PCOS

Polycystic Ovary Syndrome (PCOS) can affect any woman of reproductive age in Singapore, but certain factors increase the likelihood of developing the condition.

• Family history: if a close female relative, such as a mother, sister, or aunt, has PCOS or a history of type 2 diabetes, your risk of developing PCOS is higher. Studies suggest that multiple genes may be involved in the inheritance of PCOS, which contributes to the hormonal imbalances seen in the condition​.
• Insulin resistance: women with insulin resistance, where the body’s cells do not respond effectively to insulin, are at higher risk of developing PCOS. High levels of insulin can increase androgen production, leading to the symptoms of PCOS​. 
• Obesity: while PCOS can occur in women of all body types, obesity significantly increases the risk of developing PCOS and can exacerbate its symptoms. Excess weight can contribute to insulin resistance and hormone imbalances, which are central to the development of PCOS. 
• Sedentary lifestyle: a lack of physical activity is associated with a higher risk of insulin resistance and obesity, both of which are linked to PCOS. 
• Hormonal imbalances: women who naturally have higher levels of androgens or other hormonal imbalances may be more prone to developing PCOS.
• Ethnicity: research suggests that women of South Asian descent are at higher risk of developing insulin resistance and metabolic complications associated with PCOS compared to women of European descent​.

At Dr. Ma Li's clinic, we take a comprehensive and personalised approach to diagnosing Polycystic Ovary Syndrome (PCOS). We understand that each woman’s experience with PCOS is different, which is why our diagnosis process is thorough and tailored to your specific symptoms and health history.

• Detailed medical history: the first step in diagnosing PCOS at our clinic involves a detailed discussion about your medical history. Our doctor will ask about your menstrual cycle, any changes in weight, skin concerns like acne or excessive hair growth, and any difficulties you may have had with fertility. The doctor will also ask about your family's medical history, as genetic factors can play a significant role in PCOS.
• Physical examination: the doctor will conduct a comprehensive physical exam to confirm the signs of PCOS, such as excess hair growth (hirsutism), acne, or patches of darkened skin. We may also check your blood pressure, BMI (Body Mass Index), and waist circumference to assess your overall health and identify any potential complications associated with PCOS.
• Blood tests: to confirm the diagnosis, we perform a series of blood tests to measure hormone levels. These tests typically include checking for elevated levels of androgens (male hormones), which are often higher in women with PCOS. We also assess other hormones, such as luteinising hormone (LH), follicle-stimulating hormone (FSH), and thyroid-stimulating hormone (TSH), to rule out other conditions that might cause similar symptoms.
• Glucose and insulin testing: since insulin resistance is a common feature of PCOS, we may recommend a glucose tolerance test or measure fasting insulin levels. These tests help us determine how your body is processing sugar and whether insulin resistance is contributing to your symptoms.
• Pelvic ultrasound: this ultrasound is a key tool in diagnosing PCOS, as many women with the condition have multiple small cysts on their ovaries. However, not all women with PCOS have visible cysts, and not all women with cysts have PCOS.

At Dr. Ma Li's clinic, our treatment plans are designed to address the specific aspects of PCOS that are most concerning to you, whether it’s regulating your menstrual cycle, managing weight, and improving fertility: 

• Healthy diet and exercise: at Dr Ma Li’s clinic, we work closely with the patient to develop a balanced diet plan and an exercise regimen according to their medical condition. Even a modest weight loss of 5-10% of your body weight can significantly improve symptoms such as irregular periods and insulin resistance. 

• Medications

• • Hormonal birth control: for those not planning pregnancy, hormonal birth control pills are often prescribed to regulate menstrual cycles, reduce androgen levels, and manage symptoms like acne and excessive hair growth. These pills can also help protect the uterine lining, which helps reduce the risk of endometrial cancer.
  • Insulin-sensitizing agents: if insulin resistance is a significant issue, we may prescribe medications like metformin. This drug helps improve your body’s response to insulin, thereby reducing blood sugar levels, and it may also help regulate your menstrual cycle and promote ovulation.
  • Anti-androgens: for managing symptoms like hirsutism (excessive hair growth) and acne, we might recommend anti-androgen medications. These drugs help reduce the effects of androgens on the skin and hair follicles.

• Ovulation induction: if you are trying to conceive, we may prescribe medications such as clomiphene citrate or letrozole to stimulate ovulation. These medications help your ovaries release eggs more regularly, which can increase your chances of pregnancy.
• Fertility treatments: for women with PCOS who have difficulty conceiving, we offer detailed fertility assessment and recommend treatment accordingly. 
• Ovarian drilling: in some cases, when medication alone does not restore ovulation, we may recommend a minimally invasive surgery called ovarian drilling, which involves making tiny punctures in the ovary using a laser or fine needle to reduce androgen production and promote regular ovulation.

At Dr. Ma Li’s clinic, our goal is to empower you with the knowledge and tools to take control of your health and well-being. If you are experiencing PCOS symptoms or hormonal issues, book a consultation with Dr Ma Li for a thorough diagnosis and appropriate treatment measures.