What is Polycystic Ovary Syndrome (PCOS)?
You may have heard of the term Polycystic Ovary Syndrome (PCOS), as it’s a fairly common condition. It affects about one in 10 women but there’s a lot of confusion about the condition so we’ve broken it down.
What is PCOS?
PCOS occurs when hormones are out of balance. The name can cause confusion as not everyone who has PCOS develops cysts on their ovaries. While they can contribute to hormonal imbalances, the cysts are usually harmless. However, there is a difference between PCOS cysts and ovarian cysts that grow, rupture, and are painful.
Instead of one cyst forming and releasing an egg, many tiny cysts form. These small cysts aren’t usually uncomfortable or life-threatening but because the eggs aren’t released normally, the menstrual cycle is thrown off and periods become irregular. This leads to an abnormal buildup in the uterine lining, which is why some women have an abnormally heavy period after missing a few cycles. It’s also why some women may have trouble getting pregnant because their eggs aren’t being released as often.
What is the cause of PCOS?
Essentially, PCOS is when the endocrine system is not working properly. The endocrine system is a network of glands that produce hormones that regulate reproductive and sexual function, sleep, stress, and more. It’s not certain what causes PCOS but research suggests genetics, behavior, lifestyle, and environment can all be factors.
Increased testosterone is one of the main contributors. Testosterone slows or stops the growth and release of eggs from the ovary. Additionally, testosterone suppresses estrogen and progesterone, both of which regulate menstrual cycles.
A few things may cause an increase in testosterone. The first is an excess of insulin. Insulin helps signal to the ovaries to produce testosterone. When you have a lower sensitivity to insulin for processing glucose, your body adjusts by making more insulin, which leads to higher levels of testosterone.
Another cause for increased testosterone is inflammation, which may occur in response to illness, obesity, stress, etc. Similar to insulin resistance, inflammation causes the body to produce extra insulin, which leads to more testosterone.
What are PCOS symptoms?
The symptoms will vary for each person. Some common ones include:
- Irregular menstrual cycles
- Very heavy or light periods
- New or excess hair growth
- Hair thinning
- Skin issues (oily skin, acne, dark patches, facial hair)
- Weight gain, especially around the stomach
- Difficulty getting pregnant
- Depression and/or anxiety
How is PCOS diagnosed?
PCOS is underdiagnosed and undertreated. This is likely because symptoms are mild or can be related to many other things. However, untreated PCOS can lead to serious health conditions such as type 2 diabetes, infertility, sleep apnea, heart disease, depression, or even uterine cancer. Early diagnosis and treatment can help mitigate these risks significantly.
Generally, you need to have at least two of the following things to be diagnosed with PCOS:
- Irregular periods (aka not on a 21 to 35-day cycle)
- Signs of testosterone (extra hair on the face, acne, or indicators in bloodwork)
- Small cysts on the ovaries
While PCOS is a lifelong condition, there are many options to help manage symptoms and prevent complications. PCOS treatment depends on the cause, each person’s symptoms, and their goals. Some common treatments include:
Getting ovulation back to a regular cadence can help with the symptoms and health impacts. For some people, dietary changes and a weight loss of more than 5% may help. Reducing simple carbohydrates and sugars in the diet help keep insulin balanced, as well as prevent inflammation. However, what works for one person may not work for another. Consult your doctor before making lifestyle changes.
- Birth control pills may be prescribed after or alongside lifestyle changes to help regulate periods
- Diabetic or androgen medication may help balance hormones
- Ovulation medication might be prescribed for those trying to get pregnant
You know your body best. If you suspect you have PCOS or are not sure about your symptoms, always consult with your doctor.