Understanding PCOS | Overview of Polycystic Ovary Syndrome | PCOS Help
A woman may experience infertility for many reasons. One of the most common is a condition known as polycystic ovary syndrome, or PCOS . PCOS affects roughly 10 percent of women and, along with infertility, includes symptoms such as increased growth of body and facial hair, acne, weight gain, baldness, irregular periods, depression, and more.
The root cause of PCOS is still unknown, but a number of theories link the condition to insulin resistance and higher levels of certain hormones, including testosterone. As scientists and doctors work to understand the causes for this condition and how to effectively combat it, it helps to understand how our views on PCOS have evolved over the last several decades.
Polycystic ovary syndrome
You might be reading this without a full grasp of what PCOS actually is. Standing for polycystic ovary syndrome, the condition alters what are known as follicles on the ovaries; bumps less than a centimetre in size. These follicles are normally harmless, but in those with PCOS they are undeveloped, meaning that the eggs that are usually released by them are trapped. Polycystic ovary syndrome is a disorder involving infrequent, irregular or prolonged menstrual periods, and often excess male hormone (androgen) levels. The ovaries develop numerous small collections of fluid called follicles and may fail to regularly release eggs.
Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.
The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.The aforementioned hormonal change is how PCOS has one of the biggest impacts on the body. It’s related to higher-than-normal amounts of insulin, the hormone that controls when sugar is used and stored. This increase is due to PCOS causing insulin resistance in the body. Weight gain can be an effect of this, and is common amongst those with PCOS.
Unfortunately, only the symptoms of PCOS can be treated in the vast majority of cases, with doctors recommending a healthy lifestyle and weight loss. Surgical options to tackle follicles directly is limited to the most severe and painful of incidences (usually reserved for when it threatens fertility). For the vast majority of the population, it’s something to be dealt with on a daily basis.
“PCOS is a common endocrine disorder that owes its name to clusters of pearl-sized, fluid-filled cysts found within the ovaries of women suffering the condition.”
Symptoms commonly associated with Polycystic Ovary Syndrome
As a syndrome, PCOS is associated with a host of symptoms that you may experience. Those symptoms include:
- Cysts: PCOS often leads to enlarged ovaries holding small cysts containing fluid. Not all women with PCOS have ovarian cysts, and not all women with ovarian cysts have PCOS. If you have polycystic ovaries, further evaluation can rule in, or rule out, PCOS.
- Hyperandrogenism — excess levels of androgens (or male) hormones — is a defining symptom of PCOS. Research into PCOS suggests an underlying mechanism involving insulin resistance and the production of excess insulin. Rising insulin levels cause an increase in androgen production.
- Other hormonal imbalances: Composed of glands that release hormones into the bloodstream or lymph network, the endocrine system helps regulate physical function through chemical messaging. Endocrine diseases result when an imbalance in the release, transmission, or uptake of these important hormones occurs.
- Menstrual irregularity: Hormonal imbalance causes menstrual irregularities in young and adult women. With age, many women develop regular menstrual cycles. For some that regularity does not arrive. Partly because of the chronic release of excess male hormones, ovulatory function is impaired. Instead of the monthly release of a mature egg, the ovaries create fluid-filled cysts that contain immature eggs. You may experience menstrual irregularities like:
- Absence of periods for months, or lack of periods altogether
- Intervals between periods that exceed 35 days
- Lengthy menstrual periods that are very light or heavy
- Infertility: Because of interruption of the menstrual cycle by androgens, follicles in the ovary do not mature, and ovulation does not take place. Many women learn of PCOS when they visit their doctor after being unable to conceive. PCOS is also implicated in pregnancy complications like gestational diabetes, and higher rates of
- Hirsutism or alopecia: The presence of excess male hormones in women may result in hirsutism, or increased growth of thicker, darker hair on the face, chest, back, and buttocks. Similarly, women with high levels of these hormones may experience androgenetic alopecia, or male-pattern hair loss.
- Acne: In youth, and as an adult, you may experience ongoing bouts with acne as a result of PCOS.
- Skin changes: You may notice changes to your skin as a result of PCOS including thick, darkening patches of skin, dandruff, and skin tags.
- Pain: Pelvic pain is not uncommon among women who suffer from PCOS.
- Inflammation: Women with PCOS may suffer chronic, low-grade inflammation. While inflammation is a normal immune response to injury, long term inflammation is a serious risk factor for heart disease, stroke and other health conditions.
While PCOS can cause infertility, it is also associated with a host of other complications. These conditions, if left untreated, may cause serious illness. Diagnosis and treatment of PCOS is important to deter—or detect—related conditions including:
- Metabolic syndrome: Metabolic syndrome is a constellation of serious health problems that contribute to higher risk of stroke, heart disease, and diabetes. Women with PCOS, especially those who are overweight, may be at risk for metabolic syndrome.
- Cardiovascular disease: The risk of high blood pressure, elevated cholesterol and lipids, and narrowing of coronary arteries is higher for women diagnosed with PCOS.
- Insulin resistance: Women with PCOS are at higher risk for weight gain, and type 2 diabetes. Approximately 50 to 70 percent of women with PCOS experience insulin resistance. Darkening patches of skin seen in PCOS patients may be a sign of increased insulin resistance.
- Sleep apnea: The prevalence of obstructive sleep apnea is higher in women with PCOS. When tissue in the upper airway relaxes, the muscle softening can close or narrow the airway. Incidence of apnea is even higher among women who experience significant weight gain. Undetected sleep apnea can lead to stroke, cardiovascular disease, high blood pressure—as well as daytime fatigue and brain fog.
- Emotional difficulties: Women with PCOS report higher rates of depression, anxiety, and binge-eating. Obesity and increased androgen levels are risk factors for mood disorders in women.
How is Polycystic Ovary Syndrome Diagnosed?
There are three primary indicators of PCOS that include, Lack of a menstrual period, Polycystic ovaries, Clinical confirmation of excess androgens
Because there is no definitive test for PCOS, diagnosis comes by way of excluding other conditions that could be responsible for your symptoms. Risk factors for PCOS include a family history of diagnosed PCOS, irregular periods, or diabetes.
To evaluate for PCOS, you are likely to receive services such as:
- Medical history and physical examination
- Pelvic examination