Polycystic ovary syndrome, or PCOS, is a disorder that affects somewhere between 6-13% of women. It is a hormonal disorder in which male hormones are out of whack. Previously considered strictly a reproductive disorder, we now understand that PCOS affects a lot more than just menstrual cycles and fertility, and can affect health beyond the reproductive years.
PCOS is poorly understood by the general public and even healthcare professionals. Right off the bat, the syndrome is very poorly named which generates a lot of the confusion. Yes, many women with PCOS have multiple follicles in their ovaries, which are referred to as cysts. However, not all women with PCOS have these. Calling these follicles cysts is technically correct, but there are many different types of ovarian cysts. The ones associated with PCOS, known as follicular cysts, are not the ones that rupture and cause pain. I remember talking to a friend and questioning if I had PCOS. Her response was “have you ever even had a cyst burst before?”. Seems like a logical question to ask, but actually had nothing to do with anything I was talking about. As it turned out, I did have a bunch of cysts in my ovaries, just no one looked for them via ultrasound before. I could not feel them and it’s not something that’s routinely checked for.
To make things extra confusing, not every women’s PCOS is the same. PCOS involves having multiple follicular cysts in the ovaries, elevated male hormone levels, and having absent or irregular menstrual cycles. Not all women have all three diagnostic criteria.
Symptoms of PCOS can vary widely and may include:
PCOS is associated with other health issues including:
Overweight and obesity
Pregnancy loss, preterm births, stillbirths
Gestational diabetes, prediabetes and type 2 diabetes
High blood pressure
Elevated cholesterol levels
Fatty liver disease
There is no cure for PCOS, but different treatment options are available. Birth control and metformin are common medical treatments for PCOS as they help improve many of the symptoms. There are many over the counter supplements that can help as well. Lifestyle interventions including weight loss, dietary changes and increasing exercise can also be very impactful. Being overweight or obese does not cause PCOS, but can make symptoms worse. Even a small amount of weight loss can be helpful. In addition, some lifestyle interventions that can improve symptoms don’t involve weight loss at all. For women with PCOS struggling to get pregnant, there are many medications and interventions available.
PCOS is unfortunately an underdiagnosed, underfunded and undertreated condition. From talking with women, especially from the infertility community, it seems it may also be common to be incorrectly diagnosed with PCOS. Sometimes women have to advocate for themselves to get the care and answers that they need. I highly recommend working with a Registered Dietitian Nutritionist that has experience with PCOS to work on lifestyle modifications. If you are trying to conceive, you may want to make an appointment with a reproductive endocrinologist as many of their patients have PCOS.