September is PCOS Awareness month and I can’t let it slip away without bringing attention to the disease I suffer from – Polycystic Ovarian Syndrome. Now if medical-related blogs aren’t really your thing, which is TOTALLY okay, now would be a great time to say ‘peace out’ for today. But for others who are interested, I would love to share with you a little bit more about what PCOS is and how it affects the body, how its controlled, how to treat it and then share some great resources with you.
What is PCOS? Polycystic ovarian syndrome (PCOS for short) is the most common hormonal endocrine disorders in women. Most women with PCOS (but not all) grow many small cysts on their ovaries. We are who lucky enough to have said cysts (insert sarcastic tone here) typically call these cysts a “pearl necklace”. No, this isn’t the pretty kind of jewelry Audrey Hepburn wears around her neck, instead they are tiny cysts strung in a row around the lining of our ovaries (seen on an ultrasound). These cysts aren’t typically harmful and will mainly cause hormone imbalances (unless they burst, which is very serious unless treated immediately.)
What are the symptoms of PCOS? PCOS can be so tricky to diagnose because there are a wide variety of signs and symptoms that a woman might experience. Unfortunately there isn’t one stand-alone test that can be done. Most of the time it is a combination of tests that will lead your physician to diagnose you with PCOS. Sometimes women only have a few of these symptoms that may be mild or severe or perhaps many of the symptoms are non-existent. Common symptoms are listed below with the percentage of women with PCOS who are affected with said issue:
- Irregular periods (75-80%) (in fact 25% of women with PCOS have regular cycles)
- Excessive hair growth on the face and body (60-80%)
- Thinning hair (40-70%)
- Acne (40-60%)
- Excess weight, sugar cravings and the inability to lose weight (75-80%)
- Insulin resistance (55-80%)
- Abnormal blood lipid levels and a tendency to have an apple shape (55-80%)
- Darkening of skin areas, particularly on the nape of the neck (known as acanthosis nigricans) (10%)
- Skin tags (unknown %)
- Gray-white breast discharge (8-10%)
- Sleep apnea and sleep disturbances (8%)
- Pelvic pain (unknown %)
- Depression, anxiety and other emotional disorders (unknown %)
Unfortunately PCOS does tend to run in families, so there is an increase in diagnosis if women in your family have PCOS, symptoms of excess male hormones, weight problems, irregular periods and/or infertility.
One of the significant symptoms that I struggle with is insulin resistance, leading to weight issues as well as increased male hormones. Because I, like many women, are insulin resistant, it puts us in a category of being “pre-diabetic” and more likely to be diagnosed with diabetes down the line if not properly managed.
How is PCOS controlled? Simply put, one of the easiest ways to control PCOS is through diet and exercise. I read it that ”put very simply”, this is how it works:
Weight loss –> Reduced Insulin resistance –> Lowered insulin blood levels –> lessened secretion of male hormones by ovaries
Guys, I wish I could convey to you how difficult it is for women with PCOS to lose weight though if being overweight is a struggle. (And not all women with PCOS are overweight.) It can be extremely tough but not impossible. Managing PCOS with diet means having to follow a low-glycemic and low-carbohydrate plan. Food plays a crucial part in minimizing PCOS symptoms and even when someone is nearly perfect on their diet, they can see little to no changes in weight. It can be incredibly frustrating and women with PCOS can also gain weight at a rapid rate due to the hormones imbalances and insulin resistance. Our blood levels constantly fluctuate which leads to storing our calories as fat and then hanging on to it tightly. However, weight management is known to be one of the most powerful ways to control PCOS. In fact, one of the books I read claims that “losing 7-10% of your body weight causes more than two-thirds of women to resume ovulating, even with some long histories of infertility”. (Annnnnd unfortunately for me, I was not one of those two-thirds ladies, oh boo.)
How do you diagnose PCOS? This is pretty tricky but the doctor will take into consideration a number of factors, including two common symptoms, irregular periods and a lack of ovulation. They will also run several labs tests, for example checking your levels of male hormones, your luteinizing hormone (LH), and follicle-stimulating hormones (FSH). Many but not all doctors will do an ultrasound to look at your ovaries to see if there are multiple cysts evident and then lastly, they will rule out any other issues that may lead to similar symptoms, like thyroid issues. PCOS affects 5-10% of the female population.
How is PCOS treated? Like I mentioned above, diet is a key component to managing PCOS, however, there are times when that just isn’t enough. In women who are not actively trying to conceive, an oral contraceptive is typically one of the first things that a doctor will try, simply because it helps to steady your hormones levels. However obviously with women who are trying to start a family, being on birth control is, well, counterproductive. J Many women are started on a drug called Metformin which is commonly used in the management of type 2 diabetes. (It lowers your blood sugar levels which can reduce your insulin resistance.) Its works for many patients, but unfortunately not everyone. (Again, like me, hmmm, apparently I stick out like a bad statistic.) Many women just live with the symptoms of PCOS and treat them best they can, perhaps using an acne medicine for their acne or sleeping pills for sleep disorders or waxing for excess hair growth.
What are other conditions that may go with PCOS? There are some other diseases and conditions that are increased in women with PCOS and I don’t share any of this to make you nervous if you have PCOS yourself, but instead, share it so that you can be aware and proactive to minimize the risks. Some of these diseases are: type 2 diabetes, cardiovascular disease due to imbalanced cholesterol levels (another symptom), heart disease, endometrial hyperplasia and uterine cancer. Unfortunately women with PCOS are several times more likely than other women to develop uterine cancer due to the increased level of hormones and a lack of ovulation. (Since we don’t ovulate as often, our uterine lining doesn’t shed as often, which then affects our endometrium. If you have prolonged absences in your menstrual cycles (90+ days) work with your physician, as there are drugs that can trigger a period, such as Provera or a natural progesterone cream.)
Also, unfortunately staying pregnant is tougher for women with PCOS. Data shares that sadly, women with PCOS have three times the normal risk for miscarriage (which is 10-15% in normal women). Four out of five women with repeated miscarriages have been reported to have PCOS. There are ways to prevent this and drugs that help significantly reduce the miscarriage rate however, so again, make sure you are working closely with your doctor. There are MANY MANY MANY healthy babies born from a mommy with PCOS.
But I wanna have a baby!!!! Finally, some good news! The likelihood of having a baby with PCOS is great. PCOS is complex, yes, and perhaps I am not the best person to be writing about how pregnancy and deliveries are possible, but data shows that they are. Whenever possible, weight loss is the best place to start, but from there, there are many prescribed fertility drugs that can assist. While PCOS can never be cured, it can be controlled and that’s what we are aiming to do. ;)
Whoa! I hope I didn’t overwhelm you with too much info! PCOS certainly doesn’t make life more fun, however, it’s important to keep in mind that this isn’t just about me or you. There are many people around us who are struggling with a disease or condition. Like many diseases, education is an important tool and I hope that in reading this, you understand a little bit more about the disease you have been diagnosed with or someone you care about has. Due to its complexity, the associated hormonal imbalances, and the pure frustration of not being able to do what seems so natural to many, depression and anxiety are common in women with PCOS. It’s important to seek help when managing it on your own becomes too overwhelming. (A depressed mood, sleep disturbances, a loss of interest in things that you used to enjoy, feeling hopeless, constantly fatigued, changes in your appetite and/or suicidal thinking are all signs that it’s time to seek help.) Support groups can help tremendously. And always remember that seeking help does not mean that you are weak or less than others – professional help is there to help you cope with the hardships. Don’t be afraid to take advantage of that.
If you have made it to the end – congratulations! Thanks for taking the time to read this and I hope that I have been able to shed some light on PCOS. If you are a fellow believer, always, always, always remember that we serve a God much greater than PCOS, much more powerful than its symptoms and able to do much more than we can ask or imagine.
Reading Resources: There are two books I highly recommend if you are struggling with PCOS. The first is A Patient’s Guide to PCOS: Understanding and Reversing Polycistyc Ovary Syndrome by Walter Futterweit, M.D. with George Ryan and the second is The Ultimate PCOS Handbook: Lose Weight, Boost Fertility, Clear Skin and Restore Self Esteem by Collete Harris and Theresa Cheung. (Both books are linked here to Amazon, however, I do not receive compensation for these links. These links will simply provide you with more information on the books.)
Please note, this post is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about PCOS or any other health concern.