Polycystic Ovary Syndrome (PCOS) Symptoms & Treatment

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📅 22 novembre 2024 ✍️ By Eddie Johnston ⏱️ 7 Mins Read 🗂️ Blog 🕒 Last updated: 22 novembre 2024

Polycystic ovary syndrome (PCOS) - the most common hormone disorder in women of child-bearing age - affects 1 in 10 women of childbearing age. Women with PCOS have a hormonal imbalance and metabolism problems that may affect their overall health, appearance and fertility.

The condition causes an imbalance of hormones that causes a variety of symptoms, including excess weight, irregular periods, infertility and an overgrowth of body and facial hair. PCOS disrupts metabolism, and causes irregular menstrual periods and elevated testosterone levels. It's a leading cause of infertility and is associated with obesity, diabetes and heart disease.

What Is PCOS?

PCOS is a common health problem caused by an imbalance of reproductive hormones. The hormonal imbalance creates problems in the ovaries that the release of a woman's egg each month. The ovaries make the egg that is released each month as part of a healthy menstrual cycle.

As its name implies, polycystic ovary syndrome is a syndrome.

"This means, it presents with a range of symptoms and severity. It is often diagnosed when a woman is trying to conceive as it is a common cause of infertility," said John R. Monk, DO, obstetrician and gynecologist at Franciscan Physician Network OBGYN Health Center in Crown Point. "Women with PCOS do not ovulate regularly and their hormone balance is shifted."

The exact cause of PCOS is not known.

"There is data that points to both inherited and non-inherited factors," said Dr. Monk. Experts think that high levels of androgens can play a role. Also, excess weight and family history - which are in turn related to insulin resistance - can also contribute.

Symptoms Of PCOS

Sometimes symptoms of PCOS are clear, and sometimes the signs of polycystic ovary syndrome are less clear. In fact, the National Polycystic Ovary Syndrome Association estimates as many as half of women with PCOS symptoms are going undiagnosed.

"Women most often present with irregular periods or infertility. Symptoms also include excessive hair growth in areas such as the lip and chin, chest, significant acne," said Dr. Monk.

Common symptoms of PCOS include:

Irregular menstrual cycle.
Excess hair on the face, chin, or parts of the body where men usually have hair. This condition, called "hirsutism," affects up to 70 percent of women with PCOS.
Acne on the face, chest and upper back.
Thinning scalp hair.
Weight gain, or difficulty losing weight.
Darkened skin, particularly near neck creases, the groin and under the breasts.
Skin tags in the armpits or on the neck.

Dr. Monk noted that for most patients, symptoms of PCOS may appear during the first years of menstruation.

"However, is hard to make the diagnosis early, as adolescents can have irregular periods as the hormonal axis matures," he said. "Some of the secondary signs may not show up right away either. Anyone having periods more frequently than 21 days or longer the 90 days, should see their gynecologist."

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PCOS Diagnosis

Dr. Monk

Oligomenorrhea, this means a woman has fewer periods than expected over the course of a year.
Signs of hyperandrogenism, or excess of what is generally considered "male hormone". This can be diagnosed clinically, looking at the patient and identifying excessive hair growth or acne or with blood work.
The characteristic polycystic appearance of ovaries on ultrasound, appearing large with many small cysts.

To diagnose PCOS, it's important to get a complete physical exam as well as a detailed medical history, said Gail Cansler, MD, an obstetrician/gynecologist in Chicago Heights, Illinois, who practices at Franciscan Health Olympia Fields. She also looks at the physical signs and symptoms, which can include male-like hair growth also known as hirsutism, irregular periods, oily skin, acne, a darkening of skin in certain areas, elevated serum testosterone and obesity. Despite these common physical signs and symptoms,

Dr. Cansler points out there is no "typical" PCOS patient. To confirm suspected PCOS, Dr. Cansler orders general lab tests, including thyroid, a diabetic screen, male hormone levels and a lipid profile. Some doctors perform an ultrasound and screen for insulin insensitivity as well.

Health Risks From PCOS

According to the CDC, women with PCOS symptoms can develop serious health problems, especially if they are overweight. These medical problems can include:

Diabetes
Gestational diabetes (diabetes when pregnant)
Heart disease
High blood pressure
High LDL ("bad") cholesterol and low HDL ("good") cholesterol
Sleep apnea
Stroke
Endometrial cancer
Ovarian cancer

PCOS And Pregnancy

PCOSpolycystic ovary syndrome

"However, once diagnosed there are medications to help patients with PCOS achieve pregnancy," said Dr. Monk. "This is why it is so important that women with irregular periods seek treatment early. An accurate diagnosis, prior to trying to conceive, will save time once ready to have a baby."

PCOS And Mental Health

A British study hints at a connection between the gynecologic condition and mental health issues, but does not prove cause and effect.

For the study, the researchers examined data from nearly 17,000 women in the United Kingdom with PCOS. These women were more likely to be diagnosed with conditions such as depression, anxiety, bipolar disorder and eating disorders than women without PCOS, the study found.

Children of mothers with PCOS were found to be at higher risk of developing ADHD and autism than other children, according to the study. It was published online April 2018 in the Journal of Clinical Endocrinology and Metabolism.

"PCOS is one of the most common conditions affecting young women today, and the effect on mental health is still underappreciated," said study author Dr. Aled Rees, who's with the Neurosciences and Mental Health Research Institute at Cardiff University in Wales.

Treatment For PCOS

There is no cure for polycystic ovary syndrome, but you can manage the symptoms of PCOS.

"Treatment is often a combination of lifestyle changes and hormone-containing medications," said Dr. Monk. "This is never a one plan fits all strategy, it needs to be tailored to meet a patient where she is and help her reach her goals."

You can take steps at home to help manage your PCOS symptoms, including:

Losing weight

Healthy eating habits and regular physical activity can help relieve PCOS-related symptoms. Losing weight may help to lower your blood glucose levels, improve the way your body uses insulin, and help your hormones reach normal levels. Even a 10 percent loss in body weight (for example, a 150-pound woman losing 15 pounds) can help make your menstrual cycle more regular and improve your chances of getting pregnant.

"Weight gain makes PCOS blossom," said Nini Thomas, MD, a Franciscan Physician Network endocrinologist in Lafayette, Indiana, "so it's possible a woman might be at the beginning of the spectrum and if she loses another five to 10 percent of her body weight, which can be 10 to 15 pounds, she can change the course of PCOS. At the same time, endocrine problems can make weight loss efforts more challenging."

Lifestyle changes

"Lifestyle modifications including diet, exercise, sleep hygiene, gut health and mindfulness are all essential," Dr. Thomas said. "Medications to help with weight loss, insulin resistance, excessive hair growth and menstrual irregularities are all tools doctors can use when lifestyle alone does not suffice."

With this syndrome, in particular, she says, the association with metabolic syndrome, diabetes and obesity has an even wider range of potential complications and implications for one's overall health.

"We look at weight loss, nutrition and activity levels for the patient and make recommendations, or tweak what they're already doing and look at their goals," said Dr. Perkins. "For most patients, it's also going to mean some sort of cycle regulation. It's important we keep their periods regular to avoid any buildup of tissue in the uterus, that if left untreated, could turn into some abnormal cells or even uterine cancer."

Medication management

Various medicationsdifferent aspects

Anti-androgens: These medications can help reduce symptoms such as excessive hair growth, acne and male-pattern baldness. Anti-androgens are often used in combination with birth control pills.
Metformin: Originally used to manage diabetes, metformin has shown benefits for PCOS management. It improves insulin sensitivity, helps regulate menstrual cycles and may aid in weight management. Metformin for PCOS may be prescribed alone or in combination with other medications.
Oral contraceptives: Oral contraceptives may be prescribed to reduce androgen levels and alleviate symptoms such as acne and excessive hair growth. They provide a steady hormone dose and prevent overproduction of androgens.

Medication choices and dosages may vary depending on individual circumstances, symptoms and overall health. Talk to your doctor or nurse practitioner to determine the most suitable medication and treatment plan for you.

Removing hair

You can try facial hair removal creams, laser hair removal, or electrolysis to remove excess hair. You can find hair removal creams and products at drugstores. Procedures like laser hair removal or electrolysis must be done by a doctor and may not be covered by health insurance.