Unveiling the Complexity of Polycystic Ovary Syndrome
Also called polycystic ovarian syndrome, polycystic ovary syndrome (PCOS) was first detected thousands of years ago. Today, it affects 10% of women of childbearing age, according to the .听听
鈥淥ur understanding of PCOS has evolved over the past 50 to 70 years,鈥 says Rekha Kumar, M.D., M.S., associate professor of Clinical Medicine and attending endocrinologist at the Weill Cornell Medical College specializing in endocrine disorders. One important lesson learned: 鈥淭here are various presentations of PCOS, so it looks different in many people.鈥听
PCOS Explained听
Androgen is considered a male hormone, but women鈥檚 bodies produce a small amount of it. PCOS occurs when the ovaries or adrenal glands create excessive male hormones.听听
It鈥檚 currently unclear what causes this abnormal hormone production. However, there seems to be a link. Your risk may increase if your mother, sister or aunt has experienced PCOS.听
Though rooted in hormones, PCOS can cause symptoms that mimic many different disorders. Dr. Kumar has seen it as a gynecologic disorder, endocrine disorder and metabolic disorder.听听
Symptoms caused by PCOS include:听
- Acne听
- Infertility听
- Irregular or lack of periods听
- Oily skin or dark, thickened skin patches听
- Unwanted hair growth on the face (hirsutism)听
- Weight gain or inability to lose weight听
Detecting the Problem听
There are two common paths to detecting polycystic ovary syndrome. The first relies on the Rotterdam criteria.听
鈥淭his is a clinical diagnosis, meaning that it doesn鈥檛 always require extensive testing,鈥 Dr. Kumar says. 鈥淵ou can meet the criteria for PCOS without even knowing what your ovaries look like.鈥听
With the Rotterdam criteria, your provider diagnoses your condition without invasive testing. Instead, your diagnosis is based on the syndrome鈥檚 effects. The Rotterdam criteria are:听
- Cysts on the ovaries, which can cause pain and swelling and may be detected during a pelvic exam听
- High testosterone indicated by acne, cystic acne (painful cysts under the skin) or unwanted facial hair growth听
- Lack of ovulation indicated by irregular periods or a total lack of periods听
Having two of the above confirms a diagnosis of PCOS. If you don鈥檛 experience symptoms, your provider can still detect PCOS through:听
- Health history and physical exam. You discuss your menstruation history and fertility issues and any PCOS symptoms you or any close family members have experienced. Additionally, you undergo a complete physical exam. During the exam, your provider pays particular attention to acne, abnormal hair growth and other PCOS symptoms.听
- Laboratory tests. Your provider takes a sample of your blood. A laboratory technician then evaluates the sample for abnormal hormone levels. To rule out other conditions, your provider may also prescribe blood tests to check for pregnancy, blood glucose problems or poor thyroid function.听
- Pelvic examination. As part of your physical exam, your provider performs a pelvic exam to feel around for potential growths on the ovaries. You may also undergo a pelvic ultrasound to look for cysts or other abnormalities.听
Feeling the PCOS Effect听
Along with frustrating symptoms, PCOS can cause a variety of health issues. Complications of PCOS include:听
- Chronic inflammation听
- Endometrial cancer听
- Heart disease听
- High blood pressure听
- Obesity听
- Sleep apnea听
- Type 2 diabetes听
PCOS can also affect mental health. It may result in anxiety or depression. You may lose control of your eating habits, a disorder known as binge eating. Mention these issues to your provider to help with proper diagnosis and treatment.听
Getting PCOS Under Control听
To date, there is no cure for PCOS, but proper treatment can help manage symptoms. Treatments commonly available include:听
- Acne care. Prescription medication can help control severe acne. Options include antibiotics and retinoic acid.听
- Androgen-stopping medication. This treatment can provide some symptomatic relief by slowing the body鈥檚 androgen production. However, it can cause congenital defects, so your provider may also recommend oral contraceptives.听
- pills. Oral contraceptives contain estrogen and progestin. These hormones help slow your body鈥檚 androgen production. They also help regulate your menstrual cycle. As an added perk, the pill may lower your risk for some cancers.听
- Hair management. There are many ways to remove unwanted hair. You can shave or pluck hair or apply a topical cream to stop hair growth. Other ways to hide or eliminate unwanted hair include waxing, bleaching and laser hair removal.听
- Lifestyle changes. Staying active and losing weight can help manage PCOS symptoms and reduce your risk for complications, such as depression and cardiovascular disease. A healthy lifestyle can even help regulate your menstrual cycle and increase your odds of future pregnancy. Talk with your provider about lifestyle changes that can help you gain better control over your symptoms.听
听A Final Word听
PCOS can be a challenge for any woman, but for women who desire to become pregnant, it can feel particularly difficult. According to the , PCOS is a leading cause of infertility.听听
Thankfully, many women can overcome fertility issues brought on by the condition. Through proper treatment, you may regain appropriate hormone levels and ovulation and possibly become pregnant.听
Whether or not you want pregnancy, a multidisciplinary team helps ensure you get the care needed for the best quality of life. Team members who may help manage your care include:听
- Endocrinologists听
- Gynecologists听
- Primary care providers听
It鈥檚 important that you trust your providers and have a strong support system. Otherwise, you may feel unheard.听
鈥淏e your own advocate,鈥 Dr. Kumar says. 鈥淎ll physicians have strengths and weaknesses and interests. Seek out an endocrinologist or gynecologist who has an interest in PCOS. And if you feel that you're not being listened to, seek a second opinion and say why you're concerned.鈥听
Experiencing symptoms of PCOS? Find a doctor at 麻豆传媒高清版 who can diagnose your condition and help you achieve better health.听