HAIR loss, acne, migraine, weight gain and bloating... no woman wants to experience even one of these, what more all.
But for those who struggle with Polycystic Ovarian Syndrome (PCOS), these symptoms are part of daily life.
Deena Marzuki understands this all too well.
"It is a frustrating, vicious cycle. I know how it feels to be alone, confused and thinking that your body has failed you miserably," says Deena, who has struggled with PCOS for 14 years, with symptoms such as fatigue, bloating, migraine, obesity, hirsutism, hair loss, acne and infertility.
When her PCOS is severe, she has days where all she wants to do is sleep, but even after a full night's rest, she still feels sleepy throughout the day.
The brain fog that comes with the condition can also make her inefficient at work.
Deena explains that because the symptoms are not visible, people don't sympathise with women enduring this condition, and patients tend to mask their pain or discomfort and soldier on.
Erratic mood swings can also leave these women feeling either too happy or emotional.
When Deena was first diagnosed, her family and friends weren't supportive because they thought all her concerns were just "in her head".
Deena weighed 130kg at that point, and people just regularly told her to lose weight.
She struggled with PCOS for over a decade, battling severe anxiety, depression and pain until she started her healing journey last year after a miscarriage.
Prior to that, it was an uphill battle every day. It was exhausting having to explain to others what she was going through.
"I was left feeling inadequate for most of my life because I was always not at my 100 per cent."
UNRAVELLING PCOS
The exact cause of PCOS is not known, but it often runs in families, suggesting a genetic link, explains Metro IVF Sdn Bhd consultant obstetrician and gynaecologist Dr Lindy Bak Li Mei.
It is also common in women who are obese. Nevertheless, half of the women affected by PCOS do not have any symptoms.
The condition causes hormonal imbalance in the body and affects about 20 per cent of women at their reproductive age worldwide. About 70 to 80 per cent of women with PCOS will also experience infertility.
The hormone imbalance interferes with the growth and release of eggs from their ovaries. The quality of eggs can also be impacted, making conception difficult.
Irregular menstrual cycles, meanwhile, make it difficult to determine the woman's ovulation day or fertile window.
Hormonal imbalance also affects the quality of the womb's endometrium, making it more difficult for an embryo to implant, or raising the risk of miscarriage.
But the good news is infertility caused by PCOS is treatable, with a high success rate of pregnancy.
Dr Bak says if a woman is overweight, she should try to lose weight and exercise regularly to help her menstrual cycle become regular.
"A five per cent reduction in weight is said to bring a 20 per cent improvement in ovulation, compared with those without any weight loss prior to treatment."
Medication may be prescribed to alleviate symptoms and improve chances of pregnancy, besides ovarian drilling through laparoscopy.
Such procedure may restore ovulation in affected women for six to eight months. However, not all women need to undergo ovarian drilling.
In vitro fertilisation (IVF) will also greatly improve their chances of getting pregnant.
Dr Bak says women with PCOS who attempt IVF have up to a 70 per cent success rate in getting pregnant, even when they do not respond to medication.
SUPPORT WHEN NEEDED
WOMEN with PCOS suffer alone and in silence because of the nature of their condition.
Deena says some women even experience domestic violence because their husbands do not understand the condition or accuse their wives of making up symptoms.
Others suffer from the stigma of infertility and some women experience severe period cramps or prolonged periods that impact their work while family members have to put up with their unexplainable erratic mood swings.
"Support is what keeps you going, to know that someone else out there is going through the same thing."
Unfortunately, Deena realised there weren't any support groups in Malaysia that had the right information which is why she and two others set up My PCOS I Love You to improve the lives of women with PCOS.
The one stop resource centre, officially launched on Sept 1, rolls out information in both English and Bahasa Malaysia, so women can better understand their condition.
Additionally, it has a directory of doctors who have treated PCOS and are well informed about the condition.
It will also be a space for open dialogue between women who struggle with the condition and support for their partners, family and friends.
"We are always available to chat with any of them if they want to know something more specific. We have experts in place to ensure all women are given the most accurate and up to date information," says Deena who's president of My PCOS I Love You.
The aim is to let women with PCOS know they are not fighting their condition alone and there's an entire community behind them.
For more information, go to www.mypcosiloveyou.com