What is PCOS?
PCOS is a problem with hormones that affects women during their childbearing years (ages 15 to 44). Between 2.2 and 26.7 percent of women in this age group have PCOS. Many women have PCOS but don’t know it. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed. PCOS affects a woman’s ovaries, the reproductive organs that produce estrogen and progesterone — hormones that regulate the menstrual cycle.
- cysts in
the ovaries
- high levels of
male hormones
- irregular or
skipped periods
In
PCOS, many small, fluid-filled sacs grow inside the ovaries. The word “polycystic”
means “many cysts.” These sacs are actually follicles, each one containing an
immature egg. The eggs never mature enough to trigger ovulation.
The
lack of ovulation alters levels of estrogen, progesterone, FSH, and LH.
Progesterone levels are lower than usual, while androgen levels are higher than
usual. Extra male hormones disrupt the menstrual cycle, so women with PCOS get
fewer periods than usual. PCOS isn’t a new condition. Italian physician Antonio
Vallisneri first described its symptoms in 1721.
What causes it?
Doctors
don’t know exactly what causes PCOS. 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.
Genes
Studies
show that PCOS runs in families. It’s likely that many genes — not just one —
contribute to the condition.
Insulin
resistance
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 for type 2 diabetes.
Inflammation
Women
with PCOS often have increased levels of inflammation in their body. Being
overweight can also contribute to inflammation. Studies have linked excess
inflammation to higher androgen levels.
Common symptoms of PCOS
The
most common PCOS symptoms are:
- Irregular
periods. A
lack of ovulation prevents the uterine lining from shedding every month.
Some women with PCOS get fewer than eight periods a year or none at all.
- Heavy bleeding. The
uterine lining builds up for a longer period of time, so the periods you
do get can be heavier than normal.
- Hair growth. More than
70 percent of women with this condition grow hair on their face and body —
including on their back, belly, and chest. Excess hair growth is
called hirsutism.
- Acne. Male
hormones can make the skin oilier than usual and cause breakouts on areas
like the face, chest, and upper back.
- Weight gain. Up to 80
percent of women with PCOS are overweight or have obesity.
- Male pattern
baldness. Hair
on the scalp gets thinner and may fall out.
- Darkening of the
skin. Dark patches of
skin can form in body creases like those on the neck, in the groin, and
under the breasts.
- Headaches. Hormone
changes can trigger headaches in some women.
How PCOS affects your body
Having
higher-than-normal androgen levels can affect your fertility and other aspects
of your health.
Infertility
To
get pregnant, you have to ovulate. Women who don’t ovulate regularly don’t
release as many eggs to be fertilized. PCOS is one of the leading causes
of infertility in women.
Metabolic
syndrome
Up
to 80 percent of women with PCOS are overweight or have obesity. Both obesity
and PCOS increase your risk for:
- high blood sugar
- high blood
pressure
- low HDL “good”
cholesterol
- high LDL “bad”
cholesterol
Together,
these factors are called metabolic syndrome, and they increase the risk
for:
- heart disease
- diabetes
- stroke
Sleep
apnea
This
condition causes repeated pauses in breathing during the night, which interrupt
sleep. Sleep apnea is more common in women who are overweight — especially
if they also have PCOS. The risk for sleep apnea is 5 to 10 times higher in
women who have both obesity and PCOS than in those without PCOS.
Endometrial
cancer
During
ovulation, the uterine lining sheds. If you don’t ovulate every month, the
lining can build up. A thickened uterine lining can increase your risk
for endometrial cancer.
Depression
Both
hormonal changes and symptoms like unwanted hair growth can negatively affect
your emotions. Many with PCOS eventually experience depression and
anxiety.
How PCOS is diagnosed
Doctors
typically diagnose PCOS in women who have at least two of these three symptoms. 
- high androgen
levels
- irregular
menstrual cycles
- cysts in the
ovaries
Your
doctor should also ask whether you’ve had symptoms like acne, face and body
hair growth, and weight gain. A pelvic exam can look for any problems
with your ovaries or other parts of your reproductive tract. During this test,
your doctor inserts gloved fingers into your vagina and checks for any growths
in your ovaries or uterus. Blood tests check for higher-than-normal levels of
male hormones. You might also have blood tests to check your cholesterol,
insulin, and triglyceride levels to evaluate your risk for related
conditions like heart disease and diabetes. An ultrasound uses sound
waves to look for abnormal follicles and other problems with your ovaries and
uterus.
Pregnancy and PCOS
PCOS
interrupts the normal menstrual cycle and makes it harder to get pregnant.
Between 70 and 80 percent of women with PCOS have fertility problems. This
condition can also increase the risk for pregnancy complications. Women
with PCOS are twice as likely as women without the condition to deliver their
baby prematurely. They’re also at greater risk for miscarriage, high blood
pressure, and gestational diabetes. However, women with PCOS can get
pregnant using fertility supplements that improve ovulation. Losing
weight and lowering blood sugar levels can improve your chances of having a
healthy pregnancy.
Diet and lifestyle tips to treat PCOS
Treatment
for PCOS usually starts with lifestyle changes like weight loss, diet,
supplements and exercise. Losing just 5 to 10 percent of your body weight can
help regulate your menstrual cycle and improve PCOS symptoms. Weight loss can
also:
- improve
cholesterol levels
- lower insulin
- reduce heart
disease and diabetes risks
Any
supplement and diet that helps you lose weight can help your condition.
However, some diets may have advantages over others.
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
3 days a week can help women with PCOS lose weight. Losing weight with exercise
also improves ovulation and insulin levels.
Exercise
is even more beneficial when combined with a healthy diet and use of natural
organic nutritional Supplements. Supplements plus exercise helps you lose more
weight than either intervention alone, and it lowers your risks for diabetes
and heart disease.
Common medical treatments
Birth
control pills and other medications can help regulate the menstrual cycle and
treat PCOS symptoms like hair growth and acne.
Birth
control
Taking
progestin daily can:
- restore a normal
hormone balance
- regulate
ovulation
- relieve symptoms
like excess hair growth
- protect against
endometrial cancer
These
hormones come in a pill, patch, or vaginal ring.
Metformin
Metformin (Glucophage,
Fortamet) is a drug used to treat type 2 diabetes. It also treats PCOS by
improving insulin levels. One study found that taking metformin while
making changes to diet and exercise improves weight loss, lowers blood sugar,
and restores a normal menstrual cycle.
Clomiphene
Clomiphene
(Clomid) is a fertility drug that can help women with PCOS get pregnant.
It’s
important to note that, as you’re discussing family planning, to keep in mind
that clomiphene increases the chances for twins and other multiple births.
Hair
removal medications
A
few treatments can help get rid of unwanted hair or stop it from growing.
Eflornithine
(Vaniqa) cream is a prescription drug that slows hair growth. Laser hair
removal and electrolysis can get rid of unwanted hair on your
face and body.
Surgery
Surgery
can be used to improve fertility if other treatments don’t work. Ovarian
drilling is a procedure that makes tiny holes in the ovary with a laser or thin
heated needle to restore normal ovulation.
When to see a Wellness Consultant
See
your wellness consultant if:
- You’ve missed
periods, and you’re not pregnant.
- You have
symptoms of PCOS, such as hair growth on your face and body.
- You’ve been
trying to get pregnant for more than 12 months but haven’t been
successful.
- You have
symptoms of diabetes, such as excess thirst or hunger, blurred vision, or
unexplained weight loss.
If
your periods are already irregular or absent and you’re trying to get pregnant,
do not wait 12 months to see a specialist to be evaluated. Also, keep in mind
that if you do not wish to get pregnant, irregular or absent periods are not
birth control in themselves.
It
may still be possible to get pregnant even under these conditions. It’s best to
use contraception in this case even if you have PCOS.
PCOS
can disrupt a woman’s menstrual cycles and make it harder to get pregnant. High
levels of male hormones also lead to unwanted symptoms like hair growth on the
face and body. Lifestyle readjustment are the first treatments doctors
recommend for PCOS, and they often work well. Weight loss can treat PCOS
symptoms and improve the odds of getting pregnant. Use of Natural organic
Nutritional Supplements and aerobic exercise are two effective ways to lose
weight. Medications are an option if lifestyle changes don’t work.
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