Polycystic Ovarian Syndrome (PCOS) is a genetic, hormone, metabolic, and reproductive disorder affecting 8-13% of women of reproductive age.
And yet 70% of cases are undiagnosed. I was one of those women – I didn’t know I had PCOS until I struggled to conceive my second child.
My PCOS Struggle
I suffered from PCOS for many years, and it was not until I talked with my sister, Dr. Javaid that I had even heard of PCOS.
I had always gone to the doctor every year and had normal check ups. I was asked about my period, and when I mentioned my period was irregular, I was told it was fairly normal and I was put on the pill to help regulate it. Problem solved I thought – I was getting my period every month. I had no trouble conceiving my first born, but when I went off the pill to try and have my second child, my period just stopped happening – not because I was pregnant. I wasn’t ovulating – I couldn’t get pregnant.
I talked to my sister about it, and she asked more questions – had I gained weight? Yes. I thought it was happy marriage weight. How often was I waxing? I thought, that’s so odd! But, if I didn’t wax the hair on my face, it would come back very quickly. I thought it was part of our South Asian culture – we are hairy, and (bonus!) we have dark hair. She was gentle with my emotions, but pointed out that my hair growth was more than average. She suggested that I may have PCOS, but that I should get my blood work done to check my levels. She also shared that it ran in our family. She explained to me what PCOS was, that I had many of the common symptoms and that it could cause issues with fertility.
When I got my lab results back, she was right. My testosterone levels were elevated. My cholesterol levels were high. I was diagnosed with PCOS. This was the reason for my irregular periods. This is why I was having trouble conceiving. But no one told me until I talked with my sister about it! I am so thankful I had that conversation. I was so distraught in being unable to get pregnant and now at least I knew why and what was going on with my body. I share this story to help other women – while PCOS is not life threatening, it had a huge impact on my life and was a contributing factor to my infertility. Had I known earlier, I would have sought help. I would have asked what my treatment options were and how I could mitigate the symptoms. I’ve outlined below what some of the causes for PCOS are, how it can be treated and how it can impact your life. This is all the information I wish I had known when I first started to notice my irregular periods as a teen.
What is PCOS?
While the root causes of PCOS aren’t fully known, we do know that genetic triggers and family history contribute to a diagnosis of PCOS. So, what happens to our bodies when we have PCOS? PCOS is caused by an imbalance of hormones, with those affected showing forms of insulin resistance, and producing higher than normal amounts of male hormones like androgen or testosterone.
This hormonal imbalance causes improper signals to the ovaries which release the egg when we menstruate. What does this mean? The imbalance can lead to irregular or skipped periods, and a number of fluid-filled sacs or cysts in the ovaries. This is where the “polycystic” comes from, and these complications often result in obstacles to fertility for those with PCOS,
How is PCOS Diagnosed?
Unfortunately, there is no simple test for PCOS. It’s important to maintain an open dialogue with your healthcare provider about your overall health and your menstrual health. If PCOS is suspected, your provider will start by reviewing your family history as well as your menstrual cycles and any health or weight changes.
Your provider may then do a physical exam as well as blood tests, an ultrasound, or a pelvic exam. If you are diagnosed with PCOS, you may need ongoing tests to monitor the progression and symptoms.
What are the Symptoms of PCOS?
Below are the most common symptoms of PCOS.
- Increased hair growth on the face and chin (hirsutism)
- Presence of acne on the face, chest, and upper back
- Weight gain
- Thinning hair or hair loss in-line with male-pattern-baldness
- Irregular periods (extremes in both infrequency and frequency)
- Insulin resistance/diabetes
- Darkening of skin, especially in the groin, and under the breasts
- Increased risk of type 2 diabetes *50% of women with PCOS will develop type 2 diabetes or prediabetes before age 40
- Increased risk of high cholesterol levels
This list covers the most frequently encountered symptoms, but may uniquely affect you based on your unique genetic factors.
Treatment options for PCOS
While treatment options may differ for everyone, below are some options to help treat PCOS.
- Lifestyle changes – a balanced, low-calorie diet combined with even modest exercise can positively affect your weight, immunohealth, and fertility, and may also increase the efficiency and effectiveness of prescribed medications.
- Medication* – your doctor may prescribe a number of medications to address your specific symptoms, such as anti-androgen medications for hair loss, Metformin or other insulin-regulating medications for diabetes, Gonadotropin hormone injections, and even birth control or other similar medications to regulate your menstrual cycle and ovulation.
*Medications are determined between you and your provider, and insurance coverage may vary.
What’s most important is that you do seek help for any questions or concerns you have about PCOS and whether you are affected.
PCOS and Infertility
Infertility is one of the most common side effects of PCOS and is frequently at the core of diagnosis. This does not mean that you cannot get pregnant if you have PCOS. Some women are able to conceive naturally with PCOS with the help of treatments ranging from ovulation induction and intrauterine insemination (IUI) to In Vitro Fertilization (IVF).
If you are trying to conceive and are having issues, or think you may have PCOS, please give us a call or schedule an appointment here.
From someone who has PCOS, there is hope. My second child was born in November of 2013. I modified my diet and lifestyle, and my period is now on a regular cycle, without being on the pill. My biggest piece of advice – listen to your body and talk with your doctor about your concerns. Most of all, find a healthcare provider who will listen to you.
Source: The World Health Organization