoclinic.org/
5. World Health Organization. (2022). “Infertility.” https://www.who.int/news-room/fact-sheets/detail/infertility
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