As women, our hormones can be a little bit of a mystery — and that’s even more the case for the 1 in 10 women who have or are diagnosed with polycystic ovarian syndrome. Commonly abbreviated to PCOS, polycystic ovarian syndrome affects girls as young as 11 and women of childbearing age are at risk of developing it at any time after puberty.

What is Polycystic Ovarian Syndrome?

Polycystic Ovarian Syndrome, the term, refers to cysts (sacs of fluid) that fail to regularly release eggs. However, not all women who have Polycystic Ovarian Syndrome have polycystic ovaries, and not all women with cysts have Polycystic Ovarian Syndrome. Since the understanding of this syndrome is still developing, it’s better to think of Polycystic Ovarian Syndrome as an overall hormonal and metabolic issue that has less to do with cysts and more to do with the female hormonal systems. Of note, in this syndrome, is that women with PCOS often have higher levels of androgen (male hormones), which can disrupt the menstrual cycle and impede ovulation.

What causes PCOS?

PCOS is a varied syndrome and shows up slightly differently in all of the women who suffer from it. Some may get cysts and some may not — some women may face weight gain and others may not. Some women get normal periods but their hormones show that they are affected by the disorder.

Generally, doctors still don’t know exactly why some women get PCOS, but studies have shown that it is in some part determined by your genes. There is no single gene that causes PCOS, but there are suggestions that a series of genes, especially those that affect hormone levels and insulin resistance, contribute to it. A wide variety of other factors such as stress and diet can also contribute.

Many women with PCOS are resistant to insulin, and this is especially true in cases of women who are overweight or obese, have unhealthy eating habits, live sedentary lifestyles, or have a family history of diabetes. Insulin resistance describes a hormonal state in which your body is less able to send the proper amount of glucose to the cells. In turn, the pancreas produce more insulin to stabilize glucose levels. The extra insulin in your body causes several negative effects on the body, including the ovaries, leading to higher levels of male hormones.

What are Some Common Symptoms of PCOS?

• Irregular periods — The most common sign of PCOS is period problems. Many women will have irregular periods or infrequent periods. Irregular or infrequent menstruation is directly related to hormone imbalance. Some women experience light periods because they are not ovulating, and some women may experience extremely heavy menstruation because the lining of the uterus continues to thicken during missed periods. Women with PCOS typically have fewer than six to eight cycles in a year.
• Excessive hair growth — Up to 70% of women with PCOS experience excessive hair growth on the face, chin, back, belly, and other places that men typically grow hair. This excessive hair growth is referred to as hirsutism.
• Hair loss — Women with PCOS may experience hair loss or thinning hair on the scalp, similar to male-pattern baldness. This is attributed to high androgen levels.
• Acne — High levels of androgens due to PCOS may cause oily skin, leading to breakouts of acne on the face, chest and back for women post-puberty.
• Weight gain — More than half of women with PCOS struggle with weight gain and losing weight.
• Other skin changes — High insulin levels and insulin resistance can lead to thicker and darker patches of skin around the neck, groin, and other skin creases. Skin tags (small excess flaps of skin), often on the neck or armpits, can also be a sign of insulin resistance.

No single test can diagnose PCOS. Instead, symptoms, blood tests, and physical exams help doctors to diagnose the condition. International criteria to diagnose PCOS say that a woman may have any two out of three of the major symptoms: high androgen levels, ovarian cysts, or irregular periods.

The potential long-term effects caused by PCOS

Though PCOS symptoms are mostly things that might be considered inconveniences, there are serious long term effects associated with the syndrome. The following are more serious symptoms and comorbid disorders that appear with chronic untreated PCOS.

• Infertility — Infertility may be caused due to lack of ovulation.
• Endometrial cancer -The endometrium is the innermost lining of the uterus. When women have their periods, they shed the top layer of the endometrium. Endometrial cancer may be caused due to lack of ovulation and a build-up of endometrium.
• Metabolic syndrome & risk of diabetes — The insulin resistance in women with PCOS is a risk factor for type 2 diabetes. The risk for type 2 diabetes is four times higher in women with PCOS. Developing diabetes means the need to track blood sugar, monitor carbohydrates, and usually medication. Diabetes raises your risk of other health problems as well, including nerve damage, changes in vision, and kidney problems.
• Sleep apnea — Sleep apnea is more common in women who are overweight and especially if they also have PCOS. Sleep apnea is brief repeated pauses in breathing during sleep which can cause fatigue during the day.
• Cardiovascular disease — Women with PCOS are at an increased risk for high blood pressure, arterial problems, and high cholesterol as a result of poorly managed diabetes. Women with PCOS are also at a higher risk for heart disease, heart failure, and stroke.
• Mood disorders — Experts are not sure why anxiety, depression, and eating disorders are more common in women with PCOS. Some suspect it is hormonal imbalance that causes mood changes, and others say distress due to living with PCOS (like weight gain, hair growth, and infertility) are the cause.

Can I still get pregnant with PCOS?

Between 70 and 80 percent of women have issues with fertility due to PCOS, and are at greater risk for miscarriage and complications while pregnant. However, women with PCOS can still get pregnant through fertility treatments. Losing weight and improving overall health can also improve the chance of having a healthy pregnancy. PCOS is one of the most common causes of infertility in women, but there are still ways to get pregnant. If you are concerned about how PCOS may affect your chances of a healthy pregnancy, talk to your doctor about ways to help you ovulate and raise your chances of getting pregnant. Fertilization treatments such as ovulation-inducing drugs and in vitro fertilization are also available to women trying to get pregnant with PCOS.

How can I keep my PCOS under control?

There is no cure for PCOS, but there are ways to manage the symptoms. Losing weight is the most important step you can take at home. Healthy eating habits and regular physical activity can greatly alleviate symptoms associated with PCOS. It can improve the way your body uses insulin, in turn helping your hormones to regulate better. Even a 5–10% loss in body weight can help to better regulate your period and improve ovulation. Studies have shown that a low-carbohydrate diet is effective in both weight loss and lowering insulin levels.

Birth control pills and other forms of hormonal birth control can also help regulate the menstrual cycle and treat other symptoms of PCOS such as hair growth and acne. Hormonal birth control also decreases the risk of endometrial cancer because they keep the endometrial lining very thin. Estrogen and progestin in hormonal birth control can help to restore normal hormone balance. Metformin, a drug used to treat type 2 diabetes, and other insulin-sensitizing drugs, have also shown to treat symptoms of PCOS by improving insulin levels.

If you are diagnosed with PCOS, talk to an Alpha Provider about the best type of treatments for you.