What Is Polycystic Ovarian Syndrome (PCOS)?
Polycystic ovarian syndrome - also known as polycystic ovary syndrome or PCOS - is a condition that impacts women’s health and hormone levels, and in particular, their androgen levels.
But what exactly is PCOS and what are the symptoms of PCOS? How common is this condition, and what complications can it cause for things like ovulation, childbearing, and other aspects of women’s health?
In this article, we’ve compiled everything you need to know about polycystic ovarian syndrome, including how to get a diagnosis and access treatment.
What is Polycystic Ovarian Syndrome?
PCOS is a condition that impacts the ovaries and subsequently, womens overall health. Although many people tend to think of PCOS as a condition that only impacts women, it’s important to realise that PCOS can occur in anyone born with ovaries, including intersex people, transgender men, and nonbinary people.
PCOS is a relatively common condition, with a prevalence rate of about 9% among women of childbearing age.
As the name would suggest, one of the main features of PCOS is the growth of cysts on the ovaries. These ovarian cysts are typically benign and are the result of underdeveloped egg follicles in the ovaries. These cysts and underdeveloped follicles can prevent ovulation from taking place.
Symptoms of PCOS
Because PCOS impacts hormone levels and can lead to excess androgen in the body, there are several symptoms of PCOS to note. For most people, these symptoms tend to appear in the late teens and early 20’s.
PCOS symptoms include:
- Irregular menstrual cycle, including irregular periods, heavy periods, or not having a period all together
- Excessive hair growth - also known as hirsutism - which can include body hair or facial hair
- Infertility or difficulties conceiving
- Weight gain or obesity
- Acne breakouts and oily skin
- Hair loss or thinning hair on the head
- Patches of darkened skin, especially on the neck, armpits, and groin
What is the Cause of PCOS?
If you have PCOS, you might feel frustrated and overwhelmed regarding the myriad of symptoms, and might also wonder what the cause of PCOS is.
Unfortunately, researchers and health care providers haven’t been able to pinpoint one clear cause of PCOS, but there are a few conditions that can contribute to PCOS:
- Insulin resistance - Insulin plays a role in digestion and impacts the way your body controls blood sugar levels. Insulin resistance is when your body’s glucose levels don’t respond to the insulin you produce, leading to higher blood sugar levels. Insulin resistance plays a role in PCOS because higher insulin levels lead the ovaries to produce more androgens, leading to a hormone imbalance. Insulin resistance can also lead to type 2 diabetes and other health problems.
- Androgen levels - High levels of androgens can suppress ovulation and worsen the symptoms of PCOS. While androgen is sometimes thought of as a “male hormone”, people of all genders produce androgens, albeit at different levels. If your body happens to produce more androgens, this can contribute to PCOS.
- Inflammation - People with PCOS tend to have higher levels of inflammation in the body. This inflammation can increase androgen production by the ovaries, as well as contribute to things like high blood pressure and heart disease.
- Genetics - There is some evidence that genetics might play a factor in PCOS. If other people in your family have PCOS, there is a greater chance that you will also have PCOS.
If you suspect you might have PCOS, the best thing to do is talk to your doctor or gynecologist. There isn’t one single blood test that can diagnose PCOS, but rather most doctors look for the presence of a few key factors. A blood test can check whether you have abnormally high androgen levels. A pelvic exam or ultrasound can look for the presence of cysts on the ovaries. Your doctor will also ask about your medical history, including any history of irregular menstrual periods.
A doctor might also test for other conditions that are related to PCOS, like cardiovascular disease, unusual levels of cholesterol, high blood pressure, and insulin resistance.
Treatment for PCOS
Treatment for PCOS typically includes medication and lifestyle changes. Medications can include things like birth control pills, as they can help control your menstrual cycle and lower androgen levels. Medication could also include diabetes medication to lower insulin resistance, such as metformin.
Lifestyle changes typically include activities that support weight loss, like exercise and eating a healthy diet. These lifestyle changes can also help lower blood sugar levels.
If you are trying to become pregnant, your doctor might prescribe medication that induces ovulation, like clomiphene or clomid. These medications block estrogen receptors and trick the body into producing follicle stimulating hormone, or FSH. These medications should be used with caution, however, as they can cause your body to release multiple eggs in one cycle and subsequently have a higher risk of having twins or triplets.
In some rare cases, laparoscopic surgery can be used to treat PCOS. A procedure called ovarian drilling involves using a laser to puncture the ovary and induce normal ovulation.
Getting Pregnant with PCOS
For women with PCOS, getting pregnant can be challenging. Because PCOS interferes with ovulation, this can make it more difficult to get pregnant. Studies estimate that as many as 80% of women with PCOS experience fertility issues.
Because PCOS can be a cause of infertility, many women hoping to become mothers will wonder if they can get pregnant if they have PCOS. However, thanks to advances in reproductive medicine, most women with PCOS are able to get pregnant with some kind of medical intervention.
For some women, treatments that induce ovulation will be enough to help them conceive a child. For other women, artificial insemination procedures, such as IUI or IVF, will be necessary.
Although it may be hard and it may require medical intervention, it absolutely is possible for you to get pregnant if you have PCOS.
Finding a PCOS Support Group
If you have PCOS, you might feel that you are completely alone in your struggles. Know that this is not the case. There are many other people like you who you can connect to for support.
Here are some places to look for PCOS resources and support: