What Is Polycystic Ovary Syndrome (PCOS)? It’s Not Just Infertility

What Is Polycystic Ovary Syndrome (PCOS)? It's Not Just Infertility

What Is Polycystic Ovary Syndrome (PCOS)? It’s Not Just Infertility

Do you sometimes go two to three months without having a menstrual cycle or does it come far sooner than you expected? Are your cycles extremely heavy, and do you notice that your acne seems to be worse than for other people?  Have you had trouble conceiving, or do you have  more hair on your face and body than you expect?

If any of this sounds familiar to you, you could have PCOS.  Read on to find out “What is polycystic ovary syndrome?” and discover what to do if you think you have this condition.

What Is Polycystic Ovary Syndrome?

Polycystic ovary syndrome, better known as PCOS, is a condition that impacts 5 to 11% of women. PCOS can cause very infrequent cycles or cycles that last far longer than is typical for most women.  It can also cause your ovaries not to release eggs on a regular schedule and may cause many small follicles to collect on your ovaries.

Doctors are still trying to figure out the exact cause of PCOS is, although we do know about some factors that can raise your risk of developing this condition. While PCOS can cause infertility, it can also cause a host of other symptoms and challenges. The good news is that there are treatment options that can help to mitigate these symptoms.

Symptoms

One of the most noticeable symptoms of PCOS is an irregular menstrual cycle. For most people, their cycles happen roughly every twenty-eight days and may last between three to seven days. However, when you have PCOS, you may have fewer than nine menstrual cycles per year, extremely heavy cycles, or more than 35 days between your cycles.

In some cases, PCOS can cause higher levels of testosterone (male hormone) in female bodies, which can impact your appearance.  People with PCOS may notice that their acne is more severe or that they have more hair on their faces and bodies.  Additionally, some women with PCOS may experience hair loss on their head.   PCOS predisposes women to the development of diabetes and high cholesterol levels.

Risk Factors

Doctors don’t yet know what the exact cause of PCOS is, but they have been able to tie it to some risk factors. Some research suggests that PCOS may be a hereditary disorder, as you’re more likely to develop it if someone else in your family has it. And, in fact, some doctors think that higher levels of testosterone in the body may be a contributing factor to PCOS, in addition to a symptom.

One of the biggest symptoms of PCOS is too much insulin in the body. Your body produces insulin to break down sugar in your body, but if your cells become resistant to insulin, it can build up in your body and trigger you to release more testosterone. There is also some research that suggests that a type of low-grade inflammation could cause your body to produce the testosterone that is at the root of this condition.

Physical Complications

There are several physical complications that can arise from having polycystic ovary syndrome. First of all, it may be difficult or impossible for you to get pregnant since ovulation is so irregular. If you do get pregnant, you’re more likely to develop diabetes or high blood pressure during the course of your pregnancy.

People who are able to get pregnant with PCOS are also more likely to deliver early or have a miscarriage. You might also be at higher risk of developing severe liver inflammation caused by a buildup of fat in your liver. You’re also more likely to develop high blood pressure, high blood sugar, high cholesterol, cardiac disease, prediabetes, Type 2 diabetes, endometrial cancer, abnormal uterine bleeding, and sleep apnea.  Some women will develop darkening of the skin on the back of their neck or under their arms due to insulin resistance.

Mental Ramifications

In addition to the physical complications PCOS can present, patients are also more likely to experience some mental health challenges because of the disease. If you’re someone who wants children, dealing with infertility can be extremely difficult. You may become depressed or develop an anxiety disorder, especially if you have to go through multiple miscarriages.

Women with PCOS are more likely to be overweight than women without PCOS and may experience weight gain more in their midsection, and therefore may face body image issues and pressure to lose weight. While healthy weight loss is actually a good way to manage this condition, not everyone handles their weight loss journey in a positive way. People with PCOS may be at higher risk of developing eating disorders as a way to control their body and their condition.

Social Challenges

There are also a number of social challenges that can come with PCOS and may exacerbate some of the mental health challenges we discussed. If you’re experiencing infertility because of PCOS, the question, “So when are you going to start having babies?” can be extremely awkward and painful. You may feel pressure from friends and family members to have a baby, and you might be forced to choose between revealing your medical history and trying to deflect insensitive comments.

The irregular cycles that come with PCOS can also make life difficult. You may not know when you’re going to get your cycle, and a heavy flow can lead to embarrassing incidents. You may also deal with body image issues surrounding excess hair, more severe acne, or the male-pattern baldness that can result from PCOS.

When to See a Doctor

If any of this sounds familiar to you, it’s a good idea to talk to your doctor about whether you may have PCOS. It’s always a good idea to talk to your doctor if your cycles are irregular, especially if this is a new development.  If you suspect you have PCOS or if any of the symptoms in this article apply to you, you should make an appointment to make sure you are healthy and there are no underlying issues that need to be addressed.

It’s also always a good idea to talk to your doctor if you’re worried that you might be dealing with infertility. Your doctor can run a variety of tests to determine if anything is wrong and may be able to give you advice so you can increase your chances of becoming pregnant. You may also want to make an appointment if you have any of the symptoms we’ve discussed including excess body or facial hair, severe acne, or male-pattern baldness.

Diagnosis

When you visit your doctor, there are several tests they can run to determine if you have PCOS. They’ll likely start with a full history and exam, during which time they will evaluate you for signs and symptoms of PCOS, or other conditions that can cause similar symptoms.  They may also want to do blood tests to see what your hormone levels are, especially what your testosterone levels look like.

Your doctor may also want to get a better look at your ovaries and uterus.  They’ll likely do this with a painless procedure called a transvaginal ultrasound. They will place a wand-like device in the vagina that will emit sound waves that can then be converted into images on a screen.

Lifestyle Change Options

If you get diagnosed with PCOS, there are some lifestyle changes you can make to help manage your condition. The first thing your doctor is likely to recommend is that you lose weight, though it’s important to manage this in a healthy way. Not only do crash diets not work, but they can be extremely unhealthy for you and cause you to hold onto weight.

Try to become more active, walking for thirty minutes five days a week or joining an exercise class. You may also want to focus on incorporating more fresh fruits and veggies and lean protein into your diet. Cutting back on carbohydrates can help you lose weight, feel better, and is especially beneficial in managing PCOS.

Cycle Regulating Medications

In addition to the lifestyle changes your doctor may suggest, they can also prescribe you some medications to help regulate your cycles. One of the most popular is birth control pills; while these do help to prevent pregnancy, they’re also useful for keeping your cycles regular and lighter, and can reduce unwanted hair growth. Of course, if you’re trying to get pregnant, you’ll have to explore alternate options.

One of the best options to regulate your cycles if you’re trying to get pregnant is progesterone therapy. You can take progesterone for twelve to fourteen days every one or two months to help regulate your cycles. This treatment can also help to reduce your risk of endometrial cancer, and it won’t stop you from getting pregnant.

Ovulation Treatment Options

You may also need to undergo some additional treatment if you’re trying to get pregnant with PCOS. Your doctor might recommend you take a medication called letrozole, which initially was used for breast cancer treatment but can also stimulate your ovaries to allow the eggs to mature and to be released (ovulation).

A Type 2 diabetes medication called metformin may also help you to ovulate by reducing insulin and therefore reduce testosterone levels in your body. It can also help you to lose weight and may slow your progression to Type 2 diabetes. And finally, there are hormone injections called gonadotropins that can improve ovarian stimulation and ovulation, although In Vitro Fertilization can be safer than gonadotropins when trying to conceive and reduce your risk of a multiple pregnancy.

Hair Growth Reduction Medications

If you want to address the hair growth that is associated with PCOS, there are a few medications and treatments that your doctor may recommend. Birth control pills can actually help to decrease your facial and body hair since they decrease the amount of testosterone in your body. However, this obviously won’t be an option if you plan on becoming pregnant.

Your doctor may also prescribe you a medication called spironolactone, which blocks the effects of testosterone on the skin. You must also be using some form of effective contraceptive while you’re taking this medication since it can cause birth defects in a female baby. There’s also a cream called eflornithine that can help to slow facial hair growth and Minoxidil, a cream which can help reduce hair loss from your scalp.

Preparing for Your Appointment

Before you go to your doctor’s appointment, there are a few things you may want to do to prepare. First and foremost, it’s a good idea to put together a complete medical history.  Be sure to include any conditions you’ve been diagnosed with in the past and whether any family members of yours have ever been diagnosed with PCOS.

It’s also a good idea to keep track of your cycles for the past six to twelve months prior to going to your appointment. Make a note of when they start and stop, as well as any symptoms you experience during your cycles.  Having this information in hand can make it easier for your doctor to see if your cycles fit the pattern of PCOS.

Questions to Ask

It’s also a good idea to write down any questions you have for your doctor before you go to your appointment. When you’re in the exam room, you may not be able to remember everything you wanted to ask. Having a list can ensure you get the answers you need so you’re better informed about your condition.

You might want to start by asking your doctor about the long-term health implications of PCOS and the best way for you to manage it. If you plan to get pregnant, you should talk to your doctor about how PCOS will impact your chances of conceiving. And if you have other medical conditions, you may want to ask your doctor about the best way to manage them together.

Get Treatment for PCOS

If you have irregular cycles, a lot of facial and body hair, and difficulty conceiving, knowing the answer to the question, “What is polycystic ovary syndrome?” could be very important for you. This condition can cause many challenges beyond infertility, but medication, diet and weight management can help. Talk to your doctor about the right treatment options for you.

If you’d like to learn more about PCOS, check out the rest of our site at Inovi Fertility and Genetics Institute. We’re committed to achieving the highest success rates while providing personalized care to our patients. Schedule an appointment with us today and get access to compassionate, expert care and state-of-the-art facilities.

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Stephan P. Krotz, M.D.
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Houston, TX 77046