Messages Bag

Messages Bag‘Miniatures trapped in tiny knitted pockets reflect the abundance of foods; good, bad and beautiful we all navigate daily to choose what’s best for our health.

Pharmacopoeia’s particular focus in this artwork is the treatment of Polycystic Ovary Syndrome. PCOS is a cluster of symptoms that frequently occur together in young women. These are acne, irregular or infrequent periods and unwanted male pattern hair growth. It is associated with changes in circulating hormone levels and with a distinctive pattern of small cysts in the ovaries. Currently more than one in ten women have the syndrome and some think the number is nearer to one in six, hence it could be argued that this is a variation of normal.

The underlying cause of PCOS is genetic. Women with the syndrome have what have been described as ‘thrifty genes’. These genes are ubiquitous within the population because they confer tremendous survival advantage in times of famine. But we live in a time of plenty and therein lies the problem.

Most women with PCOS are good at storing fat. The more fat cells they store, the more insulin resistance they develop and this drives a number of biochemical and hormonal changes which cause the unwanted symptoms. Losing weight reverses some of these changes, but the catch is that the thrifty genes make weight loss more difficult to achieve.

As a family doctor I have lots of patients with PCOS. For many it is little more than an annoying inconvenience. For others with more severe symptoms it can be devastating and there is an increased risk of developing diabetes, cardiovascular disease and metabolic syndrome.

I treat people symptomatically with the contraceptive pill to regulate periods, antibiotics for their acne and topical cream or laser treatment for unwanted hair.
I also try to prevent or minimize the symptoms altogether. The medicine Metformin, which is usually used to treat diabetes, can be regularly taken as it combats insulin resistance in cells.

However, most effective of all is to identify the syndrome early in teenagers and educate them about the need to avoid creeping weight gain. Once they understand the underlying causes of PCOS subsequent discussions about weight management and increasing exercise makes more sense. It also acknowledges girls perception that it is a bit unfair that they eat the same as their friends do but only they put on weight. Slimming tablets are available and can have a minor role in aiding an initial reduction in weight but they play no part in long term weight management.’

Liz Lee
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2014