September is PCOS awareness month, an opportunity to talk more in depth about polycystic ovary syndrome, an often misunderstood and sometimes altogether unknown illness that affects women and other people assigned female at birth.
Those struggling with PCOS have hormone imbalances that occur during their reproductive years. This condition causes the ovaries to produce more androgens (the “male” sex hormone) than is typically found in women. With PCOS, small sacs of fluid (called cysts) containing immature eggs develop along the outer edge of the ovary. When women don’t make enough hormones to ovulate, these cysts develop and create androgens, causing more problems with the menstrual cycle.
It’s important to note, however, that not all people with PCOS have cysts, and some people without PCOS do have cysts.
Signs and Symptoms:
According to John Hopkins Medicine, symptoms of PCOS include the following:
- Missed periods, irregular periods, or very light periods
- Weight gain
- Ovaries that are large or have many cysts
- Excess body hair, including on the chest, stomach and back (this is called “hirsutism”)
- Acne or oily skin
- Male-pattern baldness or thinning hair
- Small pieces of excess skin on the neck or armpits (skin tags)
- Dark or thick skin patches on the back of the neck or the armpits, and under the breasts
Researchers do not know exactly what causes PCOS, but according to the NIH, it likely occurs as a result of both genetic and environmental factors. PCOS tends to run in families, so it may be caused in part by a gene mutation.
People with PCOS are more likely to develop other serious medical problems, in addition to infertility struggles. These health issues may include type 2 diabetes, high blood pressure, problems with the heart and blood vessels, and uterine cancer.
Mental health problems, such as depression and anxiety, are also common among people struggling with PCOS.
Myth: “PCOS is uncommon”. An estimated eight to 13 percent of Canadian women of childbearing age have PCOS. This means around 1.4 million Canadians struggle with the illness. According to the PCOS Awareness Association, less than half of all women with PCOS are formally diagnosed, meaning millions might be unaware of their condition.
Myth: “PCOS is only seen in overweight women”. While many women with PCOS are classified as overweight or obese, PCOS can affect people of any size. And while healthy lifestyle changes, like eating nutrient-dense foods and exercising, can help with PCOS and lead to weight loss, weight loss in and of itself is not a cure (there is currently no cure for PCOS).
Myth: “You can’t get pregnant with PCOS”. Whether you are trying to get pregnant or not, it is still possible to conceive if you have PCOS.
- Myth: “This is your fault”. Because many women who struggle with PCOS are classified as overweight or obese, and because we live in a fatphobic society, it’s common (but unfair) to place blame on PCOS sufferers for their health issues. This judgment simply doesn’t align with the science of PCOS, an illness informed by hormones and genetics.
What to Do:
If you suspect you have PCOS, the first step is to set up an appointment with your primary care physician. Leading up to your appointment, take notes of your symptoms so you are prepared. Your doctor should ask about your periods, any weight changes, and other physical and mental signs you may be suffering with the illness.
There is not one specific exam to diagnose PCOS, but your doctor will do several tests to see if you meet the criteria for a diagnosis. These include a physical exam to measure blood pressure, waist size, and increased hair growth (try not to wax or shave these areas leading up to the visit).
Your doctor may do a pelvic exam to see if your ovaries are enlarged or swollen by many small cysts, and they may check the androgen hormones and glucose levels in your blood.
Finally, your doctor may do a vaginal ultrasound to take pictures of your pelvic region.
Treatment and Lifestyle Shifts:
If you are diagnosed with PCOS and are not looking to become pregnant, hormonal birth control is often used to help with symptoms. This regulates the period and limits hair growth and acne by lowering androgen levels and protecting the inner lining of the uterus against abnormal cell growth.
Other medications that are frequently prescribed for PCOS are metformin, which makes the body more sensitive to insulin, and clomiphene or letrozole, which are both used to stimulate ovulation.
For those with PCOS looking to become pregnant, in vitro fertilization (IVF) and in vitro maturation (IVM) are other fertility treatment options.
Healthy eating and exercise can help regulate ovulation and periods in some women, so seeing an informed dietitian might be useful (if you have access to one).
Complementary treatments are still being researched to confirm effectiveness, but these can include vitamins (like vitamin D and B complex), cinnamon and turmeric, acupuncture, and inositol, a vitamin-like substance available as a supplement.
Finally, seeing a therapist or joining a PCOS support group in person or on Facebook can help with the mental health impacts of your struggle.