May 27, 2020 7 min read


So, you have been diagnosed with a complicated name syndrome, or maybe you have a sister, or a friend who has been diagnosed with it: PCOS, or Polycystic Ovary Syndrome. We want to help you navigate this confusing illness that can manifest so many different symptoms and that can leave you a little lost when it comes to how to treat it.

What is PCOS?

PCOS or Polycystic Ovary Syndrome is a hormonal disorder that causes enlarged ovaries with small cysts on the outer edges.

The ovaries make the egg that is released each month as part of a healthy menstrual cycle. With PCOS, the eggs never mature enough to trigger ovulation.

The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Estrogen and progesterone levels are lower than usual, while androgen levels are higher than usual.

PCOS can cause missed or irregular menstrual periods, and irregular periods can lead to infertility (inability to get pregnant) and to the development of cysts (small fluid-filled sacs) in the ovaries. The word “polycystic” means “many cysts".

But PCOS is an endocrine and metabolic disorder that affects the body well beyond the ovaries and not everyone with PCOS has ovarian cysts, and polycystic ovaries on their own don’t meet the criteria for diagnosis.

Women with PCOS have a hormonal imbalance and metabolism problems that may affect their overall health and appearance. It is a very common syndrome, but it remains undiagnosed and unmanaged in most people who have it. It affects 1 in 10 women of childbearing age, and of those who have it, about 7 in 10 may go undiagnosed.

Most women find out they have PCOS in their 20s and 30s, when they have problems getting pregnant and they visit their doctor, but the truth is PCOS can happen at any age after puberty.

Women of all races and ethnicities are at risk of PCOS, and your risk of PCOS may be higher if you have obesity or if you have a mother, sister, or aunt with PCOS.

What are the causes of PCOS?

The exact cause of PCOS is not known. Most experts think that several factors, including genetics, play a role. They believe that high levels of male hormones prevent the ovaries from producing hormones and making eggs normally.

Genes, insulin resistance, and inflammation have all been linked to excess androgen production:

  • High levels of Androgens: even though they are called ‘male hormones’, androgens are made in small amounts in most women. They control the development of male traits, such as male-pattern baldness. Women with PCOS have more androgens than normal. If a patient has androgen in higher than normal levels then the ovaries are prevented from releasing an egg (ovulation) during each menstrual cycle. It can also cause the growth of extra hair growth and acne, 

  • High levels of Insulin: Up to 70 percent of women with PCOS have insulin resistance, meaning that their cells can’t use insulin properly. Insulin is a hormone the pancreas produces to help the body use sugar from foods for energy. When cells can’t use insulin properly, the body’s demand for insulin increases. The pancreas makes more insulin to compensate. Extra insulin triggers the ovaries to produce more male hormones.

    Obesity is a major cause of insulin resistance. Both obesity and insulin resistance can increase your risk of type 2 diabetes.

  • Inflammation: Women with PCOS often have increased levels of inflammation in their bodies. Being overweight can also contribute to inflammation. Studies have linked excess inflammation to higher androgen levels.

What are the symptoms?

Because symptoms may be attributed to other causes or go unnoticed, PCOS may go undiagnosed for some time.

Most women with PCOS typically have irregular or missed periods as a result of not ovulating. As I mentioned before some people may also develop cysts on their ovaries, but many people do not. 

Signs and symptoms of PCOS vary:

  • Irregular periodsA lack of ovulation prevents the uterine lining from shedding every month. Some women with PCOS get fewer than eight periods a year
  • Weight gain. About half of people with PCOS will have weight gain and obesity that is difficult to manage.

  • Fatigue. Many people with PCOS report increased fatigue and low energy. Related issues such as poor sleep may contribute to the feeling of fatigue.

  • Unwanted hair growth (also known as hirsutism). Areas affected by excess hair growth may include the face, arms, back, chest, thumbs, toes, and abdomen. Hirsutism related to PCOS is due to hormonal changes in androgens.

  • Thinning hair on the head. Hair loss related to PCOS may increase in middle age.

  • Infertility. PCOS is a leading cause of female infertility. However, not every woman with PCOS is the same. Although some people may need the assistance of fertility treatments, others are able to conceive naturally.

  • Acne. Hormonal changes related to androgens can lead to acne problems. Other skin changes such as the development of skin tags and darkened patches of skin are also related to PCOS.

  • Mood changes. Having PCOS can increase the likelihood of mood swings, depression, and anxiety.

  • Pelvic pain. Pelvic pain may occur with periods, along with heavy bleeding. It may also occur when a woman isn’t bleeding.

  • Headaches. Hormonal changes prompt headaches.

  • Sleep problems. People with PCOS often report problems such as insomnia or poor sleep. There are many factors that can affect sleep, but PCOS has been linked to a sleep disorder called sleep apnea. With sleep apnea, a person will stop breathing for short periods of time during sleep. 

 

 How PCOS is Diagnosed? 

There is not one special test that can diagnose PCOS. Your doctor will start by asking questions about your medical history of symptoms such as irregular or skipped periods, weight changes, hair changes, and acne. Your doctor will also ask about your family’s medical history. Your doctor will check your weight and vitals and do a complete physical exam.

A number of lab tests may be ordered including blood sugar and androgen levels. Your doctor will also check for other hormones related to other common health problems that can be mistaken for PCOS, such as thyroid disease. Your doctor may also test your cholesterol levels and test you for diabetes.

A sonogram may also be done to evaluate the ovaries. Your doctor might also do a pelvic exam for signs of extra male hormones (for example, an enlarged clitoris) and check to see if the ovaries are enlarged or swollen.

These tests help to make a diagnosis of PCOS and exclude other causes for your symptoms.  Your primary doctor may also refer you to a hormone specialist, or endocrinologist, to help direct the work-up needed to rule out other causes and confirm the diagnosis of PCOS. 

Once other conditions are ruled out, you may be diagnosed with PCOS if you have at least two of the following symptoms:

  • Irregular periods, including periods that come too often, not often enough, or not at all
  • Signs that you have high levels of androgens:
    1. Extra hair growth on your face, chin, and body (hirsutism)
    2. Acne
    3. Thinning of scalp hair
  • Higher than normal blood levels of androgens
  • Multiple cysts on one or both ovaries

PCOS is most of the time underdiagnosed and undertreated. This may be because symptoms can be mild or seem unrelated, but untreated PCOS can lead to a wide range of more serious health conditions, and the symptoms of the disorder can cause significant distress. Unmanaged PCOS is associated with type 2 diabetes, infertility, cardiovascular disease, obesity, sleep apnea (disrupted breathing in sleep), non-alcoholic fatty liver disease, and depression. Early diagnosis and treatment can help reduce these risks significantly.

Is there a treatment for PCOS?

If a woman is not seeking to become pregnant, hormonal birth control (most often birth control pills) is a standard treatment. Birth control pills regulate periods and improve excess hair growth and acne by lowering androgen levels and protect the endometrium (inner lining of the uterus) against abnormal cell growth. Older types of birth control pills have a lower risk for dangerous blood clots and are preferable over new types of birth control pills.

Although metformin is not approved by the FDA for the treatment of PCOS, many doctors prescribe it for PCOS patients. Metformin is a medicine that makes the body more sensitive to insulin. This can help lower elevated blood glucose levels, insulin levels, and androgen levels. People who use metformin may lose some weight as well. Metformin can improve menstrual patterns, but metformin doesn’t help as much for unwanted excess hair.

Other medications that may be prescribed for PCOS include anti-diabetic medication and anti-androgen medication to help in balancing hormones. These medicines might cause problems during pregnancy.

 

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Our Myo-Inositol and D-Chiro Inositol Blend supports healthy ovarian function, provides hormonal balance, insulin support, weight management, blood pressure health, promotes a healthy menstrual cycle, egg quality, and overall reproductive health.

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Diet and lifestyle tips to treat PCOS

Lifestyle measures to achieve a weight loss of 5%-10% in overweight women can help regulate ovulation and periods. Although the basic approach of nutrition is needed, it can be more challenging to lose weight and maintain weight loss with PCOS. 

Weight loss can also improve cholesterol levels, lower insulin, and reduce heart disease and diabetes risks.

Studies comparing diets for PCOS have found that low-carbohydrate diets are effective for both weight loss and lowering insulin levels. A low glycemic index (low-GI) diet that gets most carbohydrates from fruits, vegetables, and whole grains helps regulate the menstrual cycle better than a regular weight loss diet.

A few studies have found that 30 minutes of moderate-intensity exercise at least three days a week can help women with PCOS lose weight. Losing weight with exercise also improves ovulation and insulin levels.

 


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