Although thousands of women in the United States are diagnosed with polycystic ovary syndrome (PCOS) every year, the disorder and its symptoms are still widely misunderstood.
PCOS is a hormonal condition that affects up to 10% of women in the general population. It is a complex disorder that is influenced by both genetic variants and environmental factors. PCOS can manifest as irregular periods, infertility and metabolic dysfunction.
According to Dr. Amy Schutt, a reproductive endocrinology and infertility specialist at Texas Children’s Pavilion for Women, women who are susceptible to PCOS include those with a first-degree family history of the condition, obesity, insulin-resistance, and diabetes.
There is mounting evidence that exposures during pregnancy can predispose female offspring to PCOS or other metabolic disorders.
“If a pregnant woman has PCOS, is obese, or has diabetes, her fetus has a higher chance of developing PCOS or another metabolic disorder. Mom’s environmental and hormonal exposures influence the fetus, in part through a mechanism called genetic programming,” she said.
Certain demographics are also more prone to developing PCOS. Mexican-American women are more likely to develop PCOS compared to their African-American or Caucasian counterparts.
Symptoms of PCOS
With PCOS, the hormonal communication to the brain to the ovary is abnormal. This can result in irregular or absent ovulation and women can experience irregular and unpredictable periods. An irregular period can differ from woman to woman, but having a period fewer than nine times a year typically falls into the irregular category. Other common symptoms include acne and oily skin, weight gain, bothersome hair growth, and heavy bleeding during the menstrual cycle.
When diagnosing PCOS, physicians commonly look for a person to meet at least two out of three criteria:
- Irregular menstrual cycles
- Polycystic appearing ovaries
- Elevated testosterone levels
In the first years after menstruation starts, it’s normal for all girls to have irregular periods. “It is very difficult to diagnose PCOS in adolescent girls because irregular cycles shortly after the first menstrual cycle are common. Our goal is to take a patient-centered approach to care, focus on the treatment of symptoms and less on labeling with a particular diagnosis,” says Schutt. “PCOS is often not caught early and these symptoms can go on for a long time. The sooner we can identify and treat early metabolic disease, the healthier a woman can be later in life.”
PCOS and other health factors
“PCOS is like the canary in the coal mine. When a woman is diagnosed young, we can also catch risk factors for diabetes and uterine cancer,” explains Schutt. “Usually, healthy young women don’t have diabetes, but in hormone testing these women for PCOS, we often see elevated insulin levels or pre-diabetes.” When these elevated insulin levels are detected, intervening early can prevent the development of diabetes.
Women with PCOS are also at risk for uterine cancer due to irregular periods. “When a woman has fewer than four periods a year as a result of PCOS, the uterine lining is allowed to grow and thicken which can lead to uterine cancer.” If a thickened uterine lining is detected, a biopsy is performed to rule out cancer.
Women with PCOS may find it difficult to get pregnant because of irregular ovulation, but it is not impossible. Infertility due to PCOS is commonly treated with medications that help regulate ovulation.
PCOS is a lifelong condition that is common and easily managed. It cannot be cured, but multiple factors can play a role in improving its symptoms. A healthy diet, weight loss, having a normal BMI, and avoiding refined and processed carbohydrates are helpful.
Effective medical therapies are available to regulate menstrual cycles, prevent heavy bleeding, assist in getting pregnant, and improve unwanted hair growth.
“The symptoms of PCOS can be isolating and cause a lot of anxiety for women that have not yet been diagnosed. This is a very common disorder that has excellent treatment options. If any woman is suffering from any of these symptoms, there is help out there,” says Schutt.
Dr. Schutt is assistant professor in the Division of Reproductive Endocrinology and Infertility in the Department of Obstetrics and Gynecology at Baylor. Learn more about Obstetrics and Gynecology services or call (832)-826-7500.
Learn more about PCOS Awareness Month.
See information about Reproductive Endocrinology and Infertility services at Baylor.
-By Melissa Tucker