PCOS: What it Means for You or Your Daughter

Megan was in her late 20s. She hadn’t had her period in more than nine months; she was suffering from major highs and lows with blood sugar, experienced night sweats and went through a myriad of mood swings. Her doctor diagnosed her with Polycystic Ovary Syndrome, or PCOS. Like many women, she felt confused and scared by such a frightening finding. Before leaving her doctor’s office, she was given a pamphlet and was told that trying to conceive might be a problem. She left feeling sad and alone.

Polycystic Ovary Syndrome, also known as Stein-Leventhal syndrome, is one of the most common endocrine system disorders in women. PCOS affects approximately five to ten percent of women and is one of the main causes of infertility. Many women won’t know they even have PCOS until they try to become pregnant and have difficulties.

PCOS cannot be diagnosed with one test alone and symptoms vary from woman to woman. Early diagnosis is important, as it has been linked to the development of several medical risks including insulin resistance, Type 2 diabetes, high cholesterol, high blood pressure and heart disease.

Causes
The exact cause of PCOS is not fully understood, but genetics may be a factor. PCOS seems to run in families and can be passed down from either the mother’s or father’s side. Excessive insulin and insulin resistance are known to be contributing factors and may be the biggest trigger in the development of the condition. Chronic inflammation may influence the development of PCOS by promoting insulin resistance.

Symptoms
PCOS signs and symptoms often begin soon after a woman first begins having periods. In some cases, PCOS develops later during the reproductive years, and it can occur in response to substantial weight gain.
PCOS has many signs and symptoms, all of which can worsen with obesity. Symptoms are often mild at first. Some women may have several symptoms while others may experience only a few. Some of the most prevalent symptoms include the following:
• Irregular periods: Often women with PCOS have fewer than nine periods a year. Some women have no periods. Others have very heavy bleeding.
• Acne
• Weight gain and trouble losing weight
• Excess androgen: Elevated levels of male hormones (androgens) may result in physical signs, such as excess facial and body hair. Often women get more hair on the chest, belly and back.
• Thinning hair on the scalp
• Polycystic ovaries: Polycystic ovaries become enlarged and contain numerous small fluid-filled sacs that surround the eggs.
• Fertility issues: Many women who have PCOS have trouble getting pregnant.
• Other skin problems, including skin tags and darkening skin

Diagnosis and What to Expect
To diagnose PCOS, the doctor will typically ask patients about health history, symptoms and current menstrual cycle. In addition, she will perform a physical exam to look for signs of PCOS, such as extra body hair and high blood pressure. Height and weight will also be checked to see if patients have a healthy body mass index. Lab tests will be performed to check blood sugar, insulin and other hormone levels. Hormone tests can help rule out thyroid or other glandular problems that could cause similar symptoms. Pelvic ultrasounds are often done to look for cysts on a patient’s ovaries.

Treatment
There is no cure for PCOS, but fortunately it can be managed. Treatment goals are usually based on symptoms, the age of the woman and whether the patient wants to become pregnant. In addition, treatments are performed to help further complications such as heart disease, diabetes, sleep apnea and uterine cancer. Most women will undergo a combination of treatments and make lifestyle changes to experience the best results.

For women who don’t want to get pregnant, birth control pills can help control menstrual cycles, reduce male hormone levels and clear acne. Some medications that are used to treat Type 2 diabetes can often be prescribed for PCOS patients to help alleviate certain symptoms. PCOS also causes lack of ovulation with some patients, so fertility medications are often prescribed for those women who want to become pregnant. A laparoscopic surgery known as ovarian drilling may also be an option, although it’s not the first treatment recommendation and has a less than 50 percent success rate.

One of the best treatments for PCOS is a healthy lifestyle. Since many women with PCOS are overweight, eating healthy and exercising is very important to keep weight at a healthy level. Even a ten percent loss in body weight may restore a normal period and help cycles become more consistent.

With a proper diagnosis, treatment and lifestyle changes, relief from PCOS and the overwhelming health problems it can cause is attainable. Women like Megan who are armed with a little education and a lot of persistence will lower their risk factors and can lead happier, healthier lives. HLM

Sources: mayoclinic.org, webmd.com and womenshealth.gov.