Have you experienced missed or irregular periods, weight gain or adult acne? These are some of the symptoms that may be associated with Polycystic Ovarian Syndrome (PCOS). You are not alone! For a better understanding of what PCOS is and what to do about it, here are some frequently asked questions about PCOS.
What is polycystic ovarian syndrome? PCOS is a common health problem that occurs when there’s an imbalance of reproductive hormones. The hormonal imbalance creates issues in normal ovarian function. As part of a healthy menstrual cycle, the ovaries are meant to create an egg that is released every month. With PCOS, the egg might not develop the way it’s supposed to or it may not be released during ovulation as it should.
PCOS can cause missed or irregular periods, failure to release an egg every month ( anovulation) and sometimes lead to infertility. The failure to ovulate happens to be one of the most common causes of infertility in women. PCOS can also lead to the development of multiple tiny cysts in the ovaries.
What are the symptoms of PCOS? Women with PCOS might miss their periods or have less than eight within a year, which is considered irregular. These women may have periods that come every 21 days, or sometimes even more frequently. Some women with PCOS stop getting their period altogether.
Another symptom would be having excessive hair on the face, chin, chest or back. This is referred to as hirsutism. Seventy percent of women with PCOS are affected by this.
Other symptoms include acne on the face, chest, and upper back, thinning hair or hair loss on the scalp, otherwise known as male-pattern baldness, weight gain or struggling to lose weight, darkening of the skin, specifically around neck creases, in the groin, and under your breasts, and often with skin tags, which are small excess flaps of skin in the armpits or neck.
What causes PCOS? No one knows the exact cause of PCOS. Most experts believe that it is caused by various hormonal factors.
One cause could be the high levels of androgens, also sometimes called male hormones. All women produce small amounts of androgens, which regulate the development of male characteristics, such as male-pattern baldness. Women with PCOS have more androgens than normal. Higher than expected androgen levels in women can prevent ovulation throughout each menstrual cycle, causing that extra hair growth and acne.
High levels of insulin also play a part in PCOS. Insulin is the hormone that rules how the food you consume is converted into energy. Insulin resistance is when the body’s cells don’t properly react to insulin. Because of this, your insulin blood levels are higher than usual. Many women with PCOS have insulin resistance, especially those who struggle with obesity, take on unhealthy eating habits, don’t work out enough, and have a family history of diabetes (generally type 2 diabetes). Eventually, insulin resistance can cause type 2 diabetes.
Can I still get pregnant if I have PCOS? Yes. Having PCOS does not mean you can’t get pregnant. You may get pregnant without medical assistance, but know that PCOS is one of the most common and treatable causes of infertility in women.
Your obgyn can discuss ways to help you ovulate in order to increase your chances of getting pregnant.
Is PCOS related to other health issues? Yes, studies have discovered links between PCOS and other health problems, such as:
● Diabetes. More than half of women with PCOS are predicted to have diabetes or prediabetes (glucose intolerance) before they reach 40.
● High blood pressure. Women with PCOS are at greater risk of having high blood pressure compared to women of the same age without PCOS. High blood pressure is a prominent cause of heart disease and stroke.
● Unhealthy cholesterol. Women with PCOS usually have greater levels of bad cholesterol and low levels of good cholesterol. High cholesterol also increases your risk of heart disease and stroke.
● Sleep apnea. This is when momentary and repeated stops in breathing get in the way of sleep. Many women with PCOS are obese, which may cause sleep apnea. Sleep apnea heightens your risk of heart disease and diabetes.
● Depression and anxiety. Both are more likely among women with PCOS.
● Endometrial cancer. Problems with ovulation, obesity, insulin resistance, and diabetes (all common in women with PCOS) increase the risk of developing cancer of the endometrium (lining of the uterus or womb).
Will my PCOS symptoms go away at menopause? Yes and no. PCOS affects many of the body’s systems. Many women with PCOS start getting more of a regular period as they get closer to menopause. Unfortunately, their PCOS hormonal imbalance doesn’t change with age, so they may keep facing symptoms of PCOS. Also, the risks of PCOS-related health problems increase as you get older.
How is PCOS diagnosed? There’s no single test to diagnose PCOS. To help diagnose PCOS and rule out other sources of your symptoms, your OBGYN may ask about your medical history and perform a physical exam along with different tests:
For a physical exam, your blood pressure, body mass index (BMI), and waist size will be measured. Your skin will be inspected for extra hair on your face, chest or back, acne, or skin discoloration, as will your head for any hair loss. Any signs of other health conditions will also be observed, such as an enlarged thyroid gland. You might have to go through a pelvic exam to look out for signs of extra male hormones (i.e. an enlarged clitoris) and check to see if your ovaries are augmented or swollen.
Another test that may be performed is a pelvic ultrasound, which uses sound waves to inspect your ovaries for cysts and check the endometrium. However, multiple ovarian cysts alone cannot diagnose PCOS and are sometimes seen in women without PCOS.
Your OBGYN will have to run blood tests to check your androgen hormone levels. You’ll also be examined for other hormones related to other common health issues that can be mistaken for PCOS, such as thyroid disease. You may also be tested for diabetes and your cholesterol levels.
By the time other conditions are ruled out, you could be diagnosed with PCOS if you show at least two of the symptoms of PCOS mentioned before.
How is PCOS treated? There’s no cure for PCOS, but the symptoms can still be managed. With the right OBGYN, you’ll work on a treatment plan based on your symptoms, your plans for having kids, and your risk of long-term health problems.
What steps can I take at home to improve my PCOS symptoms? You can try to lose weight by eating healthy and being active, which will not only relieve your symptoms, but also lower your blood glucose levels, improve the way your body takes insulin, and help your hormones reach a normal level. Just losing 10% of your body weight can regulate your cycle and increase your chances of getting pregnant.
To address excess unwanted hair you can try hair removal creams or for more long lasting results laser hair removal to get rid of extra hair. Note that procedures like laser hair removal or electrolysis may not be covered by your health insurance.
You can also slow your hair growth by using a prescription skin treatment (eflornithine HCl cream) to help slow down the growth rate of the hair in unwanted areas.
What types of medicines treat PCOS? For women who don’t want to get pregnant, hormonal birth control can help to regulate your period, lessen your risk of endometrial cancer, and help with acne and that unwanted extra hair on the face and body.
You may need to request birth control that contains both estrogen and progesterone. You can choose between the pill, the patch or vaginal ring.
One medication to treat Type-2 diabetes, known as Metformin or Glucophage, affects the way insulin regulates glucose and lowers the production of testosterone. Doctors discovered that when some women with PCOS take this drug, ovulation can return to normal and abnormal hair growth can slow down after a few months of use. Recent studies show that another medication, letrozole may be associated with even higher pregnancy and birth rates.
For women who have trouble getting pregnant, fertility drugs can be used to stimulate ovulation.
Keeping up a healthy weight can also help women handle PCOS. Having a workout routine and a healthy diet will help the body lower glucose levels, use insulin more productively, and can restore normal periods.
How does PCOS affect pregnancy? PCOS can cause problems during pregnancy for you and for your baby. Women with PCOS have higher rates of miscarriage, gestational diabetes, pregnancy associated high blood pressure, and Cesarean section (C-section). Your baby also has a greater risk of spending more time in a neonatal intensive care unit (NICU).
How can I prevent problems from PCOS during pregnancy? You can lower your risk of problems during pregnancy by eating a healthy diet, watching your BMI and starting a good fitness routine before pregnancy.
PCOS is nothing to be shy about. If you have any more questions about whether or not you have PCOS or how to treat it, or wish to get pregnant and treat your symptoms, don’t hesitate to ask Dr. Ghea, a top female OBGYN in Fort Lauderdale, for guidance. If you’re looking for an OBGYN to speak freely with about your physical and mental well-being and receive useful tips on women’s health, set up an appointment with her offices in Westside OB/GYN Group by calling 954-473-2011 or filling out an online request.