What Even Is PCOS?

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a constellation of symptoms related to an increased level of male hormones (also known as androgens) that primarily affects women during their reproductive years. The exact cause of PCOS is unknown, however, it tends to run in families and likely has a genetic component. Early diagnosis and treatment along with weight management may lower the risk of both short and long-term complications such as infertility, type 2 diabetes, and heart disease.

Symptoms

Diagnosis of Polycystic Ovary Syndrome (PCOS) is determined by the Rotterdam Criteria. You meet the criteria for a PCOS diagnosis if two or more of the following symptoms are present:

The manifestation of PCOS typically begins near the time when your first menstrual cycle occurs. In some cases, however, symptoms may not appear until you’ve had periods for a longer duration.

Irregular menstrual cycles

• Irregular and infrequent menstrual cycles, together with extended-duration periods are typical indications of PCOS. You may experience irregularity in the frequency of your period as well; for instance, having fewer than 6 to 9 periods each year or longer intervals between them (spanning more than 35 days). Additionally, difficulty conceiving a child due to irregularity in ovulation can be indicative of PCOS.

Elevated male pattern hormones

• Elevated amounts of androgen hormones can cause too much body hair, medically known as hirsutism. It is also possible to experience extreme acne and male-pattern baldness with high levels of the hormone. Women with PCOS often have to use hair removal techniques such as shaving, laser, or frequent waxing

Polycystic appearing ovaries on ultrasound

•  PCOS is a terribly named condition in that it has nothing to do with ovarian cysts. In actuality, the ovaries are somewhat enlarged with a very large number of egg sacs (or follicles) noted along the circumference of the ovaries. It is important to note that you may have polycystic appearing ovaries without having polycystic ovarian syndrome.

It’s essential to recognize that PCOS is a diagnosis of exclusion, meaning every other condition like thyroid abnormalities or high prolactin levels must be ruled out first.The presence of obesity can drastically exacerbate the severity and prevalence of PCOS signs and symptoms (for example, some women with PCOS may have regular cycles at a lighter weight and notice that they become irregular with weight gain).

When to see a doctor

If you’re worried about your periods or having difficulty conceiving, it’s best to see an OBGYN or fertility doctor for an evaluation. You DO NOT have to wait until you have been trying to conceive for a year before seeing a physician.

Contributing factors

The cause of PCOS remains a mystery; however, potential contributory factors include:

Insulin Resistance

• Insulin is a vital hormone manufactured by the pancreas that helps cells absorb sugar, which functions as your body’s primary energy source. When cells become resistant to insulin, blood sugar levels can rise dramatically and cause your body to increase its production of insulin in order to bring down these high levels. Insulin resistance can lead to dangerous health consequences if left unaddressed.

Anovulation

• An excessive amount of insulin may lead to an overproduction of the male hormone androgen, potentially resulting in difficulties with ovulation – when eggs are released from the ovary.

Acanthosis Nigricans

• Dark, velvety patches of skin on the lower part of your neck, armpits, groin or under you breasts could be a sign that you are insulin resistant. An increased appetite and sudden weight gain may also point to this condition.

Systemic Inflammation

• When white blood cells react to either harm or infection, the body’s response is known as low-grade inflammation. Studies show that people with PCOS often experience this type of perennial inflammation which causes polycystic ovaries to generate androgen hormones – resulting in potential heart trouble and health issues related to one’s cardiovascular system.

Hereditary Factors

• Studies have suggested that some genes are related to PCOS, implying that having a family history of the condition increases one’s chances of developing it as well.

Acne and Hair Growth

• An abundance of androgen caused by PCOS can cause hirsutism and acne which can be frusturating to deal with and can be managed along with a dermatologist as well.

Complications

Those who suffer from PCOS may experience some of these concerning symptoms:

• Infertility
• Pregnancy loss
• Gestational diabetes and pregnancy-induced high blood pressure
• Endometrial hyperplasia and endometrial cancer
• Anxiety and depression
• Metabolic syndrome– a group of medical concerns, including hypertension, hyperglycemia and high cholesterol or triglyceride values that raises your probability for cardiovascular illness. With this combination of characteristics present in an individual’s health profile, their risk level can grow exponentially.
• Insulin resistance and Type 2 Diabetes
• Nonalcoholic steatohepatitis–an intensely inflamed liver, caused by the accumulation of fat in the organ.
• Sleep apnea
• Difficulty losing weight– Not only is obesity commonly found in those who have PCOS, but it can also further exacerbate the health issues associated with this condition.

MY NAME IS NATALIE STENTZ. I AM A BOARD-CERTIFIED OB-GYN AND FERTILITY SPECIALIST. I BELIEVE THAT WOMEN’S HEALTH MATTERS AND THAT OPTIMAL HEALTH STARTS AT HOME WITH SMALL CHANGES APPLIED OVER A LIFETIME.