Polycystic ovary syndrome (PCOS) is a complex hormone disorder that can have a profound impact on a woman’s life.
Characterized by the overproduction of androgens—which are often thought of as male hormones but are also found in women in smaller amounts—PCOS can affect various aspects of reproductive health and overall well-being.
This article will explore the causes, risk factors, symptoms, diagnosis and available treatments.
What is PCOS?
In a video, Dr. Metee Comkornruecha, an adolescent medicine specialist with Nicklaus Children’s Hospital in Miami, offers a summary definition.
PCOS, he said, is a common disorder that causes menstrual issues.
“It is very common and this hormonal imbalance can cause patients to have more acne, more hair on their body, and to develop cysts within their ovaries,” Comkornruecha said.
The U.S. Centers for Disease Control and Prevention notes that women of every race and ethnicity can have PCOS. It is often discovered when women have trouble getting pregnant, but it can begin soon after a girl’s first period, typically around 11 or 12 years of age. It can also develop during the 20s or 30s.
Importantly, PCOS does not show up exclusively as a fertility issue and can affect various stages of a woman’s reproductive life.
PCOS causes and risk factors
The exact cause of PCOS remains unknown, but the Mayo Clinic points to several suspected contributors:
- Insulin resistance
- Low-grade inflammation
- Excess androgens (these are a group of sex hormones that help trigger puberty and play a role in reproductive health and body development, according to the Cleveland Clinic).
The onset of PCOS symptoms commonly occurs around the time of the first menstrual period, according to the Mayo Clinic. In some cases, though, symptoms develop after a girl has been menstruating for a while. The symptoms of PCOS can vary and a diagnosis is typically made when at least two of the following criteria are met:
- Irregular periods: Infrequent or unpredictable menstrual cycles are a common indicator of PCOS. Periods that last longer than a typical two to seven days or that occur less than nine times a year, with more than 35 days between them, are also characteristic.
- Excess androgen: Elevated levels can lead to development of excessive facial and body hair, a condition known as hirsutism. In some cases, severe acne and male-pattern baldness may also occur.
- Polycystic ovaries: Women with PCOS may have enlarged ovaries with multiple small follicles containing immature eggs. These ovaries may not function efficiently, affecting the normal release of eggs during the menstrual cycle.
For a diagnosis of PCOS, two of those symptomatic criteria must be met.
An endocrinologist, a specialist in hormone disorders, conducts a comprehensive physical examination to make the diagnosis, according to NYU Langone Health. This exam assesses the presence of excessive facial and body hair, thinning scalp hair, acne and other symptoms associated with elevated androgen levels.
When it comes to managing PCOS, a combination of medication and self-care strategies can improve symptoms and overall well-being. Currently, there is no cure for PCOS.
A key component of managing the condition in adolescents revolves around lifestyle modifications, according to a study in the Journal of Pediatric Nursing. In girls who are overweight or obese, adoption of a healthier lifestyle through increased physical activity and weight loss has shown promising results in reducing androgen levels and regulating periods.
Some common ways to demonstrate self-care while managing your PCOS and overall health include:
- Adopting a balanced and nutritious PCOS diet that focuses on whole grains, fruits, vegetables, lean protein foods and low-fat or fat-free milk, cheese or yogurt.
- Engaging in 150 minutes a week of moderate-intensity physical activity.
- Maintaining a healthy weight.
- Incorporating stress-management techniques such as mindfulness meditation, deep breathing exercises, yoga, or engaging in activities you enjoy to reduce stress.
- Prioritizing sleep, aiming for seven to nine hours each night.
- Quitting smoking and moderating alcohol consumption.
- Scheduling regular checkups with your health care provider to monitor your PCOS symptoms and overall health.
Various medications target different aspects of PCOS. Here are some commonly prescribed medications as outlined by NYU Langone Health:
- Birth control pills: Oral contraceptives are often prescribed to regulate menstrual cycles, reduce androgen levels and alleviate symptoms such as acne and excessive hair growth. They provide a steady hormone dose and prevent overproduction of androgens.
- 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.
Medication choices and dosages may vary depending on individual circumstances, symptoms and overall health. Consultation with a health care professional is essential to determine the most suitable medication and treatment plan for your specific needs.
Women with PCOS can lead fulfilling lives
While PCOS can significantly impact various aspects of a woman’s life, it is not an inherently dangerous or deadly disease. The majority of women with PCOS can lead fulfilling lives through lifestyle modifications, self-care practices and appropriate medical interventions.
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