Lately you've been experiencing some problems that make you feel like you're going through puberty all over again. You're breaking out. You've gained weight. And your period has become undependable and irregular — sometimes it's short and light, sometimes it's long and heavy, and sometimes it's not there at all.
Taken separately, these problems are more embarrassing or frustrating than anything else. But together, along with a couple of other symptoms, they could be signs of polycystic ovary syndrome (PCOS).
What is PCOS?
PCOS is a hormonal disorder that affects 1 in 10 women of reproductive age. Women with PCOS have an imbalance of hormones, metabolic problems, and dysfunctional ovaries, which affect their overall health and appearance. PCOS is important to recognize and swiftly diagnose because it is one of the most common and treatable causes of female infertility.
“Women of every race and ethnicity can have PCOS,” says Linda Luisi-Purdue, MD, an OB/GYN at Summit Health. “It is common for women to find out they have PCOS when they have trouble getting pregnant, but it often begins soon after the first menstrual period, as early as age 11 or 12. Sometimes, PCOS can also develop in women in their 20s or 30s.”
Symptoms of PCOS
Women with PCOS can have diametrically opposed health issues ranging from infertility to pregnancy complications, according to Dr. Luisi-Purdue. To be diagnosed with PCOS, two out of three of your symptoms must include:
- Excess male hormones (androgen) that lead to acne, male-pattern baldness, and extra facial or body hair.
- Irregular periods, which may be too light, very heavy, come close together, or stop completely.
- Polycystic ovaries that have small, fluid-filled sacs called follicles or cysts surroundings the eggs.
The presence of cysts isn’t required to receive a diagnosis. “Some women with PCOS do not have cysts, while some women without the disorder do develop cysts,” notes Dr. Luisi-Purdue.
Risk factors for PCOS
The cause of PCOS is unknown. But some 50 to 70% of women with PCOS have insulin resistance. Risk factors for PCOS in adults include type 1 and 2 diabetes and gestational diabetes.
Obesity is a concern, too. “A history of weight gain often precedes the development of the clinical features of PCOS,” she notes. “The first line treatment for PCOS should always be to follow a healthy lifestyle aimed at reducing body weight and abdominal fat when needed.”
Family history is also a component. “Based on the clustering of cases in families, PCOS is considered to be an inheritable disorder,” says Dr. Luisi-Purdue. “A high prevalence of PCOS or its features among first-degree relatives is suggestive of genetic influences. In addition, greater frequency is seen in identical twins versus fraternal twins.”
Unfortunately, because the syndrome has such wide-ranging symptoms, no one knows exactly how it's passed down. And genetic testing is not available yet.
There are, however, certain risk factors that can be identified at a very young age. Red flags for PCOS in babies and children include:
- High birth weight in girls born to overweight mothers
- Premature puberty
- Childhood obesity
- Adolescent metabolic syndrome (a cluster of signs including elevated blood sugar, high cholesterol, and increased blood pressure)
- Persistent irregular menstruation in teens
What is the treatment for PCOS?
Your treatment will depend on the types of symptoms you experience. For regulating menstruation, Dr. Luisi-Purdue says low-dose oral contraceptives, a type of birth control pill, can help lower androgen levels and regulate abnormal bleeding and cycles. This medication also helps improve acne and excess hair growth.
“For those dealing with infertility or obesity, drugs that treat type 2 diabetes and improve insulin sensitivity, such as Metformin, are used by many to increase ovulation rates and glucose tolerance, as well as aid in achieving weight loss,” she says.
For older patients, Dr. Luisi-Purdue also recommends oral contraceptives. Another consequence of PCOS is an increased risk of developing uterine cancers. “This is also decreased with weight loss and oral contraceptives,” she says.
With the proper treatment, PCOS is very manageable for most women. The majority of Dr. Luisi-Purdue’s patients are able to conceive and have healthy pregnancies. Talk to your physician if you have any concerning symptoms of PCOS or are having difficulty getting pregnant.