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Interview
PCOS Experiences & Interviews
ONICOS in conversation with Asst. Prof. Onur Δ°nce
What is PCOS and how often should people go for check-ups for menstrual health? Can PCOS be detected before the menstrual cycle begins?
PCOS, or Polycystic Ovary Syndrome, is a condition where ovulation is irregular and hormonal balance is altered. But it is important to emphasize: it is not just a gynecological issue, but also a metabolic syndrome.
For menstrual health, the primary point of contact is the obstetrics and gynecology department. For individuals without complaints, an annual check-up is sufficient. However, if there are symptoms such as irregular periods, acne, weight changes, or excessive hair growth, a doctor should be consulted earlier.
It is generally not possible to definitively detect PCOS before menstruation starts, because we need information about the menstrual pattern and ovulation to make a diagnosis. However, high-risk individuals can be predicted and monitored.
For menstrual health, the primary point of contact is the obstetrics and gynecology department. For individuals without complaints, an annual check-up is sufficient. However, if there are symptoms such as irregular periods, acne, weight changes, or excessive hair growth, a doctor should be consulted earlier.
It is generally not possible to definitively detect PCOS before menstruation starts, because we need information about the menstrual pattern and ovulation to make a diagnosis. However, high-risk individuals can be predicted and monitored.
What is the difference between "Polycystic Ovaries" and "Polycystic Ovary Syndrome"? Does seeing cysts on an ultrasound alone mean someone has PCOS?
This distinction is very important. Polycystic ovaries refer to the appearance of numerous small follicles in the ovaries on an ultrasound. This is an imaging finding. Polycystic Ovary Syndrome, however, is a clinical diagnosis; meaning hormones, menstrual cycle, and clinical symptoms are evaluated together.
Let me put it this way: seeing cysts on an ultrasound does not mean disease on its own. We see this image in many healthy individuals as well.
Let me put it this way: seeing cysts on an ultrasound does not mean disease on its own. We see this image in many healthy individuals as well.
What are the different subtypes (phenotypes) of PCOS? Why don't all patients show the same symptoms?
PCOS is not a one-size-fits-all disease. There are different phenotypes. In some patients, menstrual irregularity is prominent, while in others, hair growth and acne are more noticeable. In some patients, we only see changes in hormone tests.
The reason for different symptoms in each patient is that factors such as genetic structure, insulin resistance levels, and lifestyle vary from person to person.
The reason for different symptoms in each patient is that factors such as genetic structure, insulin resistance levels, and lifestyle vary from person to person.
What is the most common misconception you encounter?
Far and away, it is: "If you have PCOS, you can't have children." This is not true. In fact, with the right treatment, we see many of our patients have completely healthy pregnancies.
What is the fundamental difference between the hormonal balance of a healthy individual and someone with PCOS? Which hormones specifically fall out of balance?
In a healthy individual, hormones work in harmony, and regular ovulation occurs. In PCOS, this balance is disrupted. In particular, an increase in insulin levels, an elevation in testosterone levels, and an imbalance between LH and FSH (the two main hormones regulating ovulation) are observed. While the LH hormone, which provides testosterone secretion, rises, we see a decrease in FSH, the hormone that starts egg development. This situation makes ovulation difficult and leads to menstrual irregularity.
What are the levels of Omega-3 or DHA in individuals with PCOS? Does taking supplements regulate hormones?
These levels do not necessarily have to be low in every patient. However, we know that Omega-3 can be beneficial due to its anti-inflammatory effects. Taking supplements does not "fix" hormones on its own, but it plays a supportive role.
What is the role of supplements like Inositol, Vitamin D, or Magnesium?
These are planned individually. Inositol may provide limited contribution, especially in patients with insulin resistance, though it doesn't create massive changes. Vitamin D and Magnesium can be used if there is a deficiency.
Can nutrition, exercise, and sleep really be as effective as medication?
Yes, in fact, for some patients, this is the first-line treatment. Think of it this way: at the cellular level, insulin balance improves, inflammation decreases, and hormones begin to function more healthily. Therefore, lifestyle change is the foundation of PCOS management.
Do PCOS symptoms end with menopause or do they change form?
Symptoms usually change form. Even if menstrual irregularity disappears, metabolic risks may continue.
What is Prolactin and is it related to PCOS?
Prolactin is the hormone responsible for milk production. When it is high, it can cause menstrual irregularity and can be confused with PCOS. Therefore, it is always evaluated during the diagnosis process.
Does the fear of "I won't have a baby" and stress really affect the process?
Yes, stress can affect hormones and make the process more difficult. But it must be stated clearly: PCOS is a highly manageable condition with the right approach. So, this fear often does not reflect reality.
What is the main cause of menstrual irregularity in PCOS? What are the long-term risks?
The main reason is the lack of ovulation. Not having a period for a long time can lead to uncontrolled thickening of the uterine lining, which can result in dangerous conditions like endometrial hyperplasia or endometrial cancer in the long run. However, this can be prevented with regular monitoring and appropriate treatment.
What risks can arise if PCOS is not treated?
In the long run, risks for diseases such as Type 2 diabetes, cardiovascular diseases, and uterine cancer may increase.
What is your view on herbal methods?
Some herbal products can be supportive. However, it is not possible for them to replace modern medicine. The most correct approach is to use them consciously and under a doctor's supervision.
Will PCOS treatment become easier in the future?
Especially thanks to genetic and metabolic studies, more personalized treatments can be developed. This can increase treatment success.
What is the most concrete fact you would tell a newly diagnosed patient?
First, I say this: This condition can be controlled. PCOS is a condition that can be managed with correct follow-up and treatment, and the vast majority of patients both lead a healthy life and can achieve pregnancy if they wish.
π‘ Key Takeaway
PCOS is a manageable condition. With proper medical guidance, lifestyle changes, and regular monitoring, individuals with PCOS can lead healthy lives and achieve pregnancy if desired. The key is early diagnosis and consistent treatment.