The #1 Question People Ask About PCOS. What is PCOS?

The abbreviation for PCOS is Polycystic Ovary Syndrome or Formally Stein-Leventhal Syndrome. The name stands for the predominant symptom which is ovarian cysts on the ovaries. This can be very misleading because all women don’t the same symptoms. It is not a one size fits all illness. PCOS, is a hormonal imbalance disorder which estrogen and progesterone can cause elevated androgens testosterone, insulin resistance and other symptoms in women.

Symptoms

Polycystic ovary syndrome can develop after an adolescent’s first period but sometimes can begin in early to mid-20s. Woman with PCOS symptoms may be affected differently. A majority of woman are unware they possess this illness because the signs and symptoms can seem as if they are not in correlation with each other. Overtime one or more of these symptoms will cause them to make an appointment with their healthcare provider.

• Irregular, heavy or no menstrual periods. A normal 21-35 day menstrual cycle is not the same for everyone. The shredding of the uterus lining can last 2-7 days. Sometimes there can be an irregularity in a normal period as far as how light, heavy or how long the menstrual cycle last. Missed periods, bleeding between periods, bleeding after sex, spotting anytime in menstrual cycle, bleeding heavier or for more days than normal, Bleeding after menopause, Irregular periods that may come and go, and be very light to very heavy are abnormal. Women with PCOS typically have irregular or missed periods as a result of not ovulating.  A normal cycle can be 21-35 days and Although some women may develop cysts on their ovaries, many women do not.

• Insulin Resistance. Insulin resistance is a condition in which body cells do not fully respond to the action of insulin, a hormone that controls the amount of sugar (glucose) in the blood. As a result, blood sugar levels become abnormally high because it overproduces hormones to keep sugar levels balanced. Over time, insulin resistance can result in consistently elevated blood sugar levels. This can increase the risk for type 2 diabetes. Also, higher levels of insulin can also cause an increase production of androgen testosterone.

• Fatigue, Sweaty, Nervousness. Can be caused by an underactive thyroid, low vitamin B12 or vitamin D levels, anemia and insulin resistance

• Decrease in breast size: Some woman may start to have a decrease in breast size due to hormonal imbalance.

• Depression: Depressed mood in PCOS can be both physiologic and psychological.

• Deeper voice. This symptom can be caused by hyperandrogenism, which is an overproduction of androgen.

• Thin hair. Hair loss can occur as a woman starts to age. It depends on the individual but it may increase in middle age.

• Obesity or Weight Gain. About half of women with PCOS will have weight gain and obesity that is difficult to manage. Obesity is not a consistent symptom in all women with PCOS, 50% of patients have normal BMI.

• Trouble conceiving or Infertility. PCOS is a leading cause of female infertility. However, not every woman with PCOS is the same. Some women may need the assistance of fertility treatments, others are able to conceive naturally. Miscarriages and infertility can also lead to stress and depression. High level of testosterone can also prevent the ovaries from releasing an egg each month. Also, this illness can cause patients to be 4 times more likely to miscarry a baby.

• Unwanted hair growth (also known as hirsutism). Can cause excess hair on the face, chest, stomach, thumbs, or toes.

• Acne. Hormonal changes related to androgens can lead to acne problems. Other skin changes such as the development of skin patches of thick, darker, velvety skin are also related to PCOS.

• Mood Swings. Having PCOS can increase the likelihood of mood swings, depression, and anxiety.

• Pelvic pain. Pelvic pain may occur with periods, along with heavy bleeding. It may also occur when a woman isn’t bleeding.

• Headaches. Hormonal changes and environment factors can prompt headaches.

• Sleep Disorders. Women with PCOS often report problems such as insomnia or poor sleep. There are many factors that can affect sleep, but PCOS has been linked to a sleep disorder called sleep apnea.  With sleep apnea, a person will stop breathing for short periods of time during sleep.

• Low Sex Drive. Not direct linked to PCOS but can be caused by depression and other factors of PCOS. According to Institute of Psychiatry at the Federal University of Rio de Janeiro Brazil Study, Polycystic Ovary Syndrome patients typically have an increased sex drive but lower orgasm/completion score.

Polycystic Ovary Syndrome symptoms are cause and effect of one another due to hormonal imbalances/changes, insulin resistance and environmental factors.

What causes this illness?

The exact cause of PCOS is unknown. Researchers speculate the endocrine system and female reproductive system play a role in the development of the illness. The endocrine system is a group of glands which produce and release hormones in the blood steam.  It also assists other organ systems to regulate different aspects of bodily functions and overall health. This would include and be not limited to the reproductive system.  If these systems are not functioning correctly, then this can cause the Polycystic Ovary Syndrome. Although, it has not been a proven fact as of yet.

Researchers and health care providers know that genetic and environmental factors can contribute to the development of Polycystic Ovary Syndrome. Because the symptoms of PCOS tend to run in families, the syndrome is probably caused by genetic and/or chemical changes in the womb. This is probably a true fact because almost all of my aunts on my mother’s side has hair on their face. Although, each was unaware of signs and symptoms of PCOS.  If the illness isn’t controlled, it can eventually lead up to more series illnesses.

PCOS Risk

Polycystic ovary syndrome overtime can possibly cause conditions which include type 2 diabetes, obesity, obstructive sleep apnea, heart disease and mood disorders.

• Endometrial cancer
• Infertility
• Breast cancer (slightly increased risk)
• Lipid Abnormalities
• Cardiovascular Risks
• Thyroid Problems
• Male Pattern Baldness
• Metabolic syndrome
• Fibromyalgia (no evidence they’re directly correlated but a lot of woman with PCOS have fibromyalgia as well.

Getting Diagnosed and Treatment

There is not specific test to diagnose Polycystic ovary syndrome. However, a doctor will evaluate a combination of clinical findings such as a woman’s symptoms, medical and family history, physical exams, and laboratory test results to make a diagnosis. Some test maybe done to rule out other possible illnesses which are similar PCOS.

The treatment for PCOS is the management of the symptoms. There is not a cure per say but a lifestyle change can help a patient decrease or eliminate their symptoms.  A healthcare provider will typically ask if you’re trying to conceive before giving you a treatment plan. If your goal is to conceive a healthy baby, then your doctor may prescribe fertility treatments. If unsuccessful, refer you to a reproductive endocrinologist which can also be called a fertility doctor.

If your goals are not to conceive then a doctor may prescribe the following to help you manage PCOS symptoms.

• Metformin (Glucophage). an oral type 2 diabetes medication which can help with insulin resistance by lowering blood sugar levels. Thus, this will decrease testosterone levels as well.

• Oral contraceptives. Birth control pills with combined estrogen and progestin are prescribed to regulate menstrual cycle and unwanted hair growth. Unfortunately, the pills mayn’t be as helpful for hair growth.

• Hair Eflornithine (Vaniqa). a cream medication to slow facial hair growth in women. Spironolactone can be used as well for regular hair loss but is a risker drug.

• Lifestyle Change. Diet and exercise prescribed by doctor. A low-carbohydrate diet, less sugar intake and regular exercise can assist with insulin resistance. Although, it can be more challenging to lose weight and maintain weight loss due to hormonal changes.

• Vitamins and Supplements (always consult doctor). Cinnamon, myo-inositol, vitamin D, and B complex vitamins, zinc, evening primrose oil, ashwagandha, flaxseed and so much more.

Polycystic Ovary Syndrome can be a complicated illness to diagnose and treat. The help of different solutions can help manage the many symptoms of this illness. The important aspect is to communicate with your healthcare provider if you notice consistent symptoms. Remember you know your body better than anyone but it is up to you to relate every detail to your doctor.