May 17, 2019
Nearly 1 in every 10 teenage girls and women of childbearing age will be diagnosed with polycystic ovary syndrome. And, more than half of those diagnosed didn't know they had it, according to the PCOS Foundation.
PCOS is a hormonal imbalance that causes small cysts in the ovaries. Although the cysts themselves are harmless, the syndrome can cause infertility and increase a woman’s risk of developing uterine lining cancer, diabetes and heart disease, according to reproductive endocrinology and infertility specialist Courtney Marsh, MD, MPH.
"Polycystic" means many fluid-filled sacs. When estrogen, progesterone and androgen are in balance, they send a signal to the ovaries to release an egg. Cysts, in this case, are eggs which have not been released from the ovary because of an imbalance.
"When these hormones are out of balance, the ovary doesn't receive the proper signal. The egg may not be released like clockwork every month, or it may not be released at all," Dr. Marsh says.
Instead, the follicle (a fluid-filled sac or cyst) containing the egg remains enlarged in the ovary. Over time, the ovaries fill with many small cysts. This can lead to symptoms such as irregular periods, acne, excess hair growth, weight gain and more.
Hormone levels play a big role when it comes to cancer risk, especially endometrial cancer. They also affect a woman's ability to lose weight, leading to increased risks of diabetes and heart disease. If left unchecked, PCOS can lead to these and other complications.
There is no cure for PCOS yet. However, birth control pills are a standard treatment used to regulate hormones in women with PCOS. Also, because PCOS is linked to diabetes, certain diabetes medications can be used to treat PCOS. Weight loss is also recommended for women who are overweight or obese because excess fat disrupts hormonal balance.
Because many women aren't aware they have PCOS, it's important to know the symptoms. According to Dr. Marsh, here's what you should watch for:
- Irregular periods: Women with PCOS may have no periods, irregular periods or very long periods. Irregular periods may be a sign the ovaries are not releasing an egg each month.
- Acne: Adult acne can be a sign reproductive hormones are out of balance.
- Hair growth: Hair grows in places that should not have hair – like the chin, back or chest. This kind of hair growth could mean too many male hormones are being produced.
- Multiple cysts: Women with PCOS have a lot of cysts on their ovaries. Cysts normally are found with ultrasound, which uses a small transducer (probe) and ultrasound gel placed on the skin.
- Hair loss: Male-pattern baldness or hair loss may indicate women have a higher level of male reproductive hormones, which is a sign of PCOS.
- Weight gain: Women with PCOS often can't lose weight. They have a higher chance of insulin resistance, where the body does not respond to insulin, a hormone that keeps blood sugar in normal range. This may require changes in diet and activity or medications to assist with weight loss.
- Infertility: PCOS is a common cause of infertility in women. Women with PCOS may have trouble becoming pregnant because they ovulate irregularly or not at all. For this reason, timing intercourse with ovulation predictor kits may not work. Instead, many women with PCOS benefit from fertility treatments like IVF.
- Tiredness: Women with PCOS have a higher chance of having sleep apnea, a condition that causes breathing to stop and start repeatedly during the night. Despite going to bed on time and trying to get 8 hours of sleep, they wake up tired, causing them to feel fatigued all day.
- Mood swings: Because of the hormonal imbalance, women with PCOS also have a higher risk for depression, anxiety and extreme or rapid changes in mood.
- Heavy, painful periods: PCOS can cause painful periods with heavy bleeding. This can cause additional issues, such as anemia, and is often unpleasant and even scary.
If you experience any of the above symptoms and think you might have PCOS, don't put off seeing a doctor. We offer the most comprehensive care for women's health in the region. Our practitioners specialize in complex gynecological and reproductive healthcare, including high-risk pregnancies and adolescent obstetrical care. We offer the most advanced diagnostic and surgical procedures available.