September marks Polycystic Ovary Syndrome (PCOS) Awareness Month. PCOS is a serious genetic, hormonal, metabolic and reproductive disorder. It affects women from the onset of puberty and is one of leading causes of infertility. If untreated it can lead to obesity, type 2 diabetes, cardiovascular disease and endometrial cancer.
PCOS is actually very common. It can affect one in ten women of childbearing age. Women’s ovaries produce the female hormones oestrogen and progesterone, which regulate the menstrual cycle. But the ovaries also produce a small amount of androgens (male hormones).
In women with PCOS too many androgens are produced and this leads to issues such as:
- Cyst formation in the ovaries, hence the term polycystic meaning many cysts
- Weight gain
- Irregular, heavy or no periods
- Excess body and facial hair
- Acne and other skin issues
- Pelvic pain.
The problems with PCOS don’t end after the childbearing years. Associated complications can arise in later life, such as:
- Type 2 diabetes (T2D)
Women with PCOS are up to 40% more likely to develop T2D than a woman without the condition. This number can be as high as 50% in South East Asian women with PCOS.
- Cardiovascular disease
Women with insulin resistance, which is a common feature of PCOS, may also be at risk of developing heart disease in later life. Preventive measures are particularly important for women who are very overweight and for women who have a family history of diabetes or heart disease.
- Endometrial cancer
Women who have very infrequent/very irregular periods, fewer than four a year may have an increased risk of developing endometrial cancer.
The issue of diagnosis
One of the main problems with the condition is that women who have PCOS may not know it. In many cases symptoms can go unnoticed until a woman tries to conceive. 75% of women with PCOS struggle to get pregnant.
This is because many women are unaware of the symptoms. Also, not all women experience all the symptoms. Some symptoms may also occur intermittently, be mild and or just fleeting.
From a healthcare professional’s perspective, a doctor will generally make an initial diagnosis based on the Rotterdam criteria, which state that two of the following must be present:
- Irregular or no ovulation
- Raised male hormones (or evidence of such)
- Polycystic ovaries
Tests are then carried out to confirm the diagnosis and include:
- Blood tests: these measure the hormone levels and other factors in the blood, such as blood sugar levels
- Pelvic ultrasound: to look for cysts and enlarged ovaries
While the condition is not curable, it is manageable once it is diagnosed. And can be treated to help women with the condition conceive.
This means infrequent periods, no periods at all, or periods that last more than a week. Many women with PCOS find they have fewer than eight periods annually or more frequent than every 21 days.
PCOS related acne can occur on the face, chest, and back. However, most of the PCOS acne on the face is usually found on the chin and around the mouth.
Many women with PCOS are overweight or obese. Fast weight gain or an inability to lose weight are common symptoms of PCOS.
Excess Hair Growth
PCOS can cause excess hair growth in places like the face, chest, back and arms. This is due to the increase male hormones.
If you are experiencing any of these symptoms, then please consult your healthcare professional. The condition can be managed and with the right treatment you should be able to conceive.