Polycystic Ovary Syndrome (PCOS) in Singapore

What is Polycystic Ovary Syndrome (PCOS)?

PCOS is a common condition due to hormonal imbalance that results in infrequent or absent ovulation that affects 10-15% of women in the reproductive age group. It is diagnosed based on 2 out of 3 criteria:

  1. Irregular periods, or infrequent/no periods at all
  2. Polycystic ovaries: many follicles on pelvic ultrasound (fluid-filled spaces within the ovary that release eggs)
  3. Higher-than-normal male hormones: this can either be clinical (e.g. acne, excessive face/body hair growth, balding) or biochemical (high testosterone on blood test)

Having one of the above does not necessarily mean you have PCOS – you should discuss this with your gynaecologist.

What causes Polycystic Ovary Syndrome (PCOS)?

The exact cause of PCOS is currently unknown, although if your relatives (e.g. mother, sister) are affected, your risk of developing PCOS may be higher.

What are the symptoms of Polycystic Ovary Syndrome (PCOS)?

Symptoms of PCOS include:

Irregular periods

Women with PCOS commonly experience irregular periods, where they can go for weeks/months without having periods or have erratic spotting.

Weight gain

If you have PCOS, you may experience weight problems including experiencing a rapid increase in weight, being overweight or having difficulty losing weight.

Extra Facial or Body Hair

Women with PCOS have unwanted hair growth on areas like their face, chest, abdomen, back and limbs, which may require frequent shaving. Excessive hair growth is known as hirsutism.

Dark skin patches

Polycystic Ovary Syndrome (PCOS) may make you develop velvety or dark-looking skin patches. This is harmless, but it may make you self-conscious of your appearance.

Thinning of scalp hair

Hair on the scalp may fall out in a similar pattern to male pattern baldness.

Persistent Acne

Persistent acne that doesn’t respond to acne treatment can sometimes be a sign of PCOS.

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What health issues can PCOS cause?

Diabetes

Women with PCOS tend to have insulin resistance (poor response to insulin hormone, which controls the level of sugar in the body). 1-2 in 10 women with PCOS will develop diabetes at some point, especially if they are over 40 years old, have relatives with diabetes, have a history of gestational diabetes (GDM) or are overweight.

High blood pressure

This is usually related to the metabolic syndrome that is commonly seen in women suffering from PCOS.

Increased risk of endometrial cancer

If you frequently go beyond 3 months without periods, the lining of the uterus can thicken and lead to endometrial cancer in some women. Depending on your fertility plans, your gynaecologist will advise you to take medications to induce your periods.

Depression/ mood swings

The above issues may affect your self-esteem and cause you to feel low or down.

How is PCOS treated in Singapore?

PCOS is a lifelong disease, and your treatment will depend on factors like your symptoms and fertility plans.

Here are the common treatment options for PCOS in Singapore:

Lifestyle modifications
  • Eat a balanced, low carbohydrate diet with small frequent meals that include fruits, vegetables, wholegrain foods (brown rice), lean meats.
  • Cut down on sugar, salt, fried foods and desserts.
  • Exercise regularly – at least 45 minutes 5 times a week of moderate intensity
  • Aim to keep your body mass index (BMI) below 30 – sometimes seeing a dietician can help.

Only a 5-10% weight loss can make a difference to your health!

Go for regular check-ups

See your family physician yearly for diabetes, blood pressure and cholesterol check if you are 40 years and above (earlier if your BMI is above 30); if your tests return abnormal, you may need to change your lifestyle and/or go on medications. 

Hormonal medications
  • Medications to induce periods are typically recommended if you have irregular or heavy periods, or have gone without periods for over 3 months
  • Certain medications e.g. birth control pills can help to manage other issues of PCOS e.g. acne/ hirsutism 
Fertility treatments
  • These include medications to trigger ovulation, and in-vitro fertilization (IVF)
  • Medication to reduce your insulin resistance e.g. inositol may be helpful 
Hormone Pills