Editor’s Note: Physicians, providers and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at MauiHealth.org/HealthWise.

Q: What causes viral hepatitis, and what are the different types?

Dr. James R. Williams, Infectious Disease, Maui Memorial Medical Center Outpatient Clinic: Viral hepatitis triggers inflammation in the liver, affecting its vital functions like purifying blood. Various viruses can lead to hepatitis, each causing a different type. In Hawaii, hepatitis A, hepatitis B, and hepatitis C are the most prevalent.

Hepatitis A typically spreads through contaminated food. It may cause debilitating symptoms, but it is usually self-limiting and resolves spontaneously, while hepatitis B and C result from exposure to infected bodily fluids like blood, even in minuscule amounts. Some hepatitis types cause short-lived illness, while others can become chronic, posing severe long-term health risks. Chronic hepatitis B and C, for instance, can progress to cirrhosis and liver cancer.

Common symptoms of viral hepatitis include abdominal pain, dark urine, pale stools, low-grade fever, fatigue, nausea, loss of appetite, and jaundice (yellowing of the skin and eyes). Notably, many people with hepatitis have no symptoms, which means they can be infected and not know it.

You can protect yourself against hepatitis A and B by getting vaccinated. While there is no vaccine against hepatitis C, it can be cured with treatment. To promote early detection and treatment, the CDC recommends adults undergo screening for hepatitis B and C at least once. Pregnant individuals should be tested during each pregnancy due to the risk of transmission to the baby.

Regular screening is also essential for individuals who inject drugs, share needles or have potential exposure to hepatitis-positive blood at work, such as healthcare providers or public safety workers.

While viral hepatitis poses significant health risks, vaccination and regular testing can mitigate these dangers. To ensure you are protected, talk to your primary care provider.

Q: What is PCOS, and how does it affect my health?

Dr. Stacy Ammerman, Gynecology, Maui Lani Physicians & Surgeons: Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects people with ovaries, typically during their reproductive years. It involves a combination of symptoms related to hormone

imbalance, metabolism, dermatologic conditions and ovulatory dysfunction. It is the most common cause of infertility in women.

While the exact cause of PCOS is not fully understood, it is often linked to insulin resistance, elevated androgens (hormones like testosterone) and genetics.

Symptoms of PCOS can include: Irregular or missed periods, acne, excess facial and body hair, thinning hair on the head, ovarian cyst formation, weight gain or difficulty losing weight, and fertility issues.

Without proper treatment PCOS can have major metabolic complications. These include Type 2 diabetes, high blood pressure, and heart disease. It is also linked to higher rates of depression and anxiety, and uterine cancer.

Diagnosing PCOS involves a thorough review of your symptoms and medical history with a healthcare provider. Blood tests and a pelvic ultrasound are often used to confirm the diagnosis.

Though there is no cure for PCOS, treatment can help manage symptoms and reduce health risks. Medications, including hormonal birth control, anti-androgens, and insulin-sensitizing drugs, can regulate periods, reduce hair growth, and improve insulin sensitivity. Maintaining a healthy lifestyle can also help. Weight loss (even 5-10%) can improve symptoms and outcomes. For women trying to get pregnant, fertility treatment, including ovulation inducing medications and in vitro fertilization (IVF), may help.

PCOS is a serious but manageable condition. Working closely with your healthcare provider can help you find the best treatment plan for your needs and improve your overall health and quality of life.