What is PCOS? Polycystic Ovarian Syndrome Explained

September is Polycystic Ovarian Syndrome (PCOS) Awareness Month. More than 6 million people in the United States have PCOS, but it is one of the most difficult to diagnose and one of the most underdiagnosed chronic illnesses. So what is PCOS?

PCOS is the most common hormonal disorder among menstruators, but an estimated 70% of cases are not diagnosed. It is a reproductive and metabolic disorder that affects the ovaries (the organs that store eggs). In some cases, your body does not create enough hormones needed to ovulate. When ovulation doesn't happen, the ovaries can develop many small fluid-filled sacs (cysts). These cysts make hormones called androgens. People with PCOS often have high levels of androgens. This can cause disruptions to the menstrual cycle & many of the symptoms of PCOS.

Causes

The exact cause of PCOS is not known. There are many factors that may play a role in PCOS development, including:

- Insulin resistance: Too much insulin may cause your body to produce an excess of androgen, which can cause trouble with ovulation.

- Low-grade inflammation: White blood cells make substances in response to injury or infection. This response is called low-grade inflammation. Research shows that people with PCOS have long-term, low-grade inflammation that leads to polycystic ovaries.

- Heredity: Certain genes may be linked to PCOS. If members of your family have PCOS, you may be genetically pre-disposed to the condition.

Symptoms

PCOS symptoms often start after you get your first period. Sometimes symptoms appear much later, after you've had periods for a while. Symptoms of PCOS vary, and a diagnosis of PCOS can be made when you have a combination of the following:

- Irregular periods: having very few periods or periods that aren't regular is a sign of PCOS. Having periods that last much longer than usual is also a sign.

- Excess face and body hair, called hirsutism.

- Severe acne or oily skin

- Thinning hair or male-pattern baldness

- Ovaries that are large or have many cysts

- Weight gain, especially around the belly

- Infertility

How is PCOS diagnosed?

Your doctor will ask about your health history and your symptoms. You'll have a physical exam that will likely include a pelvic exam. this exam checks the health of your reproductive organs both inside and outside your body.

You may also have an ultrasound, which uses waves to create images of your blood vessels, tissues, and organs. This test is used to see the size of your ovaries and if they have cysts, as well as the thickness of the lining of your uterus.

Blood tests are used to look for high levels of androgens and other hormones. Your doctor may also check your blood glucose levels, cholesterol, or triglyceride levels.

How is PCOS treated?

PCOS treatment is dependent on a number of factors, including how severe your symptoms are and your overall health. The type of treatment also depends on whether or not you want to become pregnant in the future. Treatments may include:

- Change in diet & physical activity: Eating healthy & increasing exercise can help reduce symptoms, as well as helping your body use insulin more effectively.

- Medicines to cause ovulation: You may be prescribes a medicine to help the ovaries release eggs normally. There are certain risks to these treatments, including increased chance of twins (or more), and ovarian hyperstimulation.

- Birth control pills: these can help control your menstrual cycle, lower androgen levels, and reduce acne

- Diabetes medication: this is often used to lower insulin resistance in PCOS. It may also reduce androgen levels, slow body & facial hair growth, and help regulate ovulation

If you think you have PCOS

If you are experiencing PCOS symptoms and/or have a family history of PCOS, speak with your medical provider. It is important to advocate for yourself if you are feeling uncomfortable, in pain, or experiencing symptoms you don't understand. Your doctor will help guide you through options & treatments if necessary.