What is Polycystic Ovary Syndrome?

Have you ever had trouble losing weight? Suffered from anxiety or depression? Battled chronic acne, put up with troublesome periods, or even experienced infertility?

If you’re facing a combination of these symptoms, you may be suffering from one of the most common hormonal disorders impacting the female population.

Polycystic Ovary Syndrome (PCOS) affects as many as five million women in the US, but there are still many uncertainties surrounding the condition. The exact cause is unknown, and the name itself indicates the spectrum of symptomatology—it’s referred to as a “syndrome” rather than a “disorder” because it presents so differently from case to case. Although the issue can be easy to ignore in the absence of classic symptoms, the long-term complications can be serious: Infertility, type 2 diabetes, high blood pressure, elevated cholesterol, and even endometrial cancer are all potential consequences.

But a PCOS diagnosis doesn’t mean you’re destined for a life of chronic health problems. Though there’s no known cure for the condition, there are ways to successfully manage it—with and without medication.

“PCOS is very treatable, with diet and lifestyle changes as well as natural therapeutics,” says One Medical’s April Blake, ND. “I see this quite frequently—I’d say at least 20 percent of my practice is made up of women with PCOS. And for women who are worried about fertility, PCOS shouldn’t stand in the way of having a baby. If you’re willing to work with diet and lifestyle modifications, as well as the available therapies, then fertility can be optimized.”

The first step in tackling PCOS is to get a better understanding of what it is. Here’s what you need to know.

PCOS is caused by a hormonal imbalance that affects various processes in the body. When one hormone is out of whack, it can cause a cascade of other hormonal issues. It’s not understood what causes the initial imbalance, though genetics may play a role.

Women with PCOS typically begin producing slightly elevated levels of male sex hormones known as androgens. This excessive production can throw off the normal balance of the female sex hormones estrogen and progesterone. The syndrome can also impact the body’s ability to properly utilize insulin, a hormone made in the pancreas that allows the body to process sugar (glucose) in food and keep blood sugar levels stable.

Most women with PCOS also develop many tiny cysts along the outer edges of their ovaries, hence the term “polycystic.”

It’s estimated that between five to 10 percent of women in their reproductive years have PCOS, but approximately 30 percent of women have at least some of the characteristics.

PCOS symptoms can be all over the map, and there’s no single diagnostic test. Your provider will likely look for symptoms in two of the following categories before diagnosing you:

• Infrequent periods: Fewer than nine periods a year or no periods at all.
• Excess male hormones: Elevated levels of androgens can lead to issues like hirsutism (excess facial and body hair), acne, and hair loss.
• Cysts: If your health care provider suspects you have PCOS, he or she may order an ultrasound to look for cysts on your ovaries. The cysts alone don’t necessarily indicate a PCOS diagnosis, though—signs of extra androgens and menstrual abnormalities have to be present as well. Some women with PCOS don’t have cystic ovaries at all.

Though there’s no cure for PCOS, there are various ways to manage the symptoms and keep complications at bay. It’s important to discuss all treatment options with your provider. A few of the most common treatments include:

Lifestyle Modifications
Because many women with the condition are overweight or obese, maintaining a healthy weight through food and exercise is crucial. Even a five to 10 percent weight reduction has been shown to restore normal periods and fertility. A diet rich in whole grains, fruits, and vegetables, and low in processed products can help keep your blood sugar low and improve issues related to insulin. If you smoke, now is a great time to quit—smoking increases androgen levels in women. A comprehensive dietary and lifestyle program for women with PCOS is available at FLOliving.com.

Hormone Therapy
If you’re not trying to become pregnant, birth control pills can help regulate your menstrual cycle, reduce excess androgens, and improve acne. If you are trying to conceive, medications like clomiphene (Clomid, Serophene) can help stimulate ovulation.

Diabetes Medication
A common pharmaceutical treatment for PCOS is metformin (Glucophage), which is typically used to treat type 2 diabetes. Though it’s not FDA-approved for treating PCOS, it’s often used to help control insulin and blood sugar and lower testosterone production.

Some studies have indicated that additional dietary modifications and supplements can help address PCOS. Check out our upcoming post on integrative treatments for details on holistic remedies.

Make an appointment with your health care provider and be prepared to discuss your medical history. You may also need to do some blood work so your provider can assess your hormone levels. With proper treatment, women with PCOS can usually manage their symptoms, and many are able to get pregnant if and when they decide to do so.