With little information about polycystic ovary syndrome, musician Wendy Kimani battled through stigma and its association with infertility. She tells of her journey. Sandra Wekesa\u00a0@wekesa_sandra At 18 years, Wendy Kimani would frequently experience irregular menstrual flow, often accompanied by series of depression and anxiety, which most of the time would make her emotional.\u00a0 At first, she ignored the red flags of irregular periods, which she thought was normal. In many occasions, she considered it a relief because she would not experience cramping, and all those symptoms menstruation had to offer. \u00a0\u201cI remember one time I stayed for over six months without my periods. I asked my sister about it and she insisted I visit a gynecologist.\u00a0 I was then diagnosed with Polycystic Ovarian Syndrome,\u201d she recalls. Polycystic Ovarian Syndrome or PCOS is the most common hormonal disorder among women in reproductive age that affects ovulation, hormonal levels and menstruation. Shortly after the diagnosis, Wendy was forced to change her lifestyle, so that she could manage her condition. With little knowledge about the condition, she opted to devour books to have a glimpse at what to expect in future. The first words that captured her attention while doing her mini-research was infertility and this really worried her.\u00a0 Additionally, that she hadn\u2019t come across anyone with PCOS within her circle troubled her more. However, with the help of \u2018doctor Google\u2019 she was able to come up with an easier way of managing the condition. \u201cDiet change was the hardest thing for me. The fact that I was at an age of eating anything and enjoying my meals actually made it worse. It was hard coming to terms with letting go of dairy and gluten,\u201d she explains. However, she slowly managed to surpass her cravings and live a healthy life. But at 22, she started noticing hair on her chin. It was always embarrassing especially since she did know how to get rid of them. She would spend her first few days trying to tweeze them, especially on date nights with her husband.\u00a0 When time for her next appointment came, Wendy was told her sugar levels had been going up, something that was bad for her health. She also found out she had pre-diabetes symptoms. She had no choice, but to change her lifestyle once again. This time only two factors-diet and exercise-came to play. She learnt about diet, supplements, lifestyle balance and emotional wellbeing. Create awareness \u201cI decided to put down simple carbs, introduce a small amount of complex carbs, and create a PCOS-friendly diet, which helped in managing my weight.\u00a0 I also incorporated PCOS-friendly workouts (slow workouts) and soon enough I was able to experience my flow as normal,\u201d she explains. The lifestyle change played a major role in her conceiving, despite it being a bigger worry to her and her family. \u201cWhen I got married, I decided to take a year focusing on my new lifestyle to prepare my body for having a baby,\u201d she says. With the help of laser technology, she was able to deal with hirsutism (excessive hair growth).\u00a0 \u201cOne thing that I have learnt throughout my time is that insulin resistance PCOS must be managed, failure to which you will be looking at possibilities of getting diabetes,\u201d says Wendy. She adds that the reality that many women are shy to talk about PCOs because of fertility related issues, is the main reason why awareness about the condition is necessary, so that women to feel that they are not alone. Dr Wanjiru Ndegwa, a fertility specialist at Footsteps to Fertility Centre, says PCOS is a syndrome characterised by failure of a woman to ovulate. This leads to some clinical displays such as polycystic ovaries (ovaries with many cysts), no menses or very light flow. She adds that one to make a diagnosis of PCOS one should be experiencing irregular menses that through an ultra sound displays polycystic ovaries. In many cases, women with PCOS have abnormalities in metabolism of androgens and oestrogen\u00a0 hormones and in the control of androgen production. PCOS can result from abnormal function of the hypothalamic-pituitary-ovarian (HPO) axis, a tightly regulated system controlling female reproduction. In addition, they also experience excessive hair growth, mostly exhibited on the chin, chest, back, and belly. Also they will have acne problems, and weight gain, which at times can be difficult to loose, but easy to gain.\u00a0 Dr Wanjiru says there are specific tests that can point to the diagnosis of PCOS, including hormone tests and pelvic scan. The doctor will first rely on symptoms, conduct a blood test, and physical exams.\u00a0 \u201cAfter a close examination, we rule out any issues that might have similar symptoms such as thyroid problems, which many at times affect menstruation. We also do an insulin level check to determine if there could be any pre-diabetes, or insulin resistance PCOS,\u201d she says. Although it is said to be connected to infertility, Dr Wanjiru says PCOS can be managed by some lifestyle changes and one is able to conceive if they undergo a healthy treatment plan. \u201cPCOS patients shouldn\u2019t be overly worried about infertility because they have a good chance of conceiving once they start ovulating regularly. Women with PCOS should consider treatments options with exercise and diet and lifestyle change. These are the two most important things that assist them experience regular flows,\u201d she explains. In cases where one experiences irregular flows pharmaceutical treatment options may come in handy in helping manage the irregularities. \u201cWomen with PCOS shouldn\u2019t have any pressure when it comes to solving problems such as excessive hair growth because they can always be corrected by use of laser,\u201d she says. Diet and PCOS Henry Nge\u2019the, chairman of Nutrition Association of Kenya, says nutrition plays an important role in disease management and as a preventive strategy to specific diseases. With PCOS, the major nutrition goal is to reduce insulin resistance and manage weight, which affects more than half of the women with PCOS \u201cConsumption of whole grains, legumes, leafy green vegetables and fruits with various colours help reduce inflammation and oxidative stress. A plant-based diet low in fat is highly recommended as it helps in weight reduction,\u201d he says. He adds that these diets contain high fibre content, which helps in regulation of insulin, provides necessary antioxidant effects and helps in regulation of good bacteria. \u201cAnimal products and processed foods should be reduced as they contain low density lipoproteins such as cholesterol, which increases inflammation, oxidative stress and destroys the gut microbiota,\u201d says Nge\u2019the. Nutritionists believe some supplements that can assist in PCOS include fish oils, as they decrease inflammation, and Vitamin D, which helps in improving women fertility. Other micronutrients can be prescribed by nutritionists depending on the presentation of the disease.