A Filipina’s Comprehensive Guide to Polycystic Ovary Syndrome (PCOS)

More Than Just Irregular Periods: The PCOS Reality in the Philippines

Polycystic Ovary Syndrome (PCOS) is a major public health issue in the Philippines. Estimates suggest this complex condition affects approximately 4.5 million Filipinas, making it one of the most common endocrine disorders among women of reproductive age. Despite its prevalence, a staggering reality persists: the World Health Organization notes that up to 70% of cases may go undiagnosed, leaving millions navigating their symptoms in silence.

For many Filipinas, the path to a diagnosis is often filled with frustration. Troubling symptoms like irregular periods, sudden weight gain, or severe acne are frequently dismissed as “just stress” or a normal part of being a woman. This cultural tendency to downplay women’s health complaints creates a dangerous cycle of delayed diagnosis, allowing underlying metabolic and hormonal issues to progress unchecked and increasing the risk for serious long-term complications like type 2 diabetes and endometrial cancer.

The Spectrum of Symptoms: Recognizing PCOS in Your Body and Mind

Understanding PCOS begins with recognizing its diverse symptoms. Healthcare professionals in the Philippines typically use the Rotterdam criteria for diagnosis, which requires a woman to present with at least two of the following three features.

1. Irregular Cycles and Ovulatory Dysfunction

This is a defining feature of PCOS, where the ovaries do not release an egg regularly. This can manifest as:

• Oligomenorrhea: Infrequent periods (fewer than eight or nine cycles a year).
• Amenorrhea: The complete absence of periods for three or more consecutive months.
• Irregular Cycle Length: Cycles that are consistently longer than 35 days or shorter than 21 days.
• Unpredictable Bleeding: Unusually heavy or prolonged periods.

This chronic lack of ovulation is a leading cause of infertility in women.

2. Hyperandrogenism (High “Male” Hormones)

Women with PCOS have slightly higher levels of androgens (like testosterone). This can be identified through clinical signs or a blood test.

Visible Signs:

• Hirsutism: Excessive growth of coarse, dark hair in a male-like pattern (face, chest, back).
• Acne: Persistent, severe, or adult-onset acne. Local personalities like actress KC Concepcion have shared their struggles with PCOS-related acne, bringing much-needed visibility to this symptom.
• Androgenic Alopecia: Thinning of scalp hair or male-pattern baldness.

Biochemical Signs:

A blood test can confirm elevated levels of androgens. This is crucial because some women may have high levels without showing prominent physical signs.

3. Polycystic Ovarian Morphology (PCOM)

The “cysts” in PCOS are not dangerous growths but numerous small, harmless, underdeveloped egg follicles. On an ultrasound, this can create a characteristic “string of pearls” appearance. The official criteria, according to bodies like the Endocrine Society of the Philippines, is the presence of 20 or more follicles in at least one ovary. However, PCOM can be present in women without PCOS, and not all women with PCOS will have it.

The Invisible Battles: Metabolic and Mental Health

Beyond the core criteria, PCOS is fundamentally a metabolic disorder driven by insulin resistance, a condition affecting a high percentage of those with the syndrome. This leads to weight gain (especially around the abdomen) and dark, velvety skin patches called acanthosis nigricans. The psychological toll is also significant. A study at the Philippine General Hospital revealed a high prevalence of anxiety (46.25%) and depression (9.09%) among Filipino women with PCOS, driven by distressing symptoms and social stigma.

Unraveling the “Why”: The Underlying Causes of PCOS

There is no single cause of PCOS. It arises from a complex interplay of genetic, hormonal, and environmental factors.

• Genetic Predisposition: PCOS frequently runs in families. A family history of PCOS or type 2 diabetes increases the risk.
• Insulin Resistance: This is a primary driver of PCOS. The body’s cells don’t respond well to insulin, so the pancreas produces more. This excess insulin stimulates the ovaries to produce an excess of androgen hormones, disrupting the menstrual cycle.
• Low-Grade Inflammation: Many women with PCOS have chronic, low-grade inflammation, which can also stimulate androgen production and increase long-term cardiovascular risk.
• Lifestyle Factors: A sedentary lifestyle and a diet high in processed foods can worsen insulin resistance and intensify symptoms.

The Path to Diagnosis: Seeking Answers in the Philippines

Early diagnosis is crucial. It’s time to see a doctor if you have concerns about your menstrual cycle, difficulty conceiving, or signs of excess androgens. Your journey will typically involve an OB-GYN and possibly an Endocrinologist.

The Diagnostic Process: What to Expect

1. Medical History and Physical Exam: Your doctor will ask about your menstrual and family history and perform a physical exam to check your BMI, blood pressure, and for signs like acne or hirsutism.
2. Laboratory Tests: Blood tests are critical.  Tests typically include a hormone panel (Testosterone, LH, TSH), a metabolic panel (HbA1c, glucose tolerance test, lipid profile), and organ function tests.
3. Imaging: A transvaginal ultrasound is the preferred method to check for Polycystic Ovarian Morphology (PCOM).

A Foundation for Wellness: Lifestyle Management for Filipinas

Lifestyle modification is the first-line and most impactful treatment for PCOS. For many, a modest weight loss of just 5% to 10% of body weight can significantly improve symptoms.

The Filipino Plate for PCOS

A successful PCOS diet doesn’t require abandoning Filipino cuisine but making strategic choices. The goal is a low-glycemic, anti-inflammatory diet that stabilizes blood sugar.

Embrace These Foods	Limit or Avoid These Foods
Carbs: Brown/Red Rice, Adlai, Kamote, Whole Wheat Pandesal	Carbs: White Rice, White Bread, Sugary Pastries
Protein: Grilled/Steamed Fish, Skinless Chicken, Tofu, Beans (Munggo)	Protein: Processed Meats (Tocino, Longganisa), Fried & Fatty Meats
Veggies: Malunggay, Kangkong, Sayote, Leafy Greens	Starchy vegetables in very large quantities
Fruits: Berries, Saba (boiled), Papaya, Citrus (in moderation)	Canned fruits in syrup, Fruit Juices, Sweetened Shakes
Fats: Avocado, Nuts (Pili), Olive Oil, Chia/Flax Seeds	Margarine, Lard, Trans Fats (in processed/fried food)
Snacks/Drinks: Boiled Saba, Fresh Lumpia, Buko Juice, Salabat	Soft Drinks, Sweetened Iced Tea, Milk Tea, Junk Food

Movement as Medicine

Aim for at least 150 minutes of moderate-intensity exercise per week. A balanced routine is most effective:

• Cardio: Brisk walking, jogging, or swimming to improve insulin sensitivity.
• Strength Training: Using weights or bodyweight to build muscle, which boosts metabolism and can reduce androgen levels.
• Mind-Body Exercises: Yoga and Pilates to reduce stress, a key factor in worsening PCOS.

Medical and Advanced Interventions in the Philippines

While lifestyle is key, medical interventions are often necessary. Treatment is highly personalized and tailored by doctors at facilities.

Treatment	Purpose & Symptoms Addressed
Birth Control Pills (COCs)	Regulate hormones and periods, control acne/hirsutism, and lower endometrial cancer risk. The most common first-line medical treatment.
Metformin	Improves the body’s response to insulin, helping to regulate periods and manage weight.
Anti-Androgens (e.g., Spironolactone)	Blocks the effect of androgens on the skin to treat hirsutism and acne. Cannot be taken if trying to conceive.
Fertility Treatments (e.g., Clomid, IVF)	Used to stimulate ovulation for women trying to conceive. Requires specialist monitoring.
Dermatological/Cosmetic	Topical medications, laser hair removal, and other treatments address cosmetic concerns but not the underlying hormonal imbalance.

Embracing Your Journey with Knowledge and Hope

A PCOS diagnosis is not a sentence to poor health; it is the first step on a journey toward empowered self-management. While there is no cure, PCOS is a highly manageable condition.

The key is a holistic approach: rejecting cultural silence, embracing the knowledge that your symptoms are real, and building a foundation of sustainable lifestyle changes. This foundation, supported by a personalized medical plan from a qualified doctor, allows you to manage symptoms, address fertility goals, and mitigate long-term health risks.