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Tuesday, May 4, 2010

Polycystic Ovarian Syndrome (PCOS)

Entri ini sebenarnya berpunca dari pencarian lepas dapat penerangan tidak lengkap daripada doktor. Ia bermula selepas kejadian pendarahan dan kehilangan bayi yang kami nantikan.. Daripada ultrasound image, doktor pakar tu asyik cakap "ni polycystic, ni pun polycystic"... So, apa maksudnya tu doktor?. "Tu semua lemak, badan naik banyak. Sebab tu hormon tak stabil." Apa kaitan dengan keguguran? Doktor tu bukan nak terangkan betul-betul.. bercakap pun tak nak tengok muka, sambil sms. Geramnya.. Dapat ubat 7 biji, kena rm80. Huhu..

Apakah yang dimaksudkan dengan Polycystic Ovarian Syndrome (PCOS)? Menurut MedicineNet.com, "Polycystic ovarian syndrome (PCOS), also known by the name Stein-Leventhal syndrome, is a hormonal problem that causes women to have a variety of symptoms. It should be noted that most women with the condition have a number of small cysts in the ovaries. However, women may have cysts in the ovaries for a number of reasons, and it is the characteristic constellation of symptoms, rather than the presence of the cysts themselves, that is important in establishing the diagnosis of PCOS."


Dikatakan, 5-10% wanita mengalami PCOS (i'm one of them), dan dikatakan penyebab utama ketidaksuburan wanita. Antara simptom-simptom PCOS ialah:

1) Obesiti dan kenaikan berat badan (obesiti? not yet. Weight gain. Yes, oh yes)
2) Elevated insulin levels and insulin resistance
3) Kulit berminyak
4) Kelemumur
5) Masalah kesuburan
6) Skin discolorations
7) Tahap kolesterol tinggi (maybe)
8) Kenaikan tekanan darah (yup)
9) Multiple, small cysts in the ovaries.
10) akne
11) Sleep apnea - excessive snoring (very currently) and breathing stops at times while asleep (takutnyer)
12) skin tags, or tiny excess flaps of skin in the armpits or neck area (tak obvious pun)
13) patches of thickened and dark brown or black skin on the neck, arms, breasts or thighs (ni tak paham sangat, kulit jadi gelap ke? kalau tiba2 terlebam tu adalah).
14) male-pattern baldness or thinning hair.
15) infrequent menstrual periods, no menstrual periods, and/or irregular bleeding. (dah dua bulan tak period, 4kali test pregnancy sume negatif).


Mungkin tidak semua simptom ini dialami oleh mereka yang mengalami PCOS. Tetapi, semua wanita dengan PCOS akan mengalami masalah kitaran haid yang tidak stabil atau tidak menentu. Malah ada yang tidak datang haid sama sekali. Ini kerana, wanita PCOS tidak mengalami ovulasi atau pengeluaran ovum setiap bulan. Sebab tu lah period tak stabil dan dan susah mengandung. Melalui imbasan ultrasound, Polycystic tersebut akan kelihatan seperti ini:-
This is exactly how my ultrasound image looks like (ada masa makcik upload k). Antara punca PCOS adalah:-
1) Imbalance in the hormones
2) Genetic
3) Environmental factors
4) Sometimes, unknown causes


Suggestion of treatment from http://www.youngwomenshealth.org/pcosinfo.html is by taking birth control pills to:-

  • Correct the hormone imbalance
  • Lower the level of testosterone (which will improve acne and lessen hair growth)
  • Regulate your menstrual periods
  • Lower the risk of endometrial cancer (which is slightly higher in young women who don't ovulate regularly)
  • Prevent an unplanned pregnancy if you are sexually active
Weight management tips pulak:-
  • Choose nutritious, high-fiber carbohydrates instead of sugary or refined carbohydrates
  • Balance carbohydrates with protein and healthy fats
  • Eat small meals and snacks throughout the day instead of large meals
  • Exercise regularly to help manage insulin levels and your weight
Seperti soalan yang ditanya kepada so-called doktor pakar, jadi apa kaitannya polycystic dengan miscarriage? Ini Q & A dari satu artikel http://www.womenshealth.gov berkenaan PCOS:-

Q: How does PCOS affect a woman while pregnant?
A: Women with PCOS appear to have higher rates of:
• Miscarriage
• Gestational diabetes
• Pregnancy-induced high blood pressure (preeclampsia)
• Premature delivery

Jadi sangat mengecewakan apabila seorang doktor pakar tak dapat memberi penerangan yang terang. Sekurang-kurangnya beliau boleh menjawab seperti ini,"Puan mengalami PCOS yang menyebabkan hormon tidak stabil dan boleh menyebabkan keguguran. Jadi, saya cadangkan puan menurunkan berat badan sebelum merancang untuk hamil semula." Dan bukan jawapan yang berbunyi,"Saya bagi ubat untuk period. Lepas tu, cuba lagilah" (sambil ber'sms' dan tersenyum sinis.



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