Why PCOS patients are so poorly managed?
PCOS is an extremely common cause of infertility , but most of these patients are often the recipients of very poor quality treatment , as a result of which they end up without a baby , because they don't get the right medical care .
The issue begins with misdiagnosis, and it is very common to see every woman with irregular periods labelled as having PCOD .This is never documented properly , because many ultrasonographers are very casual about making a diagnosis, and whenever they see ovaries with what they call " multiple small follicles " , they label the patient as having PCO , when in fact these patients actually have poor ovarian reserve because their ovaries are small !
Also , because most patients with PCO also have irregular periods , the first focus is on regularising the periods rather than helping them have a baby . When their periods return to normal, they believe their fertility has been restored, not realising that it is simple to induce periods with hormonal tablets, but that inducing a period is not the same as inducing ovulation!Many of these patients waste years taking hormonal tablets, because they don't understand the basics , and their doctors never bother to explain to them what they need to do in order to get pregnant.
Also, its common for beauticians and dietitians to label women as having PCO because they have a little bit of hirsutism, or are slightly obese. They are "treated" with a wide array of medicines, including homeopathy, ayurveda and naturopathy the only common denominator being that they are all equally ineffective in inducing ovulation !
It's sad that no one bothers to teach women with PCO how to self-manage the disease . PCOD is a chronic disease , and patients need to learn to live with it. It is quite simple for them to regularise their periods by inducing one for themselves every month without having to see a doctor, but because doctors earn a consultation fee every time they prescribe medicines, they do not bother to teach women how to self-manage their disease.
The final issue is that these women are frequently not offered the right medical care because there is a lot of confusion as to what the right treatment is, simply because there are so many options. This is why it is critical that infertile women with Polycystic Ovarian Disease set their
goals , and explain these to their doctor before actually starting the treatment . If the doctor believes that your goal is only to get regular periods and you are not interested in having a baby, you will not be offered the right treatment. It's important that you speak up - doctors are not mind-readers !