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What is polycystic ovary syndrome (PCOS)?

What is polycystic ovary syndrome (PCOS)?

 

Polycystic ovary syndrome (PCOS) is a health problem that affects a woman’s:

  • Menstrual cycle,
  • ability to have children,
  • hormones,
  • body weight,
  • facial hair growth,
  • heart and blood vessels,
  • appearance (acne).

Women with polycystic ovary syndrome may be at increased risk for:

  • Diabetes,
  • high blood pressure,
  • high cholesterol,
  • obesity,
  • uterine cancer.

 

Women with PCOS typically have:

  • High levels of androgens (male hormones, though women also produce them).
  • Missed or irregular periods.
  • Many small cysts (fluid-filled sacs) in their ovaries.

 

 How many women suffer from PCOS?

As many as 5 million women in the United States may be affected by PCOS. That is roughly 1 in 10 women of childbearing age. PCOS can occur in girls as young as 11 years old.

 

What causes PCOS?

The precise causes of PCOS are unknown. Genetics, among several factors may play a role. Women who have a mother or sister with PCOS are more likely to have PCOS.

 

The primary problems with PCOS:

  • Hormonal imbalance.

Ovaries of the women with PCOS produce more androgens (male hormones) than normal that affect the development and release of eggs during ovulation.

  • Too much insulin in the body.

Insulin is a hormone that controls the change of sugar, starches, and other food into energy for the body to use or store.

Excess insulin appears to increase production of androgen. High androgen levels can lead to:

  • Acne,
  • changes in female body shape,
  • decrease in breast size,
  • increase in body hair in a male pattern, such as on the face, chin, and abdomen,
  • lack of menstrual periods (amenorrhea), and
  • oily skin.

These changes may also occur:

  • Increase in the size of the clitoris,
  • deepening of the voice,
  • increase in muscle mass, and
  • thinning hair and/or hair loss at the front of the scalp on both sides of the head.

 

What are the symptoms of PCOS?

While the symptoms of PCOS can vary from woman to woman, some of the more common symptoms are:

  • Infertility (not able to get pregnant) due to not ovulating,
  • irregular, and/or absent menstrual periods,
  • hair growth on the face, chest, stomach, back, thumbs, or toes,
  • cysts on the ovaries,
  • acne, oily skin, or dandruff,
  • weight gain around the waist or obesity,
  • baldness or thinning hair,
  • thick and dark patches of skin on the neck, arms, breasts, or thighs,
  • pelvic pain,
  • anxiety and/or depression, and
  • sleep apnea (stopping of breathing for short periods of time while asleep).

 

How does a person know if she has PCOS?

The physician will look at the symptoms to determine if the symptoms are caused by PCOS or something else.

  • Medical history: Menstrual periods, weight changes, and other symptoms.
  • Physical exam: Blood pressure, body mass index (BMI), and waist size are measured; areas of increased hair growth are checked.
  • Pelvic exam: Enlarged or swollen ovaries may be as a result of increased number of small cysts.
  • Blood test: Androgen hormone and glucose (sugar) levels in the blood are checked.
  • Vaginal ultrasound: Sound waves are used to take pictures of the pelvic area to examine ovaries for cysts and endometrium (lining of the womb may become thicker if the menstrual periods are irregular).

 

How is PCOS treated?

There is no cure for PCOS. The condition needs to be managed to prevent escalating problems. Treatment goals are based on the symptoms, whether or not the patient want to become pregnant, and lowering the chances of getting heart disease and diabetes. Many patients need a combination of treatments to meet the goals.

 

The only reliable treatment with long term relief from PCOS is “lifestyle change.”

 

Many PCOS sufferers are overweight or obese. Eliminating processed foods, refined carbs, gluten, sugar, sweeteners and foods with added sugars from our diet is the first step towards recovery.

Ketogenic diet and regular exercise will do the trick for most women, and help:

  • lower blood glucose (sugar) levels,
  • improve the body’s use of insulin, and
  • normalize hormone levels in the body.

 

Some other treatments may provide short term relief; however these treat the symptoms only and don’t address the cause at all. We DO NOT support or recommend these interventions.

  • Birth control pills: For women who don’t want to get pregnant, birth control pills can, control menstrual cycles, reduce male hormone levels, and help to clear acne. However, the menstrual cycle will go back to irregular once the pill is stopped.

Women may also think about taking a pill that has only progesterone to control the menstrual cycle. But, progesterone alone does not help reduce acne and hair growth.

  • Diabetes medications: Metformin (Glucophage) used to treat type II diabetes has also been found to help with PCOS symptoms, though it isn’t approved by the U.S Food and Drug Administration (FDA) for this use. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone production. It slows the growth of abnormal hair and, after a few months of use, may help ovulation to return.
  • Fertility medications: Ovulation stimulating medications may help women with PCOS become pregnant. Even so, other reasons for infertility should be ruled out before fertility medications can be used.
  • Surgery: “Ovarian drilling” may lower male hormone levels and increase the chance of ovulation when a woman does not respond to fertility medicines. However, effects of this procedure may only last a few months, doesn’t help with loss of scalp hair or increased hair growth, and carries a risk of developing scar tissue on the ovary.

 

Other health risks related to PCOS

Women with PCOS have greater chances of developing several other serious health conditions, including life-threatening diseases. Recent studies found that:

  • More than 50 percent of women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40,
  • the risk of heart attack is 4 to 7 times higher in women with PCOS than women of the same age without PCOS,
  • women with PCOS are at greater risk of having high blood pressure,
  • women with PCOS have high levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol,
  • women with PCOS can develop sleep apnea. This is when breathing stops for short periods of time during sleep,
  • women with PCOS may also develop anxiety and depression, and
  • women with PCOS are also at risk for endometrial cancer. Irregular menstrual periods and the lack of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Progesterone causes the endometrium (lining of the womb) to shed each month as a menstrual period. Without progesterone, the endometrium becomes thick, which can cause heavy or irregular bleeding. Over time, this can lead to endometrial hyperplasia, when the lining grows too much, and cancer.

 

 

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