PCOS Management in Dubai: A Comprehensive Medical Approach

PCOS: Beyond the Basics

Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder in women of reproductive age, affecting approximately 20% of women in the UAE - significantly higher than the global average of 10-13%. Despite its prevalence, many women receive inadequate care limited to "lose weight and take the pill."

Understanding PCOS

PCOS is a metabolic and hormonal condition characterised by:

• Irregular or absent periods (oligo/amenorrhoea)
• Elevated androgens (excess male hormones causing acne, hair growth, hair loss)
• Polycystic ovaries on ultrasound (though not required for diagnosis)

You need 2 of 3 criteria for diagnosis (Rotterdam criteria).

Why PCOS Is More Prevalent in the UAE

• Insulin resistance - linked to sedentary lifestyles and high-carbohydrate diets
• Vitamin D deficiency - worsens insulin resistance and hormonal imbalance
• Genetic factors - higher prevalence in Middle Eastern and South Asian populations
• Stress - elevated cortisol worsens androgen production
• Obesity rates - UAE has one of the highest in the region

The Four Types of PCOS

Comprehensive Assessment at Al Das

Our approach goes beyond basic hormone tests:

Blood work:

• Full hormonal panel (LH, FSH, testosterone, DHEA-S, SHBG, prolactin)
• Metabolic markers (fasting insulin, glucose, HbA1c, lipid profile)
• Inflammatory markers (CRP, homocysteine)
• Nutritional status (Vitamin D, B12, iron, zinc, magnesium)
• Thyroid function (TSH, Free T4, antibodies)

Imaging:

• Pelvic ultrasound (antral follicle count, ovarian volume)
• Body composition analysis

Evidence-Based Management

1. Insulin sensitisation (if insulin-resistant type):

• Metformin or inositol (myo-inositol + D-chiro-inositol)
• Low-glycaemic diet with adequate protein
• Regular exercise (both resistance and cardio)
• Adequate sleep (insulin resistance worsens with poor sleep)

2. Hormonal management:

• Anti-androgen therapy (spironolactone for skin/hair symptoms)
• Progesterone for period regulation (if not trying to conceive)
• Ovulation induction (if trying to conceive)

3. Nutritional optimisation:

• Anti-inflammatory diet (Mediterranean-style)
• Specific supplements: Vitamin D, omega-3, zinc, magnesium, inositol
• Gut health support (probiotics, fibre)
• Blood sugar stabilisation strategies

4. Lifestyle medicine:

• Strength training 3x/week (improves insulin sensitivity)
• Stress management (yoga, meditation, adequate rest)
• Sleep hygiene (7-9 hours, consistent schedule)
• Weight management (even 5% loss significantly improves symptoms)

Fertility and PCOS

PCOS is the leading cause of anovulatory infertility, but it's also one of the most treatable:

• Lifestyle modifications alone restore ovulation in 30% of cases
• Letrozole or clomiphene induces ovulation in 70-80% of cases
• IVF success rates are generally good for PCOS patients

Long-Term Health Monitoring

PCOS increases risk of:

• Type 2 diabetes (50% lifetime risk)
• Cardiovascular disease
• Endometrial cancer (if periods absent for extended periods)
• Non-alcoholic fatty liver disease
• Depression and anxiety

Regular monitoring with your endocrinologist and gynaecologist is essential.

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