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What is Polycystic Ovarian Syndrome and how might it affect me?

September is Polycystic Ovarian Syndrome (PCOS) Awareness Month. This condition is common in general, but it is something I see particularly frequently in my practice. There is a lot of misinformation on the internet and on social media about this condition, so I wanted to share more information to help better explain this condition and what it means.

What is PCOS?

Polycystic Ovary Syndrome, or PCOS, is a hormonal disorder that affects people with ovaries, and generally starts to produce symptoms during their reproductive years. It's named "polycystic" because it involves the development of small, fluid-filled sacs (cysts) on the ovaries. These cysts are not harmful on their own but the underlying condition that causes them to form is associated with numerous health conditions.

What Causes PCOS?

The exact cause of PCOS is still not fully understood, but it's believed to involve a combination of genetic and environmental factors. Here are some key factors that may contribute to the development of PCOS:

  1. Insulin Resistance: Many individuals with PCOS have insulin resistance, which means their bodies have trouble using insulin effectively. This can lead to elevated insulin levels, which in turn can affect hormone production. Insulin resistance is influenced by both genetic and lifestyle factors.

  2. Hormonal Imbalance: PCOS involves an imbalance in hormones such as estrogen, progesterone, and androgens (what most people think of as "male" hormones like testosterone). This imbalance can disrupt the normal menstrual cycle and lead to various symptoms. All people produce and need androgens regardless of gender, but most symptoms from this hormonal imbalance are due to a relative elevation in androgen levels.

  3. Genetics: If you have a family history of PCOS, you may be at a higher risk of developing the condition.

Common Symptoms of PCOS
  1. Irregular Periods: One of the hallmark signs of PCOS is irregular menstrual cycles. Some individuals with PCOS have infrequent periods, while others may experience heavy or prolonged bleeding.

  2. Excessive Hair Growth: PCOS can lead to hirsutism, which is the growth of coarse, dark hair in areas where women typically don't have much hair, such as the face, chest, and back.

  3. Acne and Oily Skin: Hormonal imbalances in PCOS can contribute to acne and excessive oiliness of the skin.

  4. Weight Gain: Many people with PCOS struggle with unexplained weight gain, often due to insulin resistance.

  5. Difficulty Getting Pregnant: PCOS is a common cause of infertility, as it can disrupt normal ovulation.

  6. Mood Changes: Individuals with PCOS are more likely to experience mood swings, depression, or anxiety.

  7. Pelvic Pain: Most people with PCOS do not experience pain associated with the cysts on their ovaries, but in some cases these cysts can become enlarged and cause pelvic pain.

Long-Term Complications of PCOS

PCOS is associated with several long-term health complications. These complications can often be avoided or reduced with early diagnosis and management.

  1. Type 2 Diabetes: Insulin resistance associated with PCOS can elevate the risk of developing type 2 diabetes.

  2. Heart Disease: PCOS can lead to higher blood pressure and cholesterol levels, increasing the risk of heart disease.

  3. Endometrial Cancer: Irregular periods can lead to abnormal buildup of the uterine lining, potentially increasing the risk of endometrial cancer.

  4. Sleep Apnea: PCOS is associated with an increased risk of sleep apnea, a condition characterized by pauses in breathing during sleep. Sleep apnea independently increases the risk of cardiovascular disease and type 2 diabetes, as well as mood disorders and fatigue.

  5. Eating Disorders: Many people who have PCOS receive inappropriate guidance on dieting and weight loss from the internet or from misinformed health professionals instead of evidence-based management of their condition. This can cause disordered eating behaviors that can worsen metabolic outcomes and spiral into an eating disorder.

What Can You Do?

If you suspect you have PCOS or are experiencing any of these symptoms, it's crucial to seek medical advice from an experienced physician. Early diagnosis and management can help prevent complications and improve your quality of life. Treatment for PCOS often includes lifestyle changes related to nutrition, movement, sleep, stress management and social connection, medications to regulate hormones and insulin levels, and, in some cases, fertility treatments. If you are seeking a physician experienced in the diagnosis and management of PCOS- please reach out! PCOS is one of the most common conditions I treat and I am passionate about providing evidence-based treatment to help patients avoid or manage complications.

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