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The irregular periods, followed by vomiting, extremely painful and almost crippling cramps left her exhausted and angry with an unanswered question: why can’t I be just like every other woman?

And this has been Rose Muthoni’s life since she was 14 when she started experiencing severe pains during her menses. It was so obstinate it defied the strongest of painkillers .

Her condition was compounded by irregular periods. In high school, her periods would be a no-show for a whole term.

Though this was welcome relief, Rose was constantly worried about her condition. But once in university, she could no longer live with the pain and decided to seek medical attention.

“I began looking for a way to ease the pain, because I always had to play catch-up in class. I opted to go to a gynecologist,” she says.  

And in 2009, after years of anxiety, she was diagnosed with polycystic ovary syndrome (PCOS), a hormonal disorder common among women of reproductive age.

Women with PCOS produce higher-than-normal levels  of androgen, a group of hormones that play a role in male traits and reproduction. 

This hormone imbalance affects menstruation and fertility. The exact trigger of PCOS is unknown, and the symptoms vary from one woman to another. 

Some factors linked to the condition include excess insulin, genetics, and inflammation that cause the production of androgen.

In Rose’s case, she had cysts the size of a tennis ball around her ovaries. At mid cycle they would burst, causing intense pain rendered her immobile. Doctors advised her that getting pregnant was the only way out. 

“I tried over and over again, but the process would be interrupted because the ovum couldn’t develop into full term.

I visited the gynecologist for the second time and she prescribed Clomid, medication that forces the ova to develop into full term for fertilisation to take place in the uterus,” she recalls.

Heartbroken

After two years of trying, she finally received the best news: she was pregnant! But even then, Rose needed confirmation. She headed back to the doctor, but her hopes were shattered when the doctors told her she had an anembryonic pregnancy; it turned out to be something else; a sac and a placenta growth, but no baby.  

Heartbroken, but hopeful, she again embarked on the journey to pregnancy. It wasn’t easy.

“I went into depression. For over a month, confusion reigned and everything stopped making sense. It took me about a month to adapt to life. But on the second Clomid round, I found out I was pregnant, but I had also developed a bigger cyst,” she says.

The cyst burst again, inflamming her lower abdomen and sending her back to hospital. She was immediately put on drugs to prevent a miscarriage and treat the fluid collection in between the uterus and rectum, known as the Pouch of Douglas. 

All went well and in July 2011, she delivered her first born. She was later put on combined birth control to tame the cysts. It wasn’t long before she got pregnant again, this time, without the help of fertility drugs.

“I delivered my second child in 2013  and went back to the combined pill on doctor’s advice. It was the only way we could keep the cysts at bay,” she says.  

Rose would later be diagnosed with complex ovarian cysts, a condition where cysts are filled with either blood or a hard substance.

Although, she  underwent  succesful surgery to remove the cysts, she had to make some lifestyle changes to stay healthy.

“I put myself on a strict diet and regular exercise to get better. It’s quite a challenge staying away from processed foods, but if that’s what it takes to get better then I don’t mind it,” she adds. 

Rose is among the six to 12 per cent —an estimated five million— of women of reproductive age suffering from PCOS, which according to World Health Organisation, is among the commonest causes of female infertility. 

Dr Kireki Omanwa, a gynecologist and obstetrician, says PCOS affects most women in various degrees. The condition manifests in many ways leaving patients confused. 

“When you start having irregular periods, you will think that it’s normal. However, when you get prolonged periods, which go to as far as 90 days, it is best to go for a check up to know what might be the problem,” he adds.

Treatment options

Women with  PCOS may have excessive hair growth on pubic areas and nipples, face or even legs. “This is because of androgen production, which is unnecessary to the female body,” Dr Omanwa says,

They may also exprience low libido, and fertility issues because of the prolonged irregular periods. 

Omanwa, however, says the best way to deal with it is to go for a check-up and examine the family’s medical history.

He says during the menstrual cycle, an egg grows in a sac called a follicle. 

“This sac is located inside the ovaries. In most cases, this follicle or sac breaks open and releases an egg. 

But if the follicle doesn’t break open, the fluid inside can form a cyst. But, when they become many then they are called multicyst or polycyst. 

“Mostly, we prescribe combined birth control pills and diabetes medicine, which assist to regulate insulin. 

If it gets worse, we may try oophorectomy, the surgical removal of ovaries.” he adds.

He highlights that, in most cases, losing weight is the only thing that may assist women in managing the lifetime condition.