Everything You Need To Know About Polycystic Ovary Syndrome (PCOS)

September is PCOS awareness month, yet research suggests that up to 70% of women who struggle with the condition are unaware that they have it and have not been diagnosed. These numbers are staggering, considering PCOS is a common disorder affecting up to 15% of women. 

So, what exactly is PCOS, and how can it affect the body? More importantly, how can women manage its symptoms? 

What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome (or PCOS) is a common condition that causes ovaries to produce excessive levels of male hormones (or androgens). Small, fluid-filled sacs or cysts form around follicles in the ovaries, producing abnormally high levels of androgens. These cysts can hinder ovulation, resulting in decreased fertility and irregular periods. 

Why Polycystic Ovary Syndrome Occurs

While researchers do not know precisely why polycystic ovary syndrome occurs, women with family members who suffer from PCOS are at higher risk for developing this condition. Though it is classified as an endocrine disorder, some research suggests that PCOS may be an autoimmune disease.

PCOS Types

Polycystic ovary syndrome is often grouped into four primary types based on the syndrome’s most common contributing factors. However, only three of these types are technically examples of PCOS; other temporary conditions can cause PCOS-like symptoms but will naturally resolve over time.

1. Firstly, insulin resistance is a condition correlated with PCOS. Insulin resistance prevents the body from reacting appropriately to insulin, causing the pancreas to produce more of the hormone to regulate blood glucose. In turn, high insulin levels stimulate the ovaries to produce androgens. If untreated, this variety of PCOS can lead to the development of type 2 diabetes. It is also the most common type of PCOS, affecting up to 70% of patients. 
2. Secondly, chronic low-grade inflammation can cause ovaries to produce excess androgens. Doctors can test for this condition by performing blood tests. 
3. Thirdly, PCOS is often triggered by stress, which may be referred to as adrenal PCOS. Elevated stress levels can lead to the production of higher levels of hormones such as cortisol. The presence of these hormones can lead to irregular periods, weight gain and other PCOS symptoms. In some cases, managing stress can help reduce PCOS symptoms. However, hypothalamic amenorrhea — caused solely by stress — is a separate condition, not a type of PCOS.
4. Finally, post-pill PCOS is the common name for a condition that often appears in women who have recently stopped taking hormonal birth control pills. In this situation, the ovaries naturally produce androgens, leading to many of the same symptoms seen in PCOS. However, this condition is not permanent and is not technically a type of PCOS.

How Does Polycystic Ovary Syndrome Affect the Body?

Polycystic ovary syndrome can have a wide range of effects on the body. It can cause weight gain — obesity and weight loss difficulties are present in approximately 80% of PCOS patients. 

Because of its effect on ovulation and hormones, the condition can also lead to periods that do not occur regularly, are very heavy or are very light.

Other physical symptoms are caused by increased levels of androgens, such as: 

• Excess hair growth (or hirsutism); 
• Acne;
• Hair loss. 

Individuals with PCOS may also notice patches of darkened skin around the armpits, neck and breasts and skin tags around the armpits and neck.

Is Polycystic Ovary Syndrome Dangerous?

Though not deadly, PCOS can become dangerous if left untreated. It often contributes to high blood pressure and puts patients at an increased risk of heart disease or stroke. It can also contribute to the development of type 2 diabetes. Finally, it can increase the risk of endometrial cancer and complicate pregnancy. 

A diagnosis of PCOS typically involves three criteria, including irregular periods, increased levels of male hormones and ovarian cysts. Patients who meet at least two of the three criteria can be diagnosed with PCOS. 

How PCOS Affects Pregnancy

Because it causes infrequent ovulation, polycystic ovary syndrome can reduce the likelihood of pregnancy. In fact, for women of childbearing age, PCOS is a common cause of infertility. The condition increases the risk of complications such as gestational diabetes and the likelihood of premature birth or even miscarriage. 

Can Polycystic Ovary Syndrome Be Cured?

While researchers have not found a cure for PCOS, medications and lifestyle changes can be used to treat symptoms. The exact treatment used for an individual patient may vary based on their symptoms and whether the patient wants to get pregnant. 

Spironolactone and Metformin for Polycystic Ovary Syndrome

Some patients may use antiandrogens (i.e., drugs that mitigate the effects of androgens) like spironolactone to treat PCOS symptoms such as excess hair growth. Others may take metformin for PCOS since it helps decrease the production of androgens by aiding insulin processing. For those who wish to become pregnant, medications that cause ovulation may be prescribed. Regulation of menstrual cycles may also be achieved through the use of birth control pills. 

Even though the condition is not curable, routine lifestyle changes can help manage the condition. For example, weight loss can lead to better insulin sensitivity and lessen the severity of symptoms. For PCOS patients, nutrients to avoid include carbohydrates, which contribute to insulin resistance and inflammation, thus worsening symptoms. 

Even though PCOS is not curable, treatment can significantly reduce the condition’s manifestations, improve patients’ quality of life and reduce long-term health risks.

A Parting Reminder

Polycystic ovary syndrome is a common condition that can affect women’s reproductive systems. There is no known cause, but genetic factors likely play a role in determining where PCOS manifests. Symptoms can include weight gain, irregular periods, excess hair growth, acne and hair loss. 

The syndrome is common, and patients are not alone. Various resources, including drugs that help manage insulin, are available to treat the condition. In some cases, lifestyle changes such as the implementation of regular exercise can also help manage symptoms. If you believe you may have PCOS, take action to protect your long-term health and consult a doctor immediately.