Payat Pero May PCOS? Understanding Lean PCOS for Filipinas

Living with PCOS really takes a lot of courage, patience, and acceptance.

Yung araw-araw na laban. Yung paalala sa sarili na hindi tayo habang buhay ganito. Yung kapit sa hope na balang araw. We will thrive despite this condition. It’s a journey talaga, full of ups and downs.

Pero lately, may bumabagabag sa isip ko, and maybe sa inyo rin.

Madalas kasi, ‘pag sinabing PCOS, ang unang pumapasok sa isip natin ay yung struggle with weight gain. Iniisip din natin yung association sa pagiging overweight. I myself thought that way for a long time!

Pero napaisip ako: Paano naman yung mga sisters nating payat or nasa normal weight range? Pwede rin ba silang magkaroon ng PCOS?

The answer is a big YES!

And today, gusto kong pag-usapan natin ito – ang Lean PCOS. Kasi knowledge is power, and understanding the different faces of PCOS helps all of us feel less alone and more empowered sa ating Filipina health journey.

Ano Ba Talaga Ang Lean PCOS?

Lean PCOS is the term used when a woman meets the diagnostic criteria for Polycystic Ovary Syndrome.

Yet, the Body Mass Index (BMI) niya ay nasa “normal” or “lean” range. This is usually considered below 23 or 25 kg/m², depending on the guidelines for Asian populations.

Akala natin bihira, pero hindi pala!

Research actually suggests na around 20-30% of women diagnosed with PCOS fall into this “lean” category. So, hindi ka nag-iisa if you’re lean and experiencing PCOS symptoms!

Paano Ba Nada-Diagnose ang PCOS (Kahit Payat Ka)?

Dito madalas nagkakaroon ng confusion.

Pero klaruhin natin: Weight is NOT part of the official diagnostic criteria for PCOS.

Yung diagnosis ay based pa rin sa tinatawag na Rotterdam Criteria. Kailangan ma-meet mo ang at least dalawa (2) out of these three (3) signs:

Irregular Menstrual Cycles (Oligo- or Anovulation): Ito yung hindi regular ang dating ng regla (oligo-ovulation) or minsan, totally absent (anovulation). This happens because hindi regular or hindi nag-o-occur yung pag-release ng egg cell from the ovary. Super common na PCOS symptom ito.
Hyperandrogenism (Clinical and/or Biochemical): Ito yung may signs ka ng mataas na level ng “male hormones” (androgens). Pwedeng clinical (yung mga nakikita natin) like:
- Hirsutism: Yung excessive hair growth sa face, chest, or back.
- Severe Acne: Yung persistent acne na mahirap i-manage.
- Androgenic Alopecia: Pagnipis ng buhok sa anit, sometimes following a male pattern. O pwede ring biochemical, meaning makikita sa blood tests na mataas nga ang levels ng androgens mo.
Polycystic Ovaries on Ultrasound: Pag na-transvaginal ultrasound ka, makikita mo ang presence ng maraming maliliit na follicles sa ovaries. Ang mga follicles na ito ay madalas na maling tinatawag na cysts. Kadalasan, mayroon kang 12 o higit pa na sumusukat ng 2-9 mm sa diameter. Maaari ding may increase sa ovarian volume.

TANDAAN: Kahit payat ka, basta matugunan mo ang 2 sa 3 sa mga pamantayang ito. Maaari kang ma-diagnose na mayroong PCOS.

Common Experiences and Symptoms ng Lean PCOS Sisters

So, ano yung mga karaniwang pinagdadaanan ng mga babaeng may Lean PCOS? Marami dito ay familiar din sa ating mga hindi lean:

Hyperandrogenism Still Exists:

Yes, kahit lean, maraming nakaka-experience pa rin ng mga PCOS symptoms related to high androgens. These symptoms include hirsutism and acne. Nakaka-frustrate, diba? Parang feeling mo, “Payat na nga ako, bakit may ganito pa rin?” It’s the hormones, sis!

Ovulatory Dysfunction:

Yung irregular periods or difficulty conceiving dahil sa anovulation ay common challenge pa rin. Hindi namimili ng timbang ang problemang ito.

Higher LH Levels:

Remember yung Luteinizing Hormone (LH)?

Isa siya sa mga “mensahero” (hormones) na crucial sa ating cycle, siya yung nagbibigay ng signal para mag-ovulate. May ilang pag-aaral na nagsa-suggest na sa lean PCOS phenotype, posibleng mas mataas or “maingay” (more frequent pulses) ang level ng LH.

Kapag laging mataas ang LH, sa halip na tumaas lang sharply mid-cycle, it can contribute sa pag-produce ng mas maraming androgens ng ovaries. Mahihirapan yung egg cell na mag-mature at ma-release properly.

Hidden Issue: Insulin Resistance (IR) on Lean PCOS

Insulin Resistance (IR) – yung condition kung saan nahihirapan ang cells ng katawan natin na i-utilize ang insulin effectively.

Isipin mo yung insulin bilang “susi” na nagbubukas ng “pinto” ng cells para makapasok ang sugar (glucose) at maging energy. Sa IR, parang nagloloko yung susi o yung pinto.

Common Association: Alam natin na ang IR ay strongly linked sa PCOS, lalo na sa mga overweight. Yung excess body fat kasi contributes significantly sa IR.

But What About Lean PCOS?

Dito nagiging “more nuanced” or medyo complex ang picture. Research consistently shows na kahit payat ang babaeng may PCOS, mas mataas pa rin ang chance na mayroon siyang IR kumpara sa ibang payat na babae na WALANG PCOS.

Kahit hindi kasing-severe agad tingnan ang metabolic profile nila, the underlying issue is often there.

Why? Hindi lang daw dahil sa taba.

Sabi ng experts, baka may “intrinsic defects” or problema mismo sa insulin signaling pathways or action sa cells ng mga may lean PCOS. Iba ang mechanism compared sa IR driven purely by obesity.

The Long-Term Risk: Ito ang pinaka-importante!

Kahit lean, may increased long-term risk pa rin sila na mag-develop ng glucose intolerance. Hindi na ma-manage ng katawan ang sugar nang maayos. They may even develop Type 2 Diabetes later in life, compared sa mga kapwa nila payat na walang PCOS.

It’s a hidden risk na kailangan nating seryosohin at ipa-check.

Other Health Considerations (Beyond IR)

Bukod sa IR, may iba pang potential long-term health considerations para sa mga may Lean PCOS:

Cardiovascular Risk Factors:

Kahit walang obesity, studies suggest na pwedeng may subtle markers indicating increased cardiovascular risk.

Kasama dito ang mild dyslipidemia (abnormal blood fat levels like cholesterol/triglycerides). It includes markers ng low-grade chronic inflammation. There are also signs ng endothelial dysfunction (hindi na optimal ang function ng lining ng blood vessels).

Small signs, pero importanteng i-monitor for heart health.

Phenotypic Differences:

Mahalagang tandaan na ang PCOS ay isang heterogeneous syndrome – meaning, iba-iba ang “flavor” or presentation niya.

Lean PCOS is considered a distinct phenotype. Kung ikukumpara sa overweight women with PCOS, ang mga lean ay maaaring may:

Less severe insulin resistance overall (pero nandiyan pa rin, as discussed).
Higher LH levels.
Minsan, mas prominent pa yung hyperandrogenic symptoms nila relative sa metabolic disturbances.

Bakit Mahalaga Ang Awareness at Tamang Diagnosis?

Dahil nga sa stereotype na ang PCOS ay para lang sa mga overweight, maraming lean women ang nakakaranas ng delay sa diagnosis.

Baka hindi agad ma-consider ng healthcare provider ang PCOS, lalo na kung ang symptoms ay irregular periods or acne lang. Pwedeng mapagkamalan or ma-dismiss ang symptoms nila.

Kaya importante, mga sis, na maging aware tayo na Lean PCOS is real and common.

We need to advocate for ourselves. We should encourage others na magpa-check if they suspect something is off. This applies regardless of their weight.

Finding a doctor who understands the nuances of PCOS is crucial. This includes understanding Lean PCOS. Proper management and monitoring of our women’s health journey depend on it.

Key Takeaways

Lean PCOS exists and affects a significant number of women (around 20-30%).
Diagnosis is based on the Rotterdam Criteria (irregular periods, high androgens, polycystic ovaries on ultrasound), NOT on weight.
Lean women with PCOS still experience symptoms like irregular periods, hyperandrogenism (acne, hirsutism), and fertility issues.
Insulin Resistance is often present even in lean women with PCOS, carrying long-term risks like Type 2 Diabetes. Hindi ito dapat balewalain!
May subtle cardiovascular risks din na kailangang bantayan.
Awareness is key para maiwasan ang diagnostic delays.

Living with PCOS, mapa-lean man or hindi, requires constant learning and self-advocacy. Pero ang maganda, hindi tayo nag-iisa dito sa PCOS Millennials community.

Let’s continue sharing our stories, our struggles, and our small victories. Kung may experience ka with Lean PCOS, or may tanong ka pa, please feel free to share sa comments section below!

Let’s empower each other with knowledge and support. Hanap tayo ng ways to take care of ourselves – body and mind. Self-care is essential, mga sis! Laban lang!

Love, Reese ❤️

Excerpt from:

PCOS Symptoms: Recognize 7 Warning Signs

Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach

BMI and Polycystic Ovary Syndrome: Demographic Trends in Weight and Health

Hirsutism, Normal Androgens and Diagnosis of PCOS

Prospective Risk of Type 2 Diabetes in Normal Weight Women with Polycystic Ovary Syndrome

What is Polycystic Ovarian Syndrome

Distinct Reproductive Phenotypes Segregate With Differences in Body Weight in Adolescent Polycystic Ovary Syndrome