PCOS: What is it, what causes PCOS and symptoms to look out for

Have you ever heard of PCOS (polycystic ovary syndrome)? Maybe, or maybe not. As it turns out, many are unaware they have PCOS until they experience difficulties conceiving. Statistics and research paper published suggests that 5% - 15% of the menstruating population is affected by PCOS.

So, let’s put PCOS under the spotlight and get a better understanding about what PCOS is, some of the common symptoms as well as treatments that may be recommended by doctors.

What is PCOS?

PCOS is a common female endocrine disorder that is caused by abnormal production of the reproductive hormones, androgens. These hormones, which are typically referred to as “male hormones”, are usually present in small amounts in a woman, whereas, in those with PCOS, the levels are too high.

The term “polycystic” means “many cysts”. Women with the condition also often have several, tiny, fluid-filled sacs growing in the ovaries that are follicles containing eggs that do not mature enough to lead to ovulation. The resulting consequence is irregular periods that can often leave women feeling lost and confused.

Although the presence of the fluid-filled sacs is prevalent in those affected by PCOS, not everyone with the condition has these ovarian cysts. You may be wondering, what are the symptoms of PCOS then? Read on, we’ve got you covered.

What happens in the body when someone has PCOS?

PCOS was first described by the Italian physician, Antonio Vallisneri in 1721. However, the exact cause of PCOS remains a mystery to this day. It is a complex condition which is widely misunderstood.

In the majority of women with PCOS, higher than normal levels of the hormone, insulin, is also produced. Insulin is the hormone that controls blood glucose levels in the body. It helps with the transfer of glucose in the bloodstream to cells throughout our body, where it is used for energy. People with PCOS develop resistance to these actions of insulin and hence, high levels of sugar remain in the blood, which leads to diabetes and weight gain.

At the same time, more insulin is produced by the body to compensate and hence, triggers the production of even more androgens, which is commonly observed in women with PCOS.

It’s also been found that chronic low-grade inflammation is a factor that is linked to PCOS. When there is inflammation, several markers like the c-reactive protein, increase in the body. Inflammation in turn tends to interfere with ovulation and causes the production of excess androgens.

PCOS symptoms to look out for

There is a whole cascade of symptoms an excess of androgens produced from PCOS can lead to.

Many suffer in silence despite peculiar symptoms they pick up on, merely due to fear of being diagnosed, which could only make matters worse. Our bodies deserve utmost love and care, so, in case you suspect something fishy, do get it checked out (and get a trusted companion to tag along if you need mental support).

Here are some symptoms of PCOS you should look out for:

• Abnormal or irregular periods: When the ovaries do not regularly release eggs to promote ovulation, the lining of the uterus does not shed and regrow as it normally should. This means that the uterus lining becomes thicker and sheds irregularly, resulting in heavy or even prolonged bleeding.

Those affected by PCOS may get their period less than eight times a year or not at all.

• Infertility: Due to irregular ovulation, many face difficulties in getting pregnant. PCOS is one of the leading causes of infertility.
• Extra hair growth: Abnormal hair growth in unwanted places like the face, stomach, back and chest. This is also referred to as hirsutism.
• Hair loss: Loss of hair from the scalp and hair thinning. Male pattern baldness occurs due to excess androgens in the body.
• Weight gain: About 80% of women affected by PCOS are overweight or have obesity.

Note: Obesity is a major cause of insulin resistance.

• Acne: Severe acne that does not respond to common treatments, especially after adolescence. This is mainly due to higher androgen levels.
• Darkened skin or excess skin: Patches of dark or excess skin, especially on the neck area. These thicker or darkened skin patches are referred to as acanthosis nigricans. This is also associated with diabetes or prediabetes.

Aside from these symptoms, PCOS is also related to many other health conditions like type 2 diabetes, sleep apnoea, heart disease and depression.

Those affected with PCOS may develop endometrial hyperplasia, which is caused by the thickening of the uterine lining, thereby, increasing the risk of developing endometrial cancer.

PCOS diagnosis

Diagnosis of PCOS has been a controversial topic for many years now. Typically, the condition is diagnosed based on standardized criteria known as the Rotterdam Criteria.

A woman may be diagnosed with the condition given that she has at least two of the three symptoms listed down below:

The three signifiers of PCOS:

• High androgen levels – causes acne, weight gain and excess hair growth on the face and body
• A high number of small, fluid-filled sacs in the ovaries – can be determined through a pelvic ultrasound
• Irregular or absent periods

An ultrasound scan would assist to identify abnormalities in one’s ovarian follicles. Alongside this, doctors may carry out a routine exam and ask you about additional symptoms like body hair growth and acne.

Common PCOS treatments

Many people, despite being diagnosed with PCOS, lead normal lives without serious complications by managing their symptoms. So, although no cure is available, PCOS can be managed or even reversed (Instagram at @the.pcos.nutritionist). Seek the guidance of a doctor to discuss and devise a plan to treat the root cause.

Adopting a healthy lifestyle is one of the most important things that can be done to reverse PCOS. This includes opting for healthier food options and keeping active on the regular to encourage weight loss, regularize your periods and decrease insulin resistance.

For treating PCOS, doctors may prescribe you oral contraceptives to regulate your periods and alleviate some physical symptoms like hirsutism and acne. Some find that it works for them, while others tend to gravitate towards alternatives due to undesirable side effects of the pills.

There are other available treatments like metformin, spironolactone, inositol, clomiphene and progestin that may be used to treat your PCOS, depending on the specific symptoms and the underlying cause. Getting to the root cause – the main driver of your symptoms - is what will help you to steer the wheel and take control of your PCOS.

Now that you are (hopefully!) more familiar with this condition, keep an eye out for anything out of the ordinary. Remember, appropriate treatment is key!

Disclaimer: Do not use the information provided on this website as a substitute for direct medical advice from a licensed healthcare professional.

References

https://www.cdc.gov/diabetes/basics/pcos.html

https://www.healthline.com/health/polycystic-ovary-disease

https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309040/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553224/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5399492/

https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/

https://www.sciencedirect.com/science/article/abs/pii/S0015028216612682

https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome