What Is PCOS?
Polycystic Ovary Syndrome (PCOS)—now referred to as Poliendocrine Metabolic Ovarian Syndrome (PMOS)—is a hormonal condition affecting the ovaries, the female reproductive organs responsible for producing eggs. It affects about 1 in 10 women (and people assigned female at birth) of generative age. It is one of the most common causes of infertility.
It can:
- Interrupt menstruation or make it difficult to predict.
- Causes acne and unwanted body and facial hair growth.
- Increase the risk of developing other health problems, such as diabetes and high blood pressure.
Some persons with PMOS may have cysts (small fluid-filled sacs) on their ovaries. However, many people with this condition do not have cysts. In fact, many do not experience any symptoms. This is one of the reasons why up to 70% of people with PMOS are unaware that they have it.
The condition typically manifests after puberty, although it may not be diagnosed until a person attempts to conceive.
It does not go away completely, but symptoms often improve after menopause. In the meantime, there are numerous treatments available that can alleviate symptoms or help achieve pregnancy.
PMOS vs. PCOD
Polycystic Ovarian Disease (PCOD) is an older term used to refer to PMOS. PMOS is also known as Stein-Leventhal syndrome.
Endometriosis vs. PMOS
In endometriosis, the type of tissue that lines the uterus grows in places where it shouldn’t—such as the vagina or the ovaries. Respectively month, this tissue can break down and bleed. Like PMOS, endometriosis can lead to the formation of cysts on the ovaries and result in infertility. Its primary symptoms are cramps and lower abdominal pain. Unlike PMOS, it does not cause symptoms such as acne or excessive body hair growth.
Types of PCOS
Some scientists suggest classifying PCOS into distinct types based on symptoms and hormone levels:
- Non-hyperandrogenic PCOS (or Type D): Characterised by ovulation problems (which may cause irregular periods or an absence of menstruation) and ovarian cysts. However, androgen levels (male hormones) remain normal.
- Ovulatory PCOS (Type C): Characterised by elevated androgen levels accompanied by ovarian cysts. PCOS without polycystic ovaries (Type B): You have elevated androgen levels as well as ovulation problems.
- Full PCOS (Type A): You have elevated androgen levels, ovulation problems, and ovarian cysts.
Informally, you may hear some people label it using other relations that refer to its causes or symptoms:
- Insulin-resistant PCOS: People with PCOS often also have insulin resistance; this occurs when the body produces the hormone insulin but is unable to utilize it effectively. Insulin struggle increases the risk of developing Type 2 diabetes.
- Inflammatory PCOS: Inflammation occurs when the immune system attempts to fight off a threat. Various studies have linked PCOS to low-grade, systemic inflammation throughout the body. This can trigger or worsen signs. Conditions such as insulin confrontation and obesity contribute to this inflammation.
- Hidden-cause PCOS: Some websites usage this term to refer to cases of PCOS with an unknown underlying cause. However, this applies to PCOS in general: scientists do not yet know what causes this condition, although they believe that both genetic and environmental factors play a significant role.
- Pill-induced PCOS or Post-pill PCOS. The birth control pill—as well as other hormonal contraceptive methods—does not cause PCOS. However, upon discontinuing the use of this type of contraceptive, you may temporarily experience irregular menstrual periods or other symptoms similar to those of PCOS. Furthermore, hormonal contraceptives can mask the symptoms of PCOS; consequently, a diagnosis may not be established until you stop using them. In some cases, doctors prescribe hormonal contraceptives as a treatment to alleviate the symptoms of PCOS.
PCOS and Hormones
Your body produces many types of hormones. Hormones are chemical heralds that help control many bodily functions. Some affect your menstrual cycle and are linked to your ability to have children. When you have PCOS, your generative hormones are out of balance. Many hormones play a role in PCOS.
PCOS and Insulin Resistance
Insulin is a hormone that panels your blood sugar levels. Scientists estimate that between 30% and 80% of people with PCOS have insulin resistance. When your body does not respond to insulin as it should, you may have an excess of insulin in your system. Some researchers believe that this excess insulin contributes to your body producing excess androgens.
Other hormones involved in the syndrome include:
Androgens. These are often referred to as male hormones, but everyone has them. When you have PCOS, your ovaries produce more androgens than usual. This can prevent your ovaries from releasing eggs in your usual monthly cycle, leading to irregular menstrual periods. Excess androgens are responsible for many of the symptoms of PCOS, including acne, hair loss, and unwanted hair growth.
Follicle-stimulating hormone (FSH). This hormone helps make your body for ovulation and helps regulate your menstrual cycle.
Luteinizing hormone (LH). This also helps regulate your monthly cycle by stimulating the ovaries to release eggs.
Progesterone. In cases of PCOS, your body may not produce enough of this hormone. Consequently, you may not have a menstrual period for long periods of time, or you may have difficulty predicting when it will arrive.
Estrogen. When you have PCOS, your estrogen levels may be too high relative to your progesterone levels.
PCOS Symptoms
What are the early signs of PCOS?
Polycystic ovary syndrome is not, strictly speaking, a disease, but rather a cluster of symptoms. These symptoms can vary from one person to another. However, the most common signs of PCOS are the absence of a period or periods that are irregular, infrequent, or excessively long.
Other possible signs of PCOS include:
Hair loss. PCOS can cause scalp hair thinning, particularly in middle-aged or older women.
Excessive facial and body hair (hirsutism). At the similar time, hair may grow in unwanted areas, such as the face, chest, abdomen, arms, fingers, and toes.
Oily skin. Excess androgens can make the skin oilier.
Embarrassment or discomfort. You may experience acne breakouts on your face, chest, and/or back.
Darkened skin. Patches of darker skin may appear, particularly under the breasts or arms, or on the neck.
Skin tags (acrochordons). These small flaps of excess skin typically appear on the neck or in the armpits.
Pain associated with PCOS. You may experience pain in the lower abdomen (pelvic area) during menstruation and, occasionally, at other times.
Weight gain (PCOS belly). Approximately 50% of people with PCOS gain weight, particularly in the abdominal area (the belly).
Ovarian cysts. During an ultrasound, your doctor may observe that your ovaries appear larger than normal or contain multiple cysts (follicles) with eggs inside.
Mood swings. PCOS increases the risk of experiencing sudden mood swings, as well as feelings of depression or anxiety. This may be due to both hormonal changes and the difficulty of coping with PCOS symptoms.
Can you have PCOS without symptoms?
Sometimes, PCOS causes no symptoms at all, or the symptoms are so mild that they go unnoticed. Because of this—and given that many other health issues can cause similar menstrual irregularities—diagnosing PCOS can take a considerable amount of time.
PCOS Causes
Doctors do not know exactly what causes this syndrome; however, the following factors are believed to play a role in its development:
- Overweight/Obesity. The relationship among body weight and PCOS is complex. Weight gain plays a role in the expansion of PCOS, but PCOS can also contribute to weight gain.
- Elevated androgen levels. This condition, known as hyperandrogenism, affects the majority of people with PCOS.
- Insulin resistance. Excess insulin can affect the ovaries and their ability to release eggs (ovulate). It can also facilitate weight gain and make weight loss difficult.
- Chronic low-grade inflammation. This factor also contributes to the body producing excess androgens.
Is PCOS genetic?
The genetic link to PCOS is not yet fully understood; however, there is a higher likelihood of developing it if close relatives also have the condition. Approximately 20% to 40% of people with PCOS have a mother or sister who also has the condition. This may be due to a combination of genetic factors and shared lifestyle factors.
PCOS Risk Factors
PCOS risk factors include:
- A family history of menstrual glitches or disorders (including PCOS)
- Type 2 diabetes
- Being overweight or obese
- Rapid weight gain
Transgender men (also known as female-to-male transsexual individuals, or FTM) have a higher likelihood of developing PCOS. Hormone therapy may or may not be a cause, as many other factors are involved. Some studies have exposed that, while hormone therapy can lead to changes in the ovaries of transgender men, it does not necessarily cause PCOS.
What are the complications of PCOS?
When you have PCOS, there is an increased likelihood of developing various other health problems, such as:
Difficulty getting pregnant. Hormonal imbalances can interfere with ovulation. If there are no healthy eggs available to be fertilized by sperm, it is not possible to get pregnant. However, it is still possible to conceive despite having PCOS. To do so, you may need to take medication and work with a fertility specialist.
Complications during pregnancy. Most people with PCOS can have healthy pregnancies. However, this condition increases the risk of developing diabetes (gestational diabetes) and tall blood pressure (preeclampsia) during pregnancy. It also rises the risk of premature birth, cesarean section, and miscarriage.
Problems related to insulin and diabetes. When insulin resistance occurs, cells in muscles, organs, and other tissues do not take up enough sugar from the blood. As a result, excess sugar collects in the bloodstream. Insulin resistance typically does not cause symptoms until blood sugar levels rise so high that diabetes develops. More than half of persons with PCOS will develop type 2 diabetes previously the age of 40.
Metabolic syndrome. This cluster of symptoms rises the risk of developing heart disease. Symptoms include elevated triglycerides and low HDL (“good”) cholesterol, high blood pressure, and higher blood sugar. Other possible complications include:
- Depression
- Anxiety
- Uterine bleeding and an increased risk of uterine and endometrial cancer
- Sleep problems, including sleep apnea
- Liver inflammation
PCOS Diagnosis
You may be identified with PCOS if you present at least two of the following symptoms:
- Irregular menstrual periods
- Signs that your body is producing an excess of androgens, such as acne, excessive facial and body hair, or a blood test revealing elevated androgen levels
- Ovarian cysts or enlarged ovaries are visible on an ultrasound
How to get tested for PCOS
There is no single test that can diagnose PCOS. Your doctor will begin by interested about your symptoms and medical history. They will perform a physical inspection to look for signs such as acne and facial and body hair.
They may also perform a pelvic examination. For this exam, they will insert a gloved hand into your vagina and then palpate your reproductive organs to determine if your ovaries are enlarged or if there are other abnormalities.
Additionally, they may perform an ultrasound—an imaging test that allows them to see if you have cysts and to measure the lining of your uterus. For a transvaginal ultrasound, the doctor will insert a wand-shaped device into your vagina; this device uses sound waves to create imageries of your multiplicative organs.
You may also undergo a blood test to check your androgen and other hormone levels.
Other tests you might get
If your doctor suspects that you have PCOS, they may wish to perform tests to detect other health conditions unrelated to PCOS. These may include:
- Blood pressure measurement
- Blood tests to check sugar, cholesterol, and triglyceride levels
- Mental health assessment
- Sleep apnea evaluation
PCOS Treatment
There is no solo test that can diagnose PCOS.
Your doctor will begin by asking around your symptoms and medical history. They will perform a physical inspection to look for signs such as acne and facial and body hair.
They may also perform a pelvic examination. For this test, they will insert a gloved hand into your vagina and then palpate your reproductive organs to determine if your ovaries are enlarged or if there are other abnormalities.
Additionally, they may perform an ultrasound—an imaging test that allows them to see if you have cysts and to measure the lining of your uterus. For a transvaginal ultrasound, the doctor will insert a wand-shaped device into your vagina; this device uses complete waves to create images of your generative organs.
You may also undergo a blood test to check your androgen and other hormone levels. Other tests you might get
If your doctor suspects that you have PCOS, they may wish to perform tests to screen for other health conditions unrelated to PCOS. These may include:
- Blood pressure measurement
- Blood tests to check sugar, cholesterol, and triglyceride levels
- Mental health assessment
- Sleep apnea evaluation
PCOS Treatment
There is no cure for PCOS. The medical treatment your doctor recommends to manage your symptoms will depend on whether you are trying to conceive. It is important to discuss this with your doctor, as some medications can harm a developing baby.
You may be prescribed:
- Hormonal contraceptives. If you do not plan to become pregnant, your doctor may prescribe a hormonal birth control method, such as the patch, the pill, the injection, or a hormonal IUD. These may contain estrogen, progesterone, or both. They can help regulate your menstrual periods, treat acne and excess body hair, and reduce your risk of endometrial cancer.
- Progestin therapy. This hormone can help normalise your menstrual cycle and reduce your risk of uterine cancer. It does not prevent pregnancy or reduce androgen levels.
- Insulin-sensitising medications. Metformin, a drug hand-me-down to treat type 2 diabetes, helps lower insulin and androgenic hormone levels. Although it is not FDA-approved for the treatment of PCOS, it can be useful for improving ovulation and alleviating menstrual irregularities.
- Androgen blockers. These medications block the effects of excess male hormones that cause problems such as unwanted hair growth and acne. However, do not take them if you are pregnant or preparation to become pregnant, as they can cause congenital disabilities. While taking them, you must use two different types of birth control methods.
Acne Medications
If you have acne that problems you, a dermatologist can recommend creams and/or pills to treat and prevent breakouts.
Excessive Hair Growth
If you wish to reduce facial or body hair, other choices include:
Electrolysis or laser therapy: Electrolysis removes separate hairs using an electric current that destroys the root. Laser therapy destroys hair follicles. You will need several sessions. Although some hair may grow back, it should be finer and less noticeable.
Depilatories: These over-the-counter creams, gels, and unguents break down the hair’s protein structure, causing it to detach from the skin. Follow the instructions on the package.
PCOS and Pregnancy
Getting pregnant with PCOS
It is possible to get pregnant if you have PCOS (polycystic ovary syndrome). However, you may need medication to help you ovulate or require fertility technologies, such as in vitro fertilization.
Medications to Help You Ovulate
If you need help ovulating to get pregnant, certain medications may be helpful:
- Clomiphene (Clomid, Serophene): An anti-estrogen medication taken at the beginning of the menstrual cycle.
- If clomiphene does not help you ovulate, you may be prescribed a diabetes medication called metformin.
- If clomiphene and metformin are ineffective, your doctor may prescribe hormonal medications called gonadotropins. This medication is administered via injection.
- Letrozole (Femara): A medication sometimes used when other treatments do not work.
Other options for improving your fertility include:
Surgery: A procedure called ovarian drilling can improve ovarian function when ovulation medications are ineffective. However, doctors perform this procedure less frequently than in the past, as more effective medications are now available. The surgeon makes a small incision in the abdomen and removes the parts of the ovaries that are producing excess androgens.
In vitro fertilization, or IVF: In this process, your doctor retrieves one of your eggs from your body and combines it with sperm from your spouse or a donor. The fertilized egg is then transferred back into your uterus. This may be the most effective method for achieving pregnancy if you have polycystic ovary syndrome (PCOS), although it can be expensive.
Talk to your doctor about how you can growth your chances of having a healthy pregnancy, including making lifestyle changes before conceiving.
Diet and Lifestyle Deviations for PCOS and Fertility
A healthy lifestyle—including weight management, regular exercise, and blood sugar control—can help improve PCOS symptoms and boost your fertility.
Weight Management
Not everyone with PCOS is overweight, but many people are. Weight gain can affect your hormones. If you are large or obese, losing weight can help transport your hormone levels back to normal. Losing just 10% of your physique weight can help make your menstrual periods more predictable.
Your doctor may recommend selecting foods lower in calories and fat, as well as controlling portion sizes. However, losing weight is not easy. A nutritionist or dietitian can assist. Additionally, some people find that keeping a food diary or with an app to track their meals and snacks makes the process easier.
Diet for PCOS
To achieve your blood sugar levels, your doctor may suggest focusing on foods lower in sugar and certain carbohydrates. Some carbohydrates are beneficial for you—such as those found in fibre-rich fruits and vegetables. However, it is best to limit refined carbohydrates, such as white flour, white rice, white potatoes, sugar, and highly processed foods. These foods have a high glycemic index, import they cause your blood sugar heights to rise rapidly.
Other healthy foods—such as chicken and other lean meats, fish, and whole grains—can also help keep your blood sugar levels stable. Aim to eat regularly, as sticking to a schedule helps your body maintain reliable insulin levels.
Exercise
Regular exercise burns calories and builds muscle mass. This can help reduce insulin resistance, which, in turn, can lower your androgen levels and alleviate symptoms. Exercise can also improve your disposition and self-esteem.
Get Enough Sleep
Lack of sleep can pay to hormonal imbalances, insulin resistance, and weight gain. Create conditions conducive to good rest by taking the following measures:
- Go to bed and wake up at approximately the same time every day.
- Avoid using screens shortly before bedtime.
- Ensure that your room is dark, cool, and quiet.
If you consistently have trouble getting at least 7 hours of sleep per night, consult your doctor.
Reduce Stress
A condition like PCOS can be stressful. In turn, stress can worsen PCOS symptoms. Your body produces cortisol (the so-called “stress hormone”) from progesterone and other hormones. This can disrupt the balance of these hormones in your system. Stress can also underwrite to weight gain and depression—common challenges for people with PCOS. Exercise can be helpful, as can stress management techniques such as breathing workouts and mindfulness meditation.
Limiting Caffeine
While moderate heights of caffeine (up to about 4 cups of coffee per day) are acceptable, consuming more than that amount can affect your sleep and, possibly, even your hormonal balance. Consult your doctor to determine whether you should reduce your caffeine intake.
Avoiding Endocrine Disruptors
Certain chemicals, known as endocrine disruptors, are believed to cause hormonal imbalances and may even be linked to PCOS. Some of the most common ones include bisphenols (including BPA), parabens, phthalates, and triclosan. These are create in plastics, cosmetics, industrial chemicals, and pesticides. They can also pollute food, water, soil, and air. It is difficult to avoid these ubiquitous chemicals completely; however, some possible ways to reduce your exposure include:
- Avoid products that contain fragrances.
- Storing food in glass or stainless steel vessels instead of plastic ones.
- Avoid canned foods with BPA-lined packaging.
- Washing your hands frequently, especially before eating.
- Use a vacuum cleaner prepared with a HEPA filter.
Alternative Medicine for PCOS
While there are no alternative treatments with proven efficacy for relieving PCOS symptoms, various studies have found indications that some of them may offer certain benefits.
Herbs and Supplements
- A review of 33 studies, conducted in 2014, found some evidence that the following herbal remedies might help alleviate symptoms of PCOS:
- Chaste tree berry (*Vitex agnus-castus*).
- Black cohosh (*Cimicifuga racemosa*).
- *Tribulus terrestris*, a vegetable used in Eastern medicine.
- Liquorice extract.
- Liquorice extract combined with Chinese peony.
The most compelling findings were obtained with chaste tree berry and black cohosh. However, the researchers noted that more comprehensive, high-quality research is needed to confirm these potential benefits.
A review of 24 studies, conducted in 2017, analysed 11 herbs and supplements to determine whether they could help alleviate symptoms or complications associated with PCOS.
Potential benefits were found for:
- Inositol, a type of sugar found in many plant-based foods
- Fish oil (omega-3) supplements
However, researchers caution that scientific evidence regarding this is scarce.
The review found little indication of benefits for:
- Vitamin D
- Vitamin D combined with calcium
- Cinnamon
- Chromium
- Selenium
- Vitamin B complex
- Black cohosh
- Chamomile tea
- Green tea
Other studies have suggested that berberine—a compound found in plants such as goldenseal—could help improve fertility and insulin resistance in people with PCOS. However, more and better research is needed in this area.
Please communication that the FDA does not regulate dietary supplements with respect to their efficacy or safety. Always consult your doctor before preliminary to take a new supplement. Ask about potential side effects, interactions with medications you are currently taking, and the most recent research regarding its efficacy.
Spearmint Tea for PCOS
Some studies have revealed that regular consumption of tea made from Mentha spicata leaves could help balance hormone levels in people with PCOS. It may also help reduce excessive facial and body hair growth. This tea is caffeine-free, so you can try drinking 2 to 3 cups a day to see if it helps alleviate your symptoms. However, consult your doctor first, especially if you are pregnant, trying to conceive, or have other health conditions.
Acupuncture for PCOS
Acupuncture is a type of opposite medicine in which a therapist inserts thin needles into specific points on the body. Some studies have suggested that it could help regulate hormones and ovulation, as well as reduce insulin resistance in people with PCOS. However, other researchers maintain that there is not yet enough solid evidence to support its efficacy as a treatment for PCOS.
PCOS and Menopause
PCOS symptoms related to the menstrual cycle often improve as menopause approaches. After menopause, the ovaries stop functioning, leading to a decrease in androgen levels. Furthermore, since menstrual periods cease, menstrual irregularity is no longer an issue.
However, your androgen levels may remain higher than normal, meaning you could continue to experience other symptoms. Additionally, the risk of developing complications associated with PCOS—such as diabetes and metabolic syndrome—increases with age.
Takeaways
Polycystic Ovary Set of symptoms (PCOS) is a hormonal disorder that distresses the ovaries. It interferes with the menstrual cycle and is a mutual cause of sterility. However, actions can recover symptoms and help you conceive.
Frequently Asked Questions (FAQs) about PCOS
How do I know if I have PCOS?
The most shared symptoms are irregular periods, acne, extreme hair growth, and difficulty conceiving. However, some people do not experience any of these symptoms. If you think you may have PCOS, talk to your doctor.
Does PCOS ever go away?
PCOS never completely goes away, but symptoms can improve over time or with treatment. For example, menopause can trigger hormonal changes that alleviate PCOS symptoms.
Can I get pregnant naturally if I have PCOS?
People with PCOS often struggle to conceive, but certain treatments can be helpful. When you have PCOS, eggs are occasionally still released (and you still have menstrual periods), but these can be irregular and difficult to predict. This makes it difficult—though not impossible—to conceive without the aid of treatment.