September Is PCOS Awareness Month
This month I want to talk about something a little different. I want to help bring awareness to a health condition called PCOS. This is something that I have been dealing with for about 25 years now and is the reason I started this site. I feel like it is so important for women and men to be educated on this subject as it actually affects both parties especially when it comes to relationships.
If you are wondering how a health condition could possibly affect someone’s relationship keep reading…
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What is PCOS?
Stein-Leventhal Syndrome also known as Polycystic Ovary Syndrome, or PCOS is a health condition that affects about 10 million women in the world or one in ten women. It is a leading cause of female infertility and is responsible for a number of symptoms that can affect the body both physically and emotionally. Despite the name, many women with this condition do not have cysts on their ovaries and some women have no symptoms that they are aware of at all. The so-called cysts are actually immature ovarian follicles.
The 3 main hormones involved in PCOS include:
- Androgens – also referred to as “male hormones” such as testosterone are made by both males and females but there are often higher levels of androgens in women with PCOS than is normal. The excess androgens are produced mostly by the ovaries, but the adrenal glands can also play a role. Excess androgens are responsible for many of the unpleasant and unwanted PCOS symptoms including acne, excess male pattern hair growth, hair loss, and irregular periods.
- Insulin. This well-known hormone allows the body to absorb glucose into the cells for energy. However, in women with PCOS, the body isn’t as responsive to insulin as it should be. This can lead to elevated blood glucose levels and cause the body to make more insulin even when it is not needed. This condition is known as Insulin Resistance. Having too much insulin can eventually lead to type II diabetes and it can also cause the body to make more androgens or male hormones thus creating a catch 22 of sorts.
- Progesterone – a lack of the hormone progesterone contributes to irregular periods and elevated levels of estrogen leading to what is known as estrogen dominance. Our bodies are supposed to have a balanced ratio of each of these hormones so having too much of one or the other creates problems within the body such as PCOS.
What Causes PCOS?
The exact cause is still being researched, but it is considered a hormonal and metabolic problem rather than a disease at this point in time. Genetics and environmental factors such as chemical exposure are believed to be involved in the development of PCOS and more and more evidence is mounting against specific chemicals such as glyphosate, BPA, phthalates, and parabens as playing a role in the development of this condition. An article published on NCBI (National Center for Biotechnology) states –
“Although polycystic ovary syndrome (PCOS) affects 5–10% of reproductive age women, its underlying causes remain uncertain. The wealth of research on PCOS in recent years has made it increasingly apparent that genetic, epigenetic, endocrine, metabolic and environmental factors may all contribute to the development and presentation of this complex disorder [1–6]. Most commonly, the “environmental” contributors considered have been related to obesity and lifestyle, and indeed, there is extensive evidence that both play important roles in PCOS.[7,8]. However recently, the range of potentially relevant environmental factors considered has broadened to include environmental chemicals, which could affect the pathogenesis and/or presentation of PCOS…” you can read the full article by clicking HERE.
Symptoms of PCOS may begin shortly after puberty at the start of menstruation, but can also develop during the later teen years or early 20’s. Because the symptoms may be attributed to other health conditions such as hypothyroidism, or they may go unnoticed, PCOS may go undiagnosed for years. Women with PCOS typically have irregular or missed periods as a result of not ovulating but not always. While some women may develop cysts or follicles on their ovaries, many women do not.
Other symptoms include:
- Weight gain – about 50% of women with PCOS experience weight gain and obesity that is difficult to lose and keep off.
- Fatigue – a lot of women with PCOS report increased fatigue and low energy.
- Unwanted hair growth (also known as hirsutism) – again many women with PCOS experience excess male-pattern hair growth. The areas affected by excess hair growth may include the face/jawline, arms, back, chest, thumbs, toes, and abdomen. Hirsutism related to PCOS is due to hormonal changes in androgens or rather testosterone levels.
- Thinning hair on the head – another common symptom among women with PCOS is to experience above average hair shedding or even male-pattern baldness. Hair loss related to PCOS may increase in middle age but not always.
- Infertility – PCOS is a leading cause of female infertility. However, not every woman with PCOS is the same. Although some women may need the assistance of fertility treatments, others are able to conceive easily and naturally. A few years back it was thought that women with this syndrome would never be able to have children luckily that turned out to be wrong.
- Acne – hormonal changes related to excess androgens can lead to oily skin and acne. Other skin changes such as the development of skin tags and/or darkened patches of skin are also related to PCOS.
- Mood changes – due to all of the crazy hormonal fluctuations PCOS can increase the likelihood of mood swings, depression, and anxiety.
- Pelvic pain – this may occur with periods, along with heavy bleeding and clotting. It may also occur in between cycles in some cases.
- Headaches or Migraines – hormonal changes can cause headaches or migraines either before, during or after menstrual cycles.
- Sleep problems – women with PCOS often report having problems such as insomnia or poor quality of sleep. There are many factors that can affect sleep, but PCOS has been linked to a sleep disorder called sleep apnea. With sleep apnea, a person will stop breathing for short periods of time during the night. This can eventually lead to other health problems as well.
- Inflammation – quite a few women with PCOS experience chronic inflammation and/or edema.
How is PCOS Diagnosed?
Unfortunately, there isn’t one special test for diagnosing PCOS. Your doctor should start by asking questions about your medical history of symptoms such as irregular or skipped periods, weight changes, hair changes, and skin changes like acne. Your doctor should also ask if there is any family medical history of infertility, menstrual irregularities, ovarian cysts, etc. Your doctor should then check your weight and vitals and do a complete physical exam including a pelvic exam. A number of lab tests may be ordered including blood tests for blood sugar, estrogen, progesterone, thyroid, adrenal, and androgen levels. A sonogram or intervaginal ultrasound may also be done to evaluate the ovaries and uterus.
These tests help to make a diagnosis of PCOS and exclude other causes for your symptoms such as Cushing’s syndrome or Non-Congenital Adrenal Hyperplasia. Your primary doctor may also refer you to a hormone specialist, or endocrinologist, to help direct any tests needed to rule out other causes and confirm the diagnosis of PCOS. It is best to see an OBGYN rather than a general practitioner if you suspect that you may have PCOS since this is not something that GP’s specialize in or are necessarily knowledgeable about.
Health Risks Associated with PCOS
Women with PCOS have an increased risk of high cholesterol, high blood pressure, heart disease, stroke, and diabetes due to the insulin resistance and hormonal imbalances. Not all women with PCOS will develop all or any of these conditions, but it’s important to know that having PCOS does increase your risk. It is important to have your health monitored regularly by a physician who has experience treating women with PCOS. Regularly scheduled physician visits should continue after menopause, even though you will no longer have erratic periods and other PCOS symptoms may lessen it never goes away completely.
Treatments for PCOS
Standard Medical Treatments:
Birth Control Pills – If a woman is not trying to conceive, hormonal birth control (most often birth control pills) is usually the first line treatment. Birth control pills are supposed to help regulate periods and improve excess hair growth and acne by lowering androgen levels and protect the endometrium or inner lining of the uterus against abnormal cell growth which can lead to endometriosis.
Older types of birth control pills have a lower risk of dangerous blood clots and are preferable to the new types of birth control pills or injections. However, taking the pill is not without side effects and may not be the best option. To read about the top 5 reasons why the pill may not be the answer CLICK HERE.
Metformin – is a drug often prescribed for the management of type II diabetes that makes the body more sensitive to insulin. It is said to help lower elevated blood glucose levels, insulin levels, and androgen levels. Using metformin may help with weight loss as well by stabilizing blood sugar levels. Metformin may improve menstrual patterns, but it doesn’t help as much with the unwanted excess hair. Although this medication is not approved by the FDA for treatment of PCOS, many doctors prescribe it for PCOS patients to help with insulin resistance.
Many women who are diagnosed with PCOS are often automatically prescribed this medication. However, it’s important to have a reason for taking it or any medications for that matter and not be on it just because of a diagnosis of PCOS. Discuss with your doctor the reason why you are being prescribed it and whether it will provide a benefit to you beforehand.
Clomiphene (Clomid) – is an oral medication that is the most common treatment used to induce ovulation especially for women who are trying to get pregnant. The use of both metformin and clomiphene has about the same fertility results as if you were to take clomiphene on its own. Other treatments to stimulate ovulation include another oral drug called letrozole (Femara) and gonadotropins which are hormones that are given by injection. In vitro fertilization (IVF) and in vitro maturation (IVM) may be other fertility treatment options should you choose to go this route. But again, discuss all of this in detail with your physician so that you are fully informed of the success rates of these treatments and what the possible side effects are.
Spironolactone – is a drug that curbs androgen levels and is another common treatment used for PCOS, although it is also not officially FDA-approved for PCOS treatment. By lowering androgen levels, many patients have reported significant improvements in androgen-related symptoms such excess hair growth. Unfortunately, this drug is unlikely to help with hair loss aka androgenic alopecia which is more difficult to treat.
Two important things to note are that the long-term safety effects of using this drug are not known and spironolactone IS NOT SAFE to use during pregnancy, so it is commonly used in conjunction with birth control pills.
Topical Creams and other treatments – these include the prescription cream eflornithine hydrochloride (Vaniqa), acne medications and topical skin care, and cosmetic treatments such as laser hair removal and electrolysis.
One of the most important things you can do to get your PCOS under control is to change your diet. If you are eating the standard American diet of high sugar, refined carbs, and hydrogenated fats you are not doing yourself any favors. In fact, you are most likely making your symptoms worse. So, as any good doctor would tell you now is the time to switch to a healthy balanced diet of whole grains, healthy fats, protein, fruits, and vegetables. I actually created a whole foods shopping guide that you can download for free HERE.
Vitamins, supplements, and other complementary treatments are popular among a lot of women with PCOS. Researchers are currently studying the effectiveness of such treatments. Popular treatments include:
- vitamin D
- B complex vitamins
- omega fatty acids (evening primrose, flax seed oil, cod liver oil)
- saw palmetto
- spearmint tea,
- Essential Oils and acupuncture.
An effective natural treatment is –
Ovasitol – a high-quality, medical-grade supplement that combines both myo and d-chiro-inositol that mimic’s the body’s own ratio. A combination of myo and d-chiro inositol has been shown to improve insulin sensitivity, restore hormone balance, improve ovulation and egg quality in women with PCOS. I found that this has really helped with my food and sugar cravings and with time it is supposed to help with the weight gain and excess hair.
Exercise is also very important for helping with weight loss and also for balancing hormones (especially the stress hormones). So try to get at least 15-20 minutes of exercise a day even if it is just walking.
A book that really helped me a lot is Making Sense of Women’s Health by Dr. Marita Schauch. It contains a wealth of information on various different women’s health issues from breast cancer to PCOS and more. Dr. Marita discusses the standard medical treatments plus the natural remedies for each condition which is great for helping one make an informed decision about which route is best. She also gives diet and exercise tips.
Another thing you can do is switch from standard beauty products to natural ones that are free from parabens, sulfates, and other irritating chemicals. You can read more about how to do that HERE.
For more facts, information on diet and how to manage PCOS I highly recommend the following websites –
To my fellow Cyster’s I wish the best of luck on your journey and I really hope this post has been helpful. And for anyone that has a friend, relative or significant other who has PCOS I hope you have found this enlightening and that it leaves you more understanding of what that person is going through on a daily basis. Please feel free to leave a comment below. 🙂