Lifestyle disease deals fair sex an unfair blow

Are you a female aged between 13 and 50, overweight and cannot exercise due to a hectic routine? Is your menstrual cycle highly irregular? Then beware, for you might be suffering from Polycystic Ovarian Disease (PCOD). Deepa Suryanarayan finds out that this genetic problem can be heavily influenced by diet and lifestyle. Doctors say that the incidence of this disease has increased two-to-three folds in the recent years

Like 90 per cent of working women in the city, 26-year-old advertising professional Anita Sharma too, has a stressful job. “I’m on my feet from the moment I wake up. My routine involves preparing food for my family, commuting to my office, which is about an hour away, and then meeting deadlines at work,” she explains.

Sharma, at 5’1” weighs 70kg and also grapples with weight issues, as she has no time to exercise. She realised that something was amiss when she noticed that her menstrual cycle had become highly irregular.

“I started getting my periods once every 15 days, and to make matters worse I had heavy bleeding,” she says.

Ghatkopar-resident Anjali Khanna, 41, is a home-maker with a Body-Mass Index (BMI) of 42 (much above the acceptable measurement for her height). Khanna visited a gynaecologist when she observed hair-growth on her chin.

Seventeen-year-old Anshuya Nair suffers from acne. “Initially, I attributed it to teenage hormones. But a visit to a gynaecologist revealed that it was more than that,” says Nair.

The three women, though from different age groups and backgrounds, share the same problem, Polycystic Ovarian Disease (PCOD), “a genetic problem that can be heavily influenced by diet and lifestyle,” explains Dr Duru Shah, a gynaecologist at Breach Candy Hospital and President of the Federation of Obstetrics and Gynaecologists Society of India (FOGSI).

“Although it existed 15 years ago as well, in recent years, incidence of PCOD have increased almost two-to-three fold as have cysts, fibroids, endometriosis, and breast cancer,” says Dr Pratima Chippalkatti, consultant gynaecologist, Bombay Hospital, who attributes it to stress and lifestyle changes.

PCOD, though not a life-threatening ailment is definitely a “lifestyle-threatening problem,” as Sharma puts it. According to gynaecologists, about 30 to 35 per cent women in India suffer from PCOD.

“The disease affects women in the reproductive age group — 13 to 50 years — and is the most common reason why young women have irregular periods,” says Dr Shah, who sees an average of five patients suffering from symptoms of PCOD daily.

The exact cause of PCOD is yet to be determined. “We do know that genetics play a role. So, if your mother, aunt or grandmother suffered from PCOD, chances are you will too,” she adds.

“Most of my patients are already aware of PCOD as someone in their family already has a history of the disorder,” agrees Dr Nandita Palshetkar, infertility specialist, and gynaecologist at Lilavati Hospital.

The National Institute for Research in Reproductive Health (NIRRH) is currently researching the genetic aspect of PCOD, by conducting tests on the blood samples of family members of those suffering from PCOD.

“Many people know about PCOD, but are not aware of wider implications of the issue. Their only concern is the symptom, like acne, hirsutism and irregular periods, not the disease itself. The disease, if left untreated, can be dangerous and cause problems like metabolic syndrome (high cholesterol, high sugar, high blood pressure). These patients later become diabetic, develop cardiac problems, are more likely to die of a sudden heart attack at a younger age or develop cancer of the uterus,” says Dr Shah.

But there is hope. “Maintain your weight and 50 per cent of the problem is solved,” advises Dr Shah.

“Lack of physical activity is the biggest culprit. Adding to the problem is the wrong diet and stress. No wonder, more and more women are suffering from it,” says Dr Chippalkatti.

However, according to Dr Palshetkar, there are two types of patients who suffer from PCOD. “There are lean patients, who despite having their weight under control, have other symptoms of PCOD. The condition comes to the fore when they consult a gynaecologist for infertility treatment. And then there are obese PCOD patients,” she says.

“The number of patients suffering from PCOD has increased due to lifestyle problems,” she adds.

Dr Palshetkar recommends a combination of weight reduction, diet modification, exercise and medicine. “Obese women with PCOD develop insulin resistance, so they are prescribed anti-diabetic drugs. They also suffer from infertility, so if they want to conceive, they are prescribed ovulation inducing drugs, while those showing symptoms like hirsutism and acne, are given anti-androgen pills to control their testosterone levels,” she explains.

“Laparoscopy, though not the first line of treatment, is also an option, which sees success in 50 per cent of my patients. But, here too, the patient eligible for such treatment has to be selected with care,” adds Dr Palshetkar.

Some names have been changed

For women only

Dr Aarti Gate-Khadka, a gynaecologist, opened a ten-bed hospital in the central suburb of Bhandup last month. What makes it different from other hospitals in the vicinity is the fact that the hospital is exclusively for women - it even has an all-woman staff.

“We deal with issues exclusively related to women, like maternity problems, gynaecological issues or surgical services that women require and we have gynaecologists, a paediatrician, surgeons including a cosmetic surgeon and an oncologist surgeon,” explains Dr Khadka, who runs Archita Women’s Hospital.

“Over the years, I noticed my patients expressing discomfort when they were around male staff or other male patients at the hospital. That is when I came up with the idea of an exclusive women’s hospital,” she says.

Female patients with gynaecological problems are already under tremendous stress. For instance if they are dealing with infertility, or want an MTP (medical termination of pregnancy) procedure, confidentiality and privacy are a must. Besides, it is understandable that female patients may not necessarily be comfortable with ward boys, male hospital staff and other male patients in the out-patient department, says a gynaecologist who works at a government hospital.

“In most hospitals, space is a major issue. And when it comes to a gynaecological a check-up, I would certainly like some privacy,” said 25-year-old Sunaina Thakker, a chartered accountant. And 33-year-old Shanta Narayanan, a mother of two, agrees, “Even a simple procedure like an electro-cardiograph, which requires you to partially undress, becomes nerve-racking, if there is not adequate privacy.”

Gynaecologists in the city agree that the concept of an exclusive women’s hospital is good. “It’s a sign of changing times. And if there is a demand for it, why not,” says Dr Nandita Palshetkar, gynaecologist, Lilavati Hospital.

“I think having a separate women’s hospital is a great idea, as it would address all women’s issues under one roof,” added Dr Duru Shah. Recently two other such hospitals have come up, one in Dombivili, and another in south Mumbai.

Bombay Endoscopy Academy and Centre for Minimally Invasive Surgery (BEAMS) located at Khar, is devoted exclusively to gynaecological endoscopic surgery. “The centre was opened as there was a need to replace open surgeries by minimally invasive surgery, with less post-operative pain,” said Dr Rakesh Sinha, consultant gynaecological endoscopic surgeon and MD of BEAMS.