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Polycystic Ovary Syndrome (PCOS) is a hormonal imbalance condition that affects around 10% of women of reproductive age. Women with PCOS often experience irregular periods, acne, weight gain, fertility issues, and other symptoms. Additionally, benign cysts in the ovaries can be detected through ultrasound. PCOS can occur in girls as young as 11, but it may also appear in teenage years, the twenties, or later. Since this syndrome significantly affects hormones, menstrual cycles, appearance, and fertility, early diagnosis is crucial. Recognizing PCOS early and seeking medical treatment can help avoid long-term complications.
Steps
Recognizing key symptoms for diagnosing polycystic ovary syndrome
Monitor your menstrual cycle. If you have polycystic ovary syndrome (PCOS), your periods will be irregular or may not occur at all. Pay attention to abnormalities in your cycle, such as long intervals between periods, missed periods, excessive or very light bleeding, or spotting between cycles. Watch for these signs:
- The time between periods lasts longer than 35 days
- Fewer than 8 periods each year
- No periods for 4 months or longer
- Periods with heavy or light bleeding
- Research shows that about 50% of women with PCOS experience longer intervals between periods (infrequent periods). Around 20% of women with PCOS have no periods (amenorrhea). Infrequent or irregular ovulation is known as oligoovulation. Anovulation refers to the complete absence of ovulation. Visit a doctor if you suspect you're not ovulating, whether the cause is PCOS or another issue.
Observe excessive facial and body hair growth. Healthy women have a small amount of androgen (male hormones) in their bodies. Polycystic ovary syndrome (PCOS) often results in increased androgen levels due to high luteinizing hormone levels (which, at normal levels, regulate the menstrual cycle and egg production) along with insulin. This can lead to concerning symptoms like increased facial and body hair. This condition is known as hirsutism.
- Hair may grow excessively on the face, stomach, toes, fingers, chest, and back.
Monitor hair loss and balding. Elevated androgen levels in the body can also cause hair thinning, hair loss, or male-pattern baldness. Hair loss may occur gradually. For instance, you should pay attention if you notice more hair shedding than usual while showering.
Watch for oily skin, acne, or dandruff. Increased androgen production can also cause oily skin and an outbreak of acne. You might also experience dandruff—flaky skin on the scalp.
Consult with a doctor about polycystic ovaries. Polycystic ovaries are ovaries containing more than 12 cysts, each measuring 2-9 mm in diameter. These cysts surround the outer edges of the ovaries, leading to an increase in ovarian volume. In some cases, surgery may be required to remove these cysts. To determine whether you have polycystic ovaries, your doctor will perform an ultrasound.
- The ultrasound results should be evaluated by a reproductive endocrinology specialist. A reproductive endocrinologist is a doctor who specializes in reproductive health and fertility issues, such as PCOS, endometriosis, in vitro fertilization, and uterine abnormalities. If the ultrasound results are reviewed by a non-specialist, polycystic ovaries are often considered 'normal,' meaning no tumors are visible. This is because the doctor may not have been trained to spot these abnormalities. Occasionally, a misdiagnosis can occur, or the doctor may recommend exercise and weight loss as a solution for PCOS.
Recognizing symptoms related to polycystic ovary syndrome
Note the increase in insulin levels. Insulin resistance is a condition where insulin levels rise significantly. Sometimes, these symptoms can be mistaken for diabetes or hypoglycemia. In women with polycystic ovary syndrome (PCOS), this issue arises because the body tends to resist the effectiveness of insulin. Visit your doctor immediately if you experience the following symptoms:
- Weight gain
- Cravings for sugar or sweets
- Frequent and intense hunger
- Difficulty concentrating
- Anxiety or panic
- Fatigue
- In PCOS, insulin resistance is linked to increased androgen production, resulting in oily skin, acne, and excess facial and body hair. Additionally, you may notice weight gain around the abdomen.
- If you suspect insulin resistance, your doctor will conduct a glucose tolerance test (GTT).
- Insulin resistance can be managed through diet and exercise, with medications like Metformin sometimes prescribed to lower insulin levels. Even if Metformin is prescribed, you should ask to be referred to a nutrition specialist. A balanced diet plays a crucial role in treatment.
- Check insulin, glucose, hemoglobin A1c, and C-peptide levels. While no single test can diagnose insulin resistance, these markers are often elevated in patients with PCOS and insulin resistance.
Pay attention to infertility issues. You may have PCOS if you're struggling to conceive and have irregular periods. In fact, PCOS is the most common cause of infertility. Irregular or absent ovulation makes it difficult, or even impossible, to get pregnant.
- High hormone levels can sometimes increase the risk of miscarriage in women with PCOS who are trying to conceive. See a doctor immediately if you're unable to get pregnant.
Take special note of obesity. Obesity is always a concerning health issue, and it can also be a sign of PCOS. Due to high insulin levels, women with PCOS often accumulate fat around their waist and develop a pear-shaped body. These individuals may also find it difficult to lose weight.
- Approximately 38% of women with PCOS are obese. Adults with obesity typically have a body mass index (BMI) greater than 30.
Watch for skin changes. Women with PCOS may notice velvety patches of skin on the neck, underarms, thighs, and chest that are red-brown or dark (a condition called acanthosis nigricans). You might also develop excess skin (skin tags), typically under the arms or on the neck.
Track abdominal and pelvic pain symptoms. Some women with PCOS may experience pain or discomfort in the pelvic area, abdomen, or lower back. The pain may be dull or sharp, varying from mild to severe. The pain or discomfort may resemble the cramps that occur at the start of a menstrual cycle.
Monitor your sleep quality. Women with PCOS may experience sleep apnea, which involves snoring and intermittent breathing pauses during sleep. This could be caused by elevated estrogen or testosterone levels, or obesity—both of which are linked to PCOS.
Be aware of psychological symptoms. Women with PCOS are often more prone to anxiety or depression. This may stem from bodily changes like hormonal imbalances or could be a response to other PCOS symptoms such as infertility.
Check your family history. PCOS can run in families. You may be more likely to have PCOS if your mother or sister has it. It's important to examine your family’s health history to determine if you are more susceptible to PCOS.
- Women with PCOS often have a family member with diabetes.
- Women with PCOS often had abnormal birth weights, either as a small or large baby.
Learn about the long-term complications of polycystic ovary syndrome.
Consult a doctor. You should visit a doctor or gynecologist if you suspect you have PCOS. The doctor will assess your condition, inquire about your symptoms, and discuss your medical history.
- Medical history: The doctor will ask about your family history, lifestyle, including exercise, smoking, diet, and stress levels. They may also inquire about your desire to become pregnant.
- General health checkup and gynecological exam: The doctor may weigh you, measure your BMI, check your blood pressure, examine glands, and conduct a gynecological checkup.
- Blood tests: The doctor may conduct blood tests to evaluate glucose, insulin, cholesterol, and androgen levels, along with other factors.
- Transvaginal ultrasound: You might need a transvaginal ultrasound to check for ovarian cysts.
Manage your weight. If you're overweight or obese, you may experience more symptoms of PCOS. Leading a healthy lifestyle can help you avoid some of the more severe consequences of PCOS.
- Consume nutritious foods, avoid unhealthy eating habits, exercise regularly, and refrain from smoking.
- Familiarize yourself with the glycemic index. This index indicates how much a particular food raises your insulin levels. Opt for foods with a low glycemic index and limit foods with a high glycemic index. You can find glycemic index charts online for most foods.
Keep an eye on your blood pressure. High blood pressure is a common condition among women with PCOS. Therefore, it's important to monitor your blood pressure regularly.
- For women, a normal and healthy blood pressure is a systolic reading below 120 and a diastolic reading under 80.
Be cautious of cardiovascular issues. Women with PCOS are at a higher risk of developing heart disease. Regular health check-ups, including heart health assessments, are recommended.
- Eating a balanced diet, exercising, and losing weight can help reduce the risk of heart-related problems.
Watch for signs of diabetes. Women with PCOS are more likely to develop diabetes. Common symptoms of diabetes include:
- Frequent urination
- Extreme thirst or hunger
- Severe fatigue
- Bruises or cuts that take a long time to heal
- Blurred vision
- Tingling or pain in the hands or feet
Be mindful of cancer risks. PCOS may increase the risk of endometrial cancer, especially if you have irregular or absent periods that aren't treated by a doctor. Abnormal hormone levels, such as elevated estrogen and androgen levels with low progesterone, can raise the risk of cancer.
- Reducing cancer risk may involve regulating menstrual cycles through birth control pills or synthetic progesterone injections to stimulate menstruation. Alternatively, you can regulate your cycle by using progestin-containing IUDs like Mirena or Skyla.
Advice
- If diagnosed with PCOS, you should read the article 'How to Treat Polycystic Ovary Syndrome' to learn about treatment options and living with the condition.
- Early diagnosis can help avoid some of the most troublesome symptoms of PCOS. If you notice any signs, seek medical treatment promptly. Always discuss all symptoms with your doctor, and don't focus solely on one issue, such as infertility or obesity. Provide your doctor with a comprehensive overview of your health status.
- Women who have or suspect they have PCOS may feel embarrassed, depressed, or anxious about their symptoms. In such cases, don't let these emotions interfere with your treatment and strive to live fully. If you begin feeling depressed or anxious, talk to your doctor or a mental health professional.
