In my practice at Fertility Centers of Illinois, we have made outreach to the Hispanic and Latina population a priority. Many of my staff speak Spanish and can converse fluently with Spanish-speaking women and couples who have questions about the intricacies of infertility treatment.
One of the reasons that we have strengthened our outreach is because women of Hispanic and Latina origin are at greater risk for polycystic ovarian syndrome (PCOS), a hormonal disorder that can lead to infertility and other health problems. As a reproductive endocrinologist, it is important to me to get the word out among couples of Hispanic or Latino origin that PCOS is a treatable condition that could be affecting their ability to have children.
It appears that people of Hispanic and Latina origin have inherited a higher risk for diabetes, and diabetes and PCOS are closely linked. More importantly, however, is lifestyle. The most likely reason PCOS is a problem among the Hispanic and Latina population is because of obesity and a sedentary lifestyle. According to the U.S. Department of Health and Human Services Office of Minority Health:
- Among Mexican American women, 78 percent are overweight or obese, as compared to 60.3 percent of the non-Hispanic White women.
- In 2010, Hispanic Americans were 1.2 times as likely to be obese than Non-Hispanic Whites.
- In 2007 - 2008 Mexican American children were 1.4 times more likely to be overweight as Non- Hispanic White Children.
- From 2007-2010, Mexican American women were 40 percent more likely to be overweight, as compared to Non-Hispanic Whites.
PCOS is the most common cause of female-related infertility caused by the absence of ovulation. Symptoms of PCOS can be present before a girl has her first menstrual period. Women with PCOS often have multiple, fluid-filled sacs - also causes "cysts" - on their ovaries; however, these cysts don't have to be present for a woman to receive the diagnosis.
Before a PCOS diagnosis can be made, a reproductive endocrinologist or Ob/Gyn should rule out other conditions that cause similar symptoms. A PCOS diagnosis may be made if a woman has two of the following factors:
- absence of ovulation and/or irregular periods
- high levels of androgens (male hormones such as testosterone) in the blood or hirsutism (excessive hair growth)
- more than 12 follicle cysts on the ovaries on an ultrasound
What Causes PCOS?
We don't know exactly what causes PCOS, but it appears to be caused by a combination of factors that includes genes and lifestyle.
We do know that women with PCOS are at risk for several other health concerns, including:
- Obesity, a condition in which the body stores more fat than is healthy for a person
- Impaired glucose tolerance, which means that blood sugar levels are higher than normal
- Insulin resistance, a condition in which the cells in the body don't use the insulin the body makes, thus higher levels of insulin are needed to get glucose into the cells for energy
- Metabolic syndrome, which is sometimes considered a sign of diabetes because it means the body has trouble balancing insulin and glucose levels
- Diabetes, a condition in which the body either stops making extra insulin or it doesn't properly use the insulin that is available, thus blood glucose levels get higher
- Cardiovascular disease, which is problems related to the heart and blood vessels that can lead to heart attack or stroke.
- Obstructive sleep apnea, a condition in which a person does not get enough air into the lungs when they sleep, which lowers oxygen levels.
Even though we do not know exactly what causes PCOS, we do know ways to treat it that can improve a woman's health, her symptoms such as excessive unwanted body hair or acne, and her fertility. The most important change a woman can make is to change her lifestyle by eating a healthy diet, exercising and losing weight. Why? Because extensive research has shown that gaining weight can cause a hormone imbalance so that the body's metabolism does not function correctly.
Even losing just 5 percent of your body weight can have a positive effect on insulin-resistance, impaired glucose tolerance and metabolic syndrome. In addition, androgen levels may be lowered, and fertility (ovulation) may be restored. In my practice, I have a Fit and Fertile program to help restore normal ovarian function. For those not trying to conceive, we can treat PCOS with oral contraceptives to regulate hormones and menstrual cycles, and insulin-sensitizing medications such as Metformin. Metformin can also be useful in conjunction with fertility medications for those trying to conceive.
If you have ideas on how to get the word out about PCOS among the Hispanic and Latina population, please contact me at email@example.com.