Polycystic Ovary Syndrome Awareness Month

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder in which the ovaries create an abnormal amount of androgens, male sex hormones, which can cause infertility, cysts on the ovaries, and many reproductive and menstrual complications. It is an extremely common problem in women's health, affecting 10 million women worldwide, and is the most common hormonal disorder among women of reproductive age.

What is Polycystic Ovary Syndrome (PCOS)?

PCOS is a complicated syndrome that involves a number of symptoms across different systems of the body, and can have a profound effect on someone both physically and emotionally.

It's the result of a hormone imbalance stemming from higher levels of androgen, the male sex hormone that all women carry. Excess androgens are responsible for many PCOS symptoms, which we'll cover in the next section. Androgens are not the only affected hormone, however.

Other hormones are involved in PCOS, such as insulin. You know insulin as the hormone that allows the body to absorb glucose, regulating blood sugar. The body of someone with PCOS is not as responsive to insulin as it should be, which can lead to elevated blood sugar levels and possibly to diabetes.

Excessive androgen production also reduces the level of progesterone, the female sex hormone that's crucial to the menstrual cycle and pregnancy. This can cause irregular menstrual cycles as well as fertility issues, with PCOS being the leading cause of female infertility.

Despite the name of the condition, many affected women do not have cysts on their ovaries. In 2013, an independent panel of experts recommended to the National Institute of Health that the name be changed because it misrepresents the illness, and hinders patient care and research efforts.

Symptoms of PCOS

Symptoms of PCOS may begin shortly after puberty, but can also develop during the later teen years into early adulthood. This is when PCOS most often goes undiagnosed because symptoms may be attributed to other causes or go unnoticed. Symptoms may include:

• Irregular or missed menstrual cycles: caused by a lack of ovulation.
• Cysts on the ovaries: this does not happen with all women with PCOS.
• Weight gain: Difficult-to-manage weight gain occurs to 50 percent of women with PCOS.
• Fatigue.
• Hirsutism: unwanted and excessive hair growth.
• Thinning hair and hair loss.
• Infertility: PCOS is the leading cause of female infertility.
• Acne: hormonal changes can cause acne outbreaks, as well as the development of skin tags or darkened skin patches.
• Mood Changes: increased likelihood of mood swings, depression, and anxiety.
• Headaches.
• Sleeping difficulties: insomnia or disturbed sleep. May be linked to sleep apnea.
• Pelvic pain: may occur both during or apart from menstruation.
• Heavy bleeding during menstruation.

Diagnosing and Treating PCOS

Diagnosis

PCOS can be difficult to diagnose, due to its variety of symptoms and the unique nature of each patient's hormonal imbalance. A diagnosis will take into account factors like the presence of cysts; physical changes involving weight, hair, and acne; the frequency of your menstrual cycle; and your androgen, glucose, and progesterone levels.

Everyone's PCOS is different, and even the presence or lack of cysts might not entirely indicate whether you have it.

Treating PCOS

PCOS has no cure, but there are many options for managing or eliminating symptoms. They may include:
Hormone therapy: such as estrogen modulators.
Hormonal birth control: which can regulate menstruation, lower androgen levels, and protect the endometrium against abnormal cell growth.
Diabetes medication: Metformin is a common PCOS treatment for its ability to regulate the metabolism.
Fertility treatments: treatments to stimulate ovulation for women attempting to conceive, as well as IVF (in vitro fertilization) and IVM (in vitro maturation).
Lifestyle changes: to counteract weight gain and improve insulin sensitivity.

Complications

The hormone imbalances that occur during PCOS can cause many different complications:

• Fertility problems.
• Insulin resistance, prediabetes, and diabetes.
• Abnormal and increased cholesterol and triglyceride levels.
• Heart disease.
• Stroke.
• Endometrial cancer.
• Ovarian cancer.
• Weight gain and obesity.
• Sleep apnea.

If you are experiencing any of the symptoms of PCOS, please speak with your doctor. Many different health care providers can diagnose and provide the correct treatments for PCOS, and it's common to see many providers while managing your illness:

• Primary care doctor.
• Gynecologist.
• Medical endocrinologist: a hormone specialist.
• Reproductive endocrinologist: fertility specialist.
• Dietician.
• Psychologist or psychiatrist: to help manage emotional changes from PCOS.

Please consult with your doctor or other qualified healthcare professional before stopping or starting any medications or supplements, or before beginning a health regimen.