Hormonal disorder among reproductive-age women

Part 1

IF you ask a man what polycystic ovary syndrome (PCOS) is and he can’t answer, that’s understandable. But asking a woman what PCOS is and she couldn’t tell you exactly what it is, then that’s another story.

But, frankly speaking, not too many women really understand what PCOS is. After all, it affects only about 5 percent to 10 percent of women ages 20 to 40 years old, according to Dr. Darleen Estuart, an obstetrician and gynecologist from Davao City. “It is a disease of the reproductive-age women,” she points out.

Take the case of Rose, a 32-year-old owner of a business firm. She grew up having irregular periods and battling her weight. When she was in her late 20s, her weight ballooned to 110 kilograms (kg). She felt lethargic and she stopped menstruating; she also began sprouting facial hair. She didn’t know it, but her ovaries were riddled with cysts. 


Alarmed, she went to see three doctors in a row, but there was no diagnosis. “They all said, ‘You need to lose weight,’” she says. 

Finally, Rose got an answer. She had PCOS, a condition in which her high levels of testosterone prevented her ovaries from releasing eggs, which then became cysts. “Two weeks into treatment, I got my first period in four years,” she says. In the three years since diagnosis, she lost 40 kg.

Dr. Patricia D. Maningat, an endocrinologist at Saint Luke’s Medical Center, considers PCOS as misleading “because not all women with multiple cysts in the ovaries have PCOS. She calls it “more than just a fertility problem.” 

“PCOS impacts several aspects of a woman’s life, including physical appearance, fertility, morbidity and quality of life,” says Maningat, a member of the Research Faculty at the University of the Philippines.

According to her, the hormonal milieu during a normal menstrual cycle of a woman causes the stimulation and development of a dominant follicle in the ovary, followed by ovulation in mid-cycle, and then by either pregnancy when the egg is fertilized by a sperm; or menstruation when no fertilization occurs.

In women with PCOS, “the ovaries are extra-sensitive to the stimulus of reproductive hormones, producing more androgens compared to estrogen.”  As a result of the imbalance, “several follicles are stimulated with no dominant follicle, leading to failure of ovulation.”


PCOS used to be called Stein-Leventhal syndrome when it was first recognized in the 1930s.  Until now, doctors still can’t figure out what causes it. Some studies suggest that genetics may be a factor. Sisters and daughters of a woman with PCOS may have a 50-percent chance of developing PCOS.

Abnormal insulin production and metabolism may also affect the development of PCOS. As Steven Dowshen, an American endocrinologist, puts it: “Women with PCOS may produce too much insulin, which signals their ovaries to release extra male hormones.” Research has also found that, when a woman does not ovulate normally for any length of time, polycystic ovaries often result.


PCOS often comes to light during puberty due to period problems, which affect around 75 percent of those with the disease. Infrequent, irregular or absent periods are all common variations, many finding their periods particularly heavy when they do arrive. The period disturbance is a sign that there is a problem with regular monthly ovulation. 

(To be continued)

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