PCOS 101: What Is Polycystic Ovarian Syndrome?

Polycystic ovary syndrome, polycystic ovarian syndrome, or PCOS, is an endocrine condition that affects millions of women around the world. PCOS can manifest in various ways and impacts not only a woman’s physical health but also her mental well-being and quality of life. This article will answer the question “What is PCOS?” as well as discuss symptoms, diagnostic criteria, and PCOS treatment options.

What Is PCOS?

PCOS is an endocrine condition and its name comes from the multiple small cysts that appear on one or both ovaries. Not all women have ovarian cysts but almost all have an imbalance in the reproductive hormones, including estrogen, progesterone, and testosterone. The irregular levels of estrogen and progesterone result in menstrual cycle irregularities and fertility challenges while elevated testosterone levels, a condition known as hyperandrogenism, can lead to symptoms, like acne and unwanted hair growth.

Prevalence of PCOS Among Women

Estimates vary depending on the data source, but it is believed that PCOS affects around 10 to 20 percent of women globally, making it one of the most common endocrine conditions in women aged 15 to 49 years. This indicates the need for awareness and early intervention with comprehensive care to minimize the impact on women’s health.

Importance of Understanding PCOS

PCOS is more than just an ovarian and reproductive condition; it has a wide-ranging impact on women’s overall health. Failing to treat PCOS can significantly increase the risk of developing type 2 diabetes, cardiovascular disease, and even depression and anxiety issues. Awareness of the signs and symptoms can lead to prompt diagnosis and better handling of PCOS. 

Causes of PCOS

Genetic Factors

Studies from varied research sources indicate that women who have a family history of PCOS or other metabolic issues have a chance of encountering PCOS themselves in the future due to the presence of specific genes that influence hormone regulation and insulin metabolism in the body. Understanding these links can aid in the identification and management of PCOS, for better treatment outcomes. 

Hormonal Imbalances

PCOS is characterized by hormonal imbalance in females, resulting from an excess production of male sex hormones. The hormonal imbalance interferes with normal ovulation and alterations in the menstrual cycle and results in interference in the hypothalamic-pituitary-ovarian axis, which manifests other symptoms.

Insulin Resistance and PCOS

Insulin resistance is one of the major complaints in PCOS. It results from the inability of the body cells to respond to insulin; this leads to an increase in blood insulin levels. High levels of insulin trigger the production of male hormones, which worsen the symptoms of PCOS. Insulin resistance increases the chances of type 2 diabetes.

Common Symptoms of PCOS

Irregular Menstrual Cycles

One key indicator of PCOS is the irregularity of menstrual cycles. Women with PCOS might have some normal cycles, then skip periods altogether (amenorrhea), making it challenging to monitor ovulation accurately.  

Excess Hair Growth and Acne

Excessive facial hair growth in women, known as hirsutism, is an issue for those with PCOS because their androgen levels are elevated. Additionally, severe acne that doesn’t respond well to treatments is also commonly experienced by many women with PCOS.

Weight Gain and Difficulty Losing Weight

PCOS tends to come with unexplained weight gain, particularly around the midsection. Because of metabolic issues, many PCOS women find it difficult to lose weight despite staying on a healthy diet with an exercise routine.

Thinning Hair and Hair Loss

Androgenic alopecia, or thinning hair on the scalp, is another common symptom of PCOS. It has been described as female-pattern hair loss and may lower the level of self-esteem greatly.

Diagnosing PCOS

Accurately diagnosing polycystic ovary syndrome (PCOS) demands an integrated approach: patient history, physical examination, laboratory tests, and modern diagnostic methods. Early diagnosis of this condition is important for symptom management and prevention of complications associated with infertility, diabetes, and cardiovascular diseases.

Medical History and Physical Exam

Diagnosis of PCOS usually starts with an extended history and a detailed physical examination. During this phase, healthcare providers ask about:

• Menstrual Irregularities: Frequency, duration, and heaviness of menstrual flow.
• Signs of PCOS: Excess hair growth on the face, chest, or back (hirsutism), persistent acne, or thinning of scalp hair.
• Weight Changes: Sudden or persistent weight gain, especially in the midsection area (also known as “PCOS belly”).

Doctors may also need to rule out other causes of the symptoms that are similar to PCOS, like thyroid issues and problems with adrenal glands.

Blood Tests for Hormone Levels

Laboratory evaluation is one of the important components of diagnosis in PCOS. Blood investigations measure the level of relevant hormones and metabolic parameters and include the following:

• Androgens: High levels of testosterone or androstenedione confirm hyperandrogenism, a frequent characteristic of women who experience PCOS.
• Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH): An increased LH-to-FSH ratio is common in PCOS. This translates to changes in ovulation.
• Insulin and Glucose Levels: Insulin resistance, frequently associated with PCOS, can be identified through a glucose tolerance test.

These tests help tell PCOS apart from other disorders with overlapping symptoms, such as Cushing’s syndrome or congenital adrenal hyperplasia.

Innovative Hormone Tests

Advances in at-home hormone monitoring technology have transformed the capacity of women to recognize and control PCOS-related hormonal abnormalities. Panorama, Mira Monitor and wands for hormonal testing are examples of products that make collecting clinical-grade data simple and accessible.

For example: 

• Panorama Lab Test: A home-based blood panel kit that measures key markers associated with PCOS, such as testosterone. The Panorama Lab Test allows users to understand their hormone profiles without having to visit the lab frequently.
• Mira App and Wands: The Mira system combines urine-based hormone wands and a monitor with an app for analyzing and tracking hormone levels over time. This program tracks swings in hormones and their metabolites like E3G (metabolite of estradiol in urine), LH, and PdG (metabolite of progesterone in urine) during the cycle, providing information about ovulation patterns and general hormone balance.

These can be especially useful for women who have irregular cycles or are attempting to conceive, as they can assist pinpoint exactly when ovulation occurs and identify trends that a standard ovulation prediction kit (OPK) may miss.

Other features in the Mira app include cycle-to-cycle comparisons, hormone pattern analysis, and extensive reports that may be easily shared with healthcare specialists.

Ultrasound for Ovarian Cysts

Ultrasounds can be used to identify cysts in the ovaries which are often associated with PCOS. However, it is important to note that not all women with PCOS will necessarily show these cysts and their presence does not always confirm the diagnosis of PCOS in every case either. Similarly some women with ovarian cysts may not exhibit all other symptoms required for a PCOS diagnosis. 

Criteria for PCOS Diagnosis

According to the Rotterdam criteria, a diagnosis of PCOS is based on the presence of at least two of the following three criteria: 1) irregular or absent ovulation, manifesting as inconsistent menstrual cycles; 2) signs of hyperandrogenism, either clinical-excess hair, acne, scalp hair thinning-or biochemical-elevated androgen levels; and 3) the ultrasound detection of polycystic ovaries showing multiple small follicles on one or both ovaries.

How PCOS Affects Long-Term Health

Polycystic ovary syndrome (PCOS) is often thought of as a condition that primarily affects the reproductive system, but its impact goes far beyond that. PCOS can influence a woman’s overall health, both in the short and long term, increasing the risk of fertility challenges, metabolic issues, heart disease, and even emotional health concerns. Understanding these risks can help women take charge of their health and manage the condition more effectively.

Fertility and Pregnancy Complications

PCOS is one of the leading causes of infertility due to intermittent or absent ovulation.

Besides infertility, pregnant women with PCOS are at an increased risk of the following:

• Miscarriage: The potential for early pregnancy loss is increased in women with PCOS. It has been said to be linked with insulin resistance and hormonal imbalance.
• Gestational Diabetes: Women with PCOS are at a higher risk of acquiring gestational diabetes, a condition that can lead to complications such as high birth weight in infants and increased risk of cesarean delivery.
• Preeclampsia: This serious pregnancy complication, which includes high blood pressure and damage to organs such as the liver or kidneys, is more common in women with PCOS.

Risk of Type 2 Diabetes

Insulin resistance in PCOS greatly increases the risk of type 2 diabetes. In insulin resistance, the cells of the body do not respond well to insulin. Consequently, blood sugar levels go up. Over time, this may advance to prediabetes and type 2 diabetes, especially in women who are overweight or obese. The risk can be reduced by early intervention with life modification and medication.

Increased Risk for Heart Disease

Metabolic complications arise, including the risk of cardiovascular disease in PCOS patients, through several interrelated factors:

• Obesity: Many women with PCOS are overweight, often carrying their weight around the abdomen, also known as the “PCOS belly,” which increases their risk for heart disease.
• High Cholesterol/Dyslipidemia: Common in PCOS are high levels of LDL, or “bad,” cholesterol combined with high triglycerides and low levels of HDL, or “good,” cholesterol.
• Hypertension: High blood pressure is also more common among women with PCOS, further increasing cardiovascular risk.

Emotional and Mental Health Impact

PCOS can have a big impact on emotional health and lead to increased levels of anxiety and depression as well as decreased self-confidence. The visible symptoms of PCOS, such as hirsutism, acne breakouts, and weight gain could play a role in exacerbating these issues.

Women who have PCOS also face the challenge of managing infertility, which can strain relationships and contribute to feelings of isolation. There may be mood swings and irritability caused by imbalances and PCOS medication.

A few helpful tips for improving your health include:

• Mindfulness Practices: Engaging in activities such as meditation, yoga, and breathing exercises can be beneficial for managing stress and maintaining equilibrium.

• Herbal Remedies: Organic remedies like Mira Fertility Tea, are used to support hormonal balance, and have shown to alleviate symptoms associated with stress.

• Customized Meditation Playlists: Tailored meditation playlists focused on managing stress and anxiety could offer a soothing escape.

Treatment Options for PCOS

Lifestyle Changes: Diet and Exercise

Managing PCOS effectively relies on embracing a healthy lifestyle. This involves following a balanced diet rich in whole foods, lean proteins, and healthy fats, along with incorporating physical exercise into your routine regularly to enhance insulin sensitivity and reduce symptoms.

Medications to Manage Symptoms

PCOS medication can be prescribed to treat and manage different aspects of the syndrome such as:

• Oral contraceptives: They help regularize menstrual cycles and lower androgen levels.
• Metformin: It enhances insulin sensitivity and can help with weight management.
• Anti-androgens: Reduce symptoms like hirsutism and acne.
• PCOS Supplements: Supplements like inositol, omega-3 fatty acids, and vitamin D might aid women with PCOS by promoting insulin sensitivity and hormonal balance.

Fertility Treatments for Women with PCOS

For women struggling with infertility, treatments like clomiphene citrate, letrozole, or gonadotropins can stimulate ovulation. Other advanced reproductive technologies such as in-vitro fertilization (IVF) are also available for treatment.

Specialized clinics, such as the Hormone Health Clinic for Fertility, offer holistic care, support and hormonal monitoring for women with PCOS.

Conclusion

PCOS is a multi-faceted condition in diagnosis and management. Empowering women to understand the causes, symptoms, and future health implications is important so that they may take responsible steps toward health. Managing PCOS is easier than ever with at-home diagnostic tools on the rise, along with supplements and fertility treatments. Early intervention and an individualized care plan enable women diagnosed with PCOS to live healthier and more fulfilling lives.

Frequently Asked Questions

Infographic: What is Polycystic Ovarian Syndrome and What You Should Know