Not getting your period? It could be stress, obesity or PCOS
By Maliha Rehman
Roshaanay Zafar desperately wanted to have a baby. She lived in a joint family and her two elder brothers-in-law had three children each. Her home usually swarmed with children. As a housewife, Roshaanay’s free time was spent playing with her nieces and nephews - but she longed for a child of her own.
“My husband and I had been married for three years by then, and we had never used contraceptive measures,” she recalls. “Still, I wasn’t able to conceive.” Finally, she decided to consult a gynaecologist. “My menstrual cycle had always been irregular, sometimes I would miss my period for two months in a row,” she explains. “My doctor told me that my menstrual cycle would have to be regulated so that I could have a baby. For this, I had to lose weight.”
Roshaanay went on a strict diet. For seven months, she ate only fruit, vegetables and boiled white meat. After she managed to lose nearly 15 kg, her menstrual cycle became regular. Four months later, she conceived.
According to Dr Fauzia Nasir, a gynaecologist at Bismillah Taqi hospital, irregular menstrual cycles are a very common problem among women, both married and unmarried, these days.
“Generally, the problem is not very serious nor is it usually irreversible. Hormonal imbalances within the body disturb the menstrual cycle, which is often a result of stress or obesity. The girl just has to relax or seriously try to lose weight, through exercise and diet control.” However, if the problem persists, then a number of tests are carried out to test the level of glucose or sugar in the body. “If the proportions are wrong, it indicates that the patient is suffering from Polycystic Ovarian Syndrome (PCOS),” says Dr Fauzia. “In that case, the medicine Metformin, or Glucophage, is orally given to her. We only perform surgery in the most chronic cases of infertility.”
“Normally, in a woman’s body, the two ovaries are filled with follicles or cysts,” says Dr Neelam Zubair, another gynaecologist. “These follicles contain eggs. At the time of ovulation, the matured egg is released from the follicle. In the case of women with PCOS, the ovaries do not make all the hormones necessary for ovulation. The eggs do not mature and many of the follicles remain as cysts, filled with liquid. These cysts produce male hormones, which prevent ovulation and since ovulation does not occur, the hormone progesterone does not get made. Eventually, the menstrual cycle ceases completely.”
Dania Asad discovered that she suffered from PCOS after one year of marriage. Her ultrasound revealed that the cysts in her ovaries were so large that they may have existed from before her wedding. “I went to the gynaecologist only when I was unable to conceive,” says Dania. “I missed my menstrual period every alternate month but had hitherto never considered it unusual. I had thought that it was just the way my body functioned.”
Dania’s gynecologist told her that surgery would have to be performed. A slight incision would be made in her ovary in order to rupture the cysts. “I was scared by the thought of surgery,” remembers Dania. “So, I sought a second opinion. This second doctor told me that she would first try to regulate my menstrual cycle by making me follow a strict diet plan. However, if this failed, she also recommended surgery.” Luckily for Dania, losing weight managed to get her menstrual cycle back on track.
Dr Neelam Zubair cites irregular menstrual periods as only one of the symptoms of PCOS. “There are other symptoms also,” she informs. “They include thick facial and chest hair, acne, dandruff, obesity, hair loss and high blood pressure.” The exact cause of PCOS is not yet known. “It can be genetic,” says Dr Neelam. “It can also simply be due to obesity.”
Most women find out that they have PCOS only after marriage. However, even unmarried girls may be suffering from this syndrome. Perturbed by her thick facial hair, 15-year-old Nilofer Zain went to a gynaecologist - only to discover that she had PCOS. Neither she nor her mother had ever considered her slightly irregular menstrual cycle a cause for concern. Dr Razia Korejo states that with the right treatment, an irregular menstrual cycle - due to PCOS or any other reason - can usually be corrected. “Girls just need to go to a doctor as soon as they notice irregularities in their menstrual periods,” she advises. “If they ignore these irregularities, there is a chance that the cysts in their ovaries will become larger over time. Ovulation could then cease completely, leading to chronic infertility.”
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