Polycystic ovary syndrome (PCOS) can affect a woman’s health in more ways than one.
As more people are becoming aware of PCOS as a disorder women experience, there is more questions to answer as we discover female health continues to be more complex.
For instance, there are four categories of PCOS. Healthcare professionals try to avoid diagnosis until a person’s menstrual cycle has become regular or fully formed.
PCOS is characterised by irregular periods, high testosterone levels and ovarian cysts. The average age of diagnosis is around your late 20s.
However, there is not a long-lasting solution to help with PCOS. Different life occurrences can alter the symptoms of the syndrome, such as childbirth, excessive exercise and stress.
Shirley McQuaid, who works with Dublin Well Woman Centre as a medical director, spoke about PCOS in Ireland and attitudes to female health in Ireland.
“PCOS involves certain changes to the cycle,” she said. “If someone has very irregular periods, then it’s worth looking at whether or not that is due to polycystic ovary syndrome.”
Laoise Cruise, now 23 years old, spoke to The City.ie about her experience of getting diagnosed with PCOS at the age of 15, which is very unusual.
“It was like I had given birth because I had stitches, and I couldn’t stand up straight,” said Cruise.
In March 2016, Cruise thought she was getting her period for the first time. In reality, a cyst that was sitting and killing her ovary was causing her to bleed. After experiencing side effects such as extreme bloating, tiredness and intense cramps, Cruise went to her doctor and had to have surgery.
“It was basically the size of a melon is what I was told – they told me this is so strange for a 15-year-old.”
However, due to the size of the cyst, one of Cruise’s ovaries also had to be removed.
“It has affected my life completely – 50% of my chance of fertility gone,” she said.
Cruise also spoke about the lack of services provided during this time at 15 years old.
“I had my surgery in a general hospital, but it was under my insurance. Then I had to go privately for nearly a year after to go see the same surgeon that took out my ovary [in their private practice]”
“I wish it was more accessible; I’m hoping there will be more PCOS specialists in the future, who are more accessible for women who are younger.”
The process of getting diagnosed can be a stressful experience.
Katlyn Connolly, who is 22 years old, is currently on the journey of being diagnosed with PCOS.
“I started looking for help and advice on my female health around 14 months ago and since then I have been referred and sent to person after person,” said Connolly.
“I feel If I had backed myself up and was confident in my knowledge 14 months ago, I might be on a very different journey now. I am thankful that people are now talking about female health and fertility. It’s lovely to hear other people’s stories and tips and tricks regarding these issues.”
Female health issues continue to be a complex issue.
In terms of the long-standing ways of managing PCOS, McQuaid said there unfortunately isn’t one.
“There are a few things to manage PCOS but there isn’t a pill that they can take long term to deal with PCOS. It’s just as life events happen, we can help along the way with various things.”
Despite an enduring question over how serious female healthcare is taken within the Irish healthcare system, McQuaid said the introduction of the free conception has been a positive change.
“In the past a lot of women just were on the pill simply because that what was all available for them or they couldn’t afford to use coils and implants. But now they’ve got a huge choice,” she said.
Although there has been a positive progression for female healthcare in Ireland there is still a long way to go as many women continue to go undiagnosed.
“It’s not just four letters it’s your life,” said Cruise.
As people journey through life, independence can grow and thrive – however, sometimes, in life, and especially as some people get older, independence can unfortunately decline.
With a decline in a person’s ability to be independent, comes dependency with everyday issues, that can begin to overpower, to the point where living at home might prove to be unsustainable.
Long-term care facilities are a beacon of hope for a person who needs 24/7 care – allowing the person to still be able to indulge in their own life experience, all while in the hands of professional care givers.
However, it’s not always an easy journey into long-term care as established nursing homes are more than often full and have waiting lists for potential future admissions.
In August 2024, research involving 1000 people was conducted by Coyne Research and commissioned by Nursing Homes Ireland (NHI) and found that six out of 10 people fear for their loved ones being able to find a place in local nursing homes.
It was a nursing home in Kinsealy, Co. Dublin, that had the advantage of space and more accessible admissions, for a time – as it was only recently opened, with no waiting list, and with rooms available for anyone in its local community, looking at long-term care options.
A short distance from coastal towns, Malahide and Portmarnock, in the tranquil countryside setting of Kinsealy, Woodlawn Manor opened its doors in February 2024 to less than 10 new residents requiring care facilities.
The entrance to Woodlawn Manor on the grounds of St. Doolaghs Park in Kinsealy, Co. Dublin. Photo: Gary Petrov
With a maximum capacity of 97 residents, Woodlawn Manor had space for new residents for a total of nine months, before reaching its maximum capacity earlier this month.
Teagan MacAodhagáin is the Director of Nursing at Woodlawn Manor and has worked exclusively in elderly care since graduating as a nurse, and has been a Director of Nursing since 2018.
“We’re very passionate about what we do,” said MacAodhagáin. “The core team, myself, the clinical nurse managers, reception administrators and that – we really live by our motto ‘Care is what we do’.”
Teagan MacAodhagáin, Director of Nursing at Woodlawn Manor. Photo: Courtesy of Woodlawn Manor.
“I always tell my staff that the standard of care is what you want for the person you love most and anything less than that is falling below the standard that we should have. I think that’s important, that that’s what you aim to deliver – you try and achieve that.
“Some days the tea might be cold when it arrives, or the laundry might be a bit delayed. Things will happen with human error and various things, but if you’re aiming for something you would like for the person you love most, then I think you’re going to do a good job, nine times out of 10.
“We have filled up remarkably fast. I’ve been involved in a number of new nursing homes, and I would be familiar with nursing homes opening up. It was faster than what would’ve been expected, perhaps, given the number of nursing homes in the locality. What has led to that? Definitely, I think the setting, the setting is beautiful. The countryside and sea-views. Having a brand-new purpose-built facility was also very helpful. That had a big attraction, early on.
“Internal factors – assembling a good core team at the beginning. I hired people I was familiar with and people I worked with before – people I knew. It wasn’t a brand-new venture with lots of people pulled into it. It was a team that knew each other and worked together before. We knew one another and knew how we worked together.
“Having a dedicated admissions nurse helped, a role I created for the first year – which was really important and instrumental in filling the place up. Someone who was out doing assessments, being a point of contact for all.
“It was a little bit daunting to have 97 rooms and the onus to fill them, but not having to have a waiting list, it was really nice. It was great to not have to turn anyone away. To be able to take people for respite, short-term care, to take people who were at the end of life and needed a few days of care while passing. It was nice to be able to do that,” he said.
Staff from the dedicated team at Woodlawn Manor. Photo: Courtesy of Woodlawn Manor
Since reaching maximum capacity this month, MacAodhagáin discussed the inevitable shift in the admissions process saying that they are starting their waiting list now and new admissions will only be selected from the waiting list when a room becomes available.
MacAodhagáin said he must “give credit” to Woodlawn Manor’s admissions nurse Camelia Ganea, who is also a clinical nurse manager in the facility – for her “marvellous” hard work all year as they welcomed their new residents.
Staff at Woodlawn Manor during a fire brigade visit, where they discussed safety procedures for their residents, in case of emergencies. Photo: Courtesy of Woodlawn Manor
Since 2018, at least 77 nursing homes have closed around Ireland. Of that number, 10 closed in 2023 and seven have closed this year to date. Last month, Nursing Homes Ireland said that this is due to a mixture of rising operational costs and Fair Deal Scheme pressures.
When asked about the issues and worries surrounding nursing home closures in the country, MacAodhagáin said, “From what I know, the nursing homes that have closed down have been smaller, family-run nursing homes.”
“Standalone nursing homes, or the building might be old and isn’t up to the current regulations. Fire regulations and things like that have become, and rightly so, more stringent and more in depth of what’s required. For older buildings, they can be a very large cost implication, to bring them up to the standard that’s required.
“I’m also aware of lots of larger companies opening more and more homes or buying homes. I do think there are homes out there, all-right,” he said.
Woodlawn Manor’s new purpose-built facility was built adjacent to an existing manor on the grounds of St. Doolaghs Park. Photo: Gary Petrov
Something that can naturally accompany a person being placed into long-term care is the emotional element for their family, ending their chapter of life with their loved one in the family home.
Patrick Maguire recently placed his spouse into long-term care and chose Woodlawn Manor. “When the time came to put my wife into long-term care, my family and I, while coping with the emotional aspect of it, feared it would be a race against time with her individual case, to find a nursing home in the local community that tended to her needs, with a vacant room available as soon as it was needed for her,” he said.
“With all of the organising and preparing of affairs that comes with this difficult choice of accepting that your spouse can no longer live independently at home, it was daunting for my family and I to go and view nursing homes in my local area and be told that they are currently full and that they have waiting lists that I could add my wife’s name to.
“Not everyone has time for waiting lists and we didn’t. Woodlawn Manor was a God send. After enquiring about several nursing homes, my family and I rushed to view it as soon as we were made aware of it having less than 10 residents, at the time.
“We were very impressed and acted quickly. We were then able to have my wife in their care within a few days, after the necessary admission paperwork was done. The process worked out well for us in the end, and I say that delicately, because her condition proved for living at home to no longer be an option. However, luck played a huge part as firstly, we liked the nursing home for my wife, and secondly, the nursing home had room.
“The difficulty of finding a local nursing home with a vacancy, and one that is suitable for your loved one’s needs, is a task in itself – on top of all of the emotions and pain that comes with accepting the reality of it all.
“We were lucky to have a difficult journey made easier with Woodlawn Manor not being full, but when the time comes for people nationwide, not many will find themselves with a new nursing home nearby, full of rooms at their convenience for them or a loved one,” he said.
The exterior of the newly built facility in St. Doolaghs Park. Photo: Courtesy of Woodlawn Manor
Asking the Director of Nursing what he would say to someone looking at Woodlawn Manor as a long-term care option for a loved one, he referred to their motto and the feedback they have received since opening, and said, “Our motto is ‘Care is what we do’, and I came up with that motto because care is what I’m really passionate about. Firstly, we’ve been told that it’s a very calm and homely environment. Secondly, people most commonly say that the staff really care.”
“As the Director of Nursing, it makes me very very proud that people can see that the staff genuinely care about the residents. I think that’s what we have to offer. When you care, you go the extra mile for the residents. This is their home and their time with us is perhaps the last time they’ll have anywhere – and we want it to be good, we want people to feel at home. We want people to be cared for and cared about,” he said.
Woodlawn Manor offers residential nursing care, respite care, convalescence care, dementia care and end of life care.
Useful resources from Nursing Homes Ireland on choosing a nursing home can be found here.
Many children are still facing long waiting times for diagnosis and treatment for scoliosis in Ireland, according to Scoliosis Awareness & Support Ireland.
When Taoiseach Simon Harris was minister for health in 2017, he said that no child would wait longer than four months for scoliosis surgery.
However, campaigners say that seven years on, surgery is still a long way away for many.
“As of September 2024, we continue to face significant challenges in addressing the backlog of scoliosis waiting lists for children,” said Elaine Kelly from Scoliosis Awareness & Support Ireland.
Kelly explained that the demand for spinal procedures often outpaces the available capacity within the healthcare system despite the efforts to improve the situation.
“Over the past 10 years efforts to improve the issue have included, allocating additional funding, an increased investment in healthcare and an increase in infrastructure and personnel to expand surgical capacity. Despite these efforts, many children and their families continue to experience significant delays in accessing necessary surgery,” Elaine Kelly said.
Source: CHI website, Children’s Hospital Temple Street
Aoibhínn Dunne, 20, from Dublin has been waiting over a year for spinal surgery with private healthcare.
Due to the cut in scoliosis screening in primary schools Dunne found out very late in life that she had scoliosis.
Dunne’s scoliosis causes her severe back pain, and because her scoliosis is in the shape of an ‘S’ it means her spine is pulling in different directions. This puts a lot of stress on her lungs and eventually her heart, as her ribs are pressing in against her lungs.
This is especially difficult for her as she studies drama in university and it affects her movement for acting on stage and breathing for singing.
Since being diagnosed with scoliosis at the age of 18, Dunne has had immense difficulty in getting on waiting lists for surgeries as “children often get prioritised,” Dunne said.
“By the time you are 18 there is a certain cutoff point for the number of degrees in the curvature of the spine; if you’re under a certain number then it probably won’t keep getting worse. However, mine is double the cutoff point, so I do have to get surgery, it’s just so hard, especially for me because I’m not a child anymore,” she explained.
“We appreciate that no politician can wave a magic wand and solve this overnight, but this has been going on now since 2009,” said Elaine Kelly.
“Even the emergency wait lists are over three months long,” Dunne said.
Kelly explained how past warnings have fallen on deaf ears and that the “response has been unacceptable from the Government. This is the last chance to get it right.”
“The waiting list for spinal surgery has increased in recent months, this is due to the backlog of children waiting for a first appointment with a consultant,” Kelly said.
According to Kelly, it’s not just physical pain that affects patients with scoliosis. Anxiety and stress associated with the delays in care can also have a negative impact on the mental health of children and families.
Kelly advises families to reach out for help. “Give families support groups contact details and information on their child’s diagnosis. Research- knowledge is power,” she said.
Professor Sir Peter Donnelly, CEO of Genomics plc. Image courtesy of Sir Peter Donnelly
Being diagnosed with a serious illness is something no one likes to think about.
To experience treatment and therapies is to suffer, and depending where you are in the world, even survival can mean financial ruin – if you can afford it in the first place. This is the reality for millions worldwide.
But, what if we lived in a world where we didn’t begin treating heart disease, breast cancer or even diabetes once you became sick, but preventative measures were taken decades beforehand?
This is the aim of Genomics plc, an Oxford-based company who may be on the cusp of changing worldwide medicine forever – and the secret? It’s in our genes.
I spoke to Oxford professor and CEO of Genomics plc, Professor Sir Peter Donnelly, to understand the ins and outs of Genomics’ research and what is standing between his company’s vision and medical practice.
“Over the last 20 years the increase in our knowledge of which little bits of DNA make some people more likely to get heart disease, and some people more likely to get diabetes has been extraordinary. I realised, along with some colleagues, that it wasn’t really having much impact on healthcare,” Prof Donnelly told me.
With this realisation, Prof. Donnelly and his colleagues banded together to put this knowledge to practical use and make an impact on the medical industry.
Thus, Genomics plc was born.
Now, seven years later, the company is about 110 people strong, and spread out between Oxford and Cambridge in the UK, and Boston in the US.
The company is developing a method of examining a person’s DNA to discover what their genes say about the potential of developing a multitude of illnesses.
“We realised [our research] wasn’t really having much impact on healthcare”
Sir Professor Peter Donnelly
This test can reveal if a person is likely to develop heart disease, lung disease, breast cancer, prostate cancer, colon cancer, diabetes and more.
The end goal is to isolate these potential diseases, and instead of treating them when they develop, they want to prevent them altogether.
“Although we call it healthcare, it’s really sick care, so the key idea for governments and systems all over the world is for us to get better at preventing disease or catch it really early […] which will benefit the individuals and make the healthcare system more sustainable,” says Prof Donnelly.
‘Polygenic risk scores’ are used to gauge the patient’s likelihood of developing a serious illness, and these scores are made up of two separate evaluations.
Firstly, a patient’s genes are examined using the techniques developed by Genomics plc which generate a score by isolating millions of DNA to evaluate how likely the individual’s genes are to develop certain diseases.
Secondly, this information is sent to the patient’s doctor, who will then evaluate the patient’s lifestyle, (weight, diet, exercise, smoking etc) and this evaluation will give a separate score.
The two scores are combined to form the polygenic risk score.
“We know that genetics can show likelihood of developing a disease, we now have a way of measuring that, and when you use that we can do a better job than we are now at working out who are the individuals really at risk,” explains Prof. Donnelly.
“You only do the test if you can identify someone as high-risk and do something about it. If there’s nothing you can do about it, what’s the point?”
Prof Donnelly
With this kind of evaluation, a patient can make changes to their lifestyle preemptively, or be prescribed personalised medication which specifically targets their particular genetic anomaly causing the disease to lower their risk of developing an illness they may be at risk of.
What if, instead of telling you that you’re at risk of a curable disease, the test instead tells you that you’re on the way to developing an untreatable, incurable disease?
“It’s a very natural worry. You only want to do [the tests] if you identify someone as high-risk and there is something you can do about it. If there is nothing you can do about it, what’s the point? There are lots of diseases where there is something you can do – we already have preventing programmes in place, but we don’t know who to deploy them on,” says Prof. Donnelly.
While Prof. Donnelly and many others view the ‘pros’ outweighing the ‘cons’ in this case, not everyone will agree with this assessment, and the main flaw in Genomics plc’s plans could be due to modern medicine’s inability to treat certain illnesses.
It is a complicated question, and possibly the biggest roadblock in Genomics plc’s way could be the human element – no one wants to be handed a death sentence.
Being told that you are likely to develop an untreatable disease is likely to change your life, and the thought is surely to be ever-present, at least at the back of your mind.
What if you get this terrible news and years later you don’t even develop the disease in question? This may become a big detractor in this method, and will no doubt be the topic of controversy surrounding these tests over the coming years.
Does our DNA let us look into the future? Photo by Edward Jenner via Pexels.com
So how close are Genomics plc to making their testing available to the world?
“We’re doing a pilot programme with the NHS on heart disease […] We’re also working in the US in the Stanford [University] Hospital,” Prof. Donnelly explains.
These pilot testing programmes will consist of testing 1000 people in the north of England and 5000 people in Stanford. Genomics will use blood tests to isolate millions of DNA from each sample to identify those who are at risk of cardiovascular disease.
“These initial programmes are fairly small, but in time, I do genuinely believe in 10 or 15 years, a version of this will be routine in healthcare,” says Prof. Donnelly.
It’s an exciting prospect, but as Prof. Donnelly said himself, it is early days.
There is a bumpy road ahead for Genomics plc and navigating through it could be the key to millions of lives being saved as close as 20 years from now. The professor’s enthusiasm, passion and belief in this project was contagious and I could not help but wonder, in a world where very common causes of death are isolated and prevented in people’s 20s and 30s, how much misery could we all be spared? We will just have to wait and see.
A human heart used in the spelling of “LOVE”. Although the hearts won’t be available by Valentine’s day, Carmat hopes to have them on the market by the end of 2021. Photo and design by Dolapo Agunbiade
The month of February is a month designed to remind people of matters of the heart. That’s right, Heart Awareness Month is currently being celebrated across the globe. It is a time when people can reflect on their lifestyle choices, bring awareness and raise money for those who suffer from heart disease.
“Heart disease is the number one killer of men and women across the United States and also worldwide and a lot of that is highly preventable,” said cardiologist Dr. Alex Harrison to KEYT News.
According to the Irish Heart Foundation, heart failure is one of Ireland’s leading causes of death. They stated that, in Ireland, there are approximately 10,000 new cases each year. The best remedy for severe heart failure is a transplant. However, thousands die each year waiting for their operation.
“The idea behind this heart was to create a device which would replace heart transplants”
Stéphane Piat
French company Carmat received their CE marking on 22 December from European regulators. This mark gives them the permission to sell their total artificial heart system. Their product, Aeson – named after a character in Greek mythology who drank a potion that added more years to his life – is designed to impersonate real hearts by using biological sensors and materials. The artificial heart is able to regulate blood flow by using its mechanical pump.
“The idea behind this heart, which was born nearly 30 years ago, was to create a device which would replace heart transplants, a device that works physiologically like a human heart, one that’s pulsating, self-regulated and compatible with blood,” Stéphane Piat, Carmat’s CEO, told Reuters.
For now, the three-part device will be used as a stopgap until a transplant is available for those suffering from severe, incurable heart disease. This will give patients who may not have received an organ in time a chance to wait patiently for donations. Even though the battery operated piece of technology is a temporary solution, it has been recorded that the hearts can last up to five years, allowing patients to live comfortably in the meantime.
In the company statement they say, “Carmat aims to provide a lasting solution to the treatment of terminal heart failure, a disease for which there are very few effective options today, the main one being heart transplants.”
However, this device may not be available to everyone. It has been recorded that Aeson will be sold at the price range of €150,000 and upwards. This extravagant price-point is not suitable for lower-income patients who are in dire need of support.
Another possible disadvantage of Carmat’s artificial heart is its weight. The device weighs in at 900g, which is three times more than the average heart – the average ranging from 250 to 300g. This size also alienates children in need from receiving the company’s temporary heart.
I spoke with former senior cardiology specialist Dr. Oye Akindele to understand the possible negative outcomes of artificial hearts.
Dr. Akindele said, “the implications of an artificial heart are numerous. Due to its mechanical nature, parts can wear out or the electrical motor system could fail causing the blood passing through the system to form clots and cause strokes.”
He continued, “also, some patients are prone to severe bleeding. Their blood may be too thin from previous medications used to support the artificial heart.”
Dr. Akindele then stressed the importance of heart donors and how the right donor should improve and prolong the recipient’s quality of life.
A 3D demonstration of Carmat’s hear at work
The three-part device might not be ready just in time for 14 February, but Piat estimates there will be “a smooth commercial launch during the second quarter of 2021”. The introductory launch will be focused on France and Germany and then subsequent distribution across Europe will follow.
What are the signs of heart failure? According to the Mayo Clinic, signs of heart failure include but aren’t limited to; shortness in breath, fatigue, rapid or irregular heartbeats and lack of appetite.
If you believe that you or a loved one is suffering from heart disease, please contact your local doctor.
You must be logged in to post a comment.