By Elise Chambers, MD
Women have complex healthcare needs, and unfortunately, many clinicians have not received proper, specialized training for diagnosing and treating many women-specific conditions. One of those conditions – Polycystic Ovary Syndrome, or PCOS – can sometimes take years to diagnose. In recognition of September as PCOS Awareness Month, let’s take a deep-dive into the disorder that puts women at high risk for infertility, diabetes and depression, and learn more about its symptoms, risks and treatment options.
What is Polycystic Ovary Disorder?
PCOS actually is more than just an ovarian issue. According to the National Polycystic Ovary Syndrome Association, PCOS is “a serious genetic, hormone, metabolic and reproductive disorder that affects up to 15% of women.” It is a condition in which the ovaries produce excess amounts of androgens (male sex hormones), which are normal in small amounts, but when abnormal amounts are produced, can cause a number of symptoms and possible chronic complications. The cause is unknown; however, many women with PCOS have a mother or sister with the condition. Additionally, many PCOS patients appear to have insulin resistance issues and/or obesity (which can also affect insulin levels.)
Although the name comes from the ovarian cysts that are typically found with PCOS, not all PCOS patients present with cysts; and, not all women who present with ovarian cysts have PCOS. When the body fails to ovulate due to hormonal imbalance, tiny cysts can form on the ovaries, releasing higher levels of androgen. It is this increase in androgen that causes the
symptoms of PCOS.
What are the Symptoms of PCOS?
Some of the most common symptoms are missed periods or irregular periods, which is typically one of the first indicators. Because of the increased androgen, women also may experience excess body hair, and thinning of hair or balding. Weight gain, especially in the abdominal area, is also common. Infertility is also a symptom and complication.
- Irregular periods
- Male-pattern baldness, excess body hair, oily skin/acne
- Enlarged ovaries or ovarian cysts
- Difficulty conceiving
How is PCOS Diagnosed?
In addition to a pelvic exam and discussion of your symptoms, your doctor might order blood tests to measure hormone levels, glucose tolerance and fasting cholesterol and triglyceride levels. Your doctor might also order a transvaginal ultrasound to examine your ovaries, looking for any abnormalities including the presence of ovarian cysts.
What are Long-Term Complications of PCOS?
In addition to troubling symptoms, nearly 70 – 80% of women with PCOS experience some form of infertility. The good news, however, is that most women with PCOS can conceive; it just takes longer to do so (and proper diagnosis and treatment).
Women with PCOS are also at much higher risk (50%) of developing Type II diabetes or pre-diabetes before age 40, and are three times more likely to develop endometrial cancer. Other concerns include obesity, liver disease, cardiovascular disease, metabolic syndrome, and depression and anxiety.
What are the Treatments for PCOS?
Treatment options include managing the symptoms and concerns related to PCOS.
For hormonal balance/managing your periods, your doctor might prescribe birth control pills. Other medications might be prescribed to help women ovulate and conceive. And yet other medications can be used to control acne and excessive body hair. Your doctor also might address lifestyle modifications to control your weight, such as adopting a low-calorie, low-fat, low-carbohydrate and plant-based diet, and incorporating regular exercise. If you’re experiencing anxiety and depression, your doctor can discuss the many treatment options, ranging from cognitive behavioral therapy to lifestyle modifications to medication.
Unfortunately, it is estimated that 50% of women living with PCOS go undiagnosed. Knowledge is power. If you have a family history of PCOS, are experiencing symptoms, such as irregular periods or having difficulty getting pregnant, visit your doctor, and ask if PCOS might be a concern.