Polycystic ovarian syndrome (PCOS) can have many variable and subtle symptoms. Unfortunately, some doctors may overlook the diagnosis in young women who are not trying to get pregnant, particularly if the young woman is simply interested in regulating her periods with medications, such as Provera or birth control pills.
While PCOS has several potential implications for fertility and is the most common form of female-related infertility caused by the absence of ovulation, the condition may also lead to numerous serious general health problems. PCOS Awareness is an important first step. My practice is now offering a screening program called PCOS Awareness.
What Causes PCOS?
Researchers have determined that most women with PCOS have an endocrine imbalance known as insulin resistance in which the body doesn't handle insulin normally. The resulting higher insulin levels lead to more fat storage (obesity) and also disrupt proper ovarian hormone production, increasing male hormone, which prevents ovulation.
Insulin resistance ultimately can produce all the symptoms of PCOS, as well as contributing to the numerous serious health risks.
What Are the Symptoms of PCOS?
Symptoms of PCOS may include:
- Oligomenorrhea (irregular periods) or amenorrhea (absent periods)
- Oligoovulation (infrequent ovulation) or anovulation (absent ovulation)
- Hirsutism (excessive hair growth) on face, chest or abdomen
- Obesity or weight gain.
How Do You Diagnose PCOS? The PCOS Awareness Program
There's no single test to definitively diagnose PCOS. For this reason, it is important to have a thorough evaluation to help rule out other conditions such as adrenal or thyroid disease, and to accurately confirm the diagnosis of PCOS.
For a diagnosis of PCOS, women must have two out of three of the following diagnostic criteria:
- History of irregular or absent menstrual cycles and/or no ovulation
- Hirsutism and/or high blood levels of male hormones (androgens)
- Ultrasound evidence of polycystic-appearing ovaries using specific criteria
In my practice, we are offering PCOS Awareness, a screening program for PCOS. This inexpensive program consists of an appointment performed on days 2-4 of your menstrual cycle, at which time a brief questionnaire, vaginal ultrasound and comprehensive hormonal blood work will be done.
Should any abnormalities be found, we will advise you to schedule a follow-up appointment for a physician consultation, physical exam and discussion of additional adrenal testing. Call (877) 324-4483 for details.
What Are the Health Concerns of PCOS?
We do know that women with PCOS are at risk for several other health concerns, including:
- Obesity, a condition in which the body stores more fat than is healthy for a person
- Impaired glucose tolerance, which means that blood sugar levels are higher than normal
- Insulin resistance, a condition in which the cells in the body don't use the insulin the body makes, thus higher levels of insulin are needed to get glucose into the cells for energy
- Metabolic syndrome, which is sometimes considered a sign of diabetes because it means the body has trouble balancing insulin and glucose levels
- Diabetes, a condition in which the body either stops making extra insulin or it doesn't properly use the insulin that is available, thus blood glucose levels get higher
- Cardiovascular disease, which is problems related to the heart and blood vessels that can lead to heart attack or stroke.
- Obstructive sleep apnea, a condition in which a person does not get enough air into the lungs when they sleep, which lowers oxygen levels.
- Endometrial hyperplasia and cancer (uterine) at a relatively young age
What Are the Treatments for PCOS?
There are several ways to treat PCOS that can improve a woman's health and symptoms. Changes in lifestyle, such as eating a healthy diet, exercising and losing weight, are an important first step. When women with PCOS are able to correct the insulin resistance with proper low-carb/good carb diets and exercise, normal ovarian often returns. Regular exercise and/or weight loss of 5 percent to 10 percent can be very beneficial for health and fertility problems. Use of insulin-sensitizing medications, such as Metformin, also can be very helpful.
For those seeking pregnancy, ovulation-inducing medications are often successful in leading to proper ovulation, but they don’t always result in a successful pregnancy. Frequently, intrauterine inseminations (IUIs) and/or in vitro fertilization (IVF) may be needed.