Polycystic Ovarian Syndrome & Implications for the future of Women’s Health

First off, lets start with the basics: what exactly IS PCOS ( Polycystic ovarian syndrome )?

PCOS is a complex disorder characterized by irregular periods, mild obesity & signs of androgen excess (ie. unwanted hair & acne). Approximately 33% of women suffering from PCOS present with acne and 60-70% of women present with unwanted hair. In PCOS, the ovaries produce higher amounts of male hormones (androgens) than normal which interferes with proper egg production. 

Do you suffer from PCOS? Click here for more resources 

 

Why this matters. 

Polycystic ovarian syndrome occurs in up to 10% of women in the united states & is the most common cause of infertility. 

PCOS affects many as 1.4 million Canadian women.  Although it is one of the most common endocrine disorders, it’s diagnosis & treatment remains unclear. This is a BIG deal! PCOS is clearly a  problem affecting a huge number of women (that we know of) and their quality of life is being equally as impacted ! 

What is the confusion surrounding PCOS? 

 

 A lot of confusion when it comes to PCOS is namely due to the fact that it presents differently in many women.  Many women suffering from PCOS are not overweight, and are actually surprisingly thin.  Diagnostic criteria has evolved throughout the years to acknowledge the wide variability in the presentation of this disorder. 

The different faces of PCOS 

 

PCOS Category Hyperandrogenism (eg. facial, back or chest hair, acne) Anovulation (irregular cycles, lack of a period, no ovulation) Polycystic ovaries (finding on ultrasound)
Frank PCOS X X X
Classic PCOS X X  
Ovulatory PCOS X   X
Mild PCOS   X X

What is meant by irregular periods? Irregular periods can mean skipped periods, or an increased cycle length. You may also find yourself spotting between periods or having some periods heavier than normal.

Diagnostics 

 

Below are a few of the tests your doctor will run if they suspect PCOS may be present: 

  • Thyroid function test
  • Pregnancy test
  • Hormone tests (estrogen, progesterone, LH, FSH, testosterone, Sex hormone binding globulin)
  • Ultrasound 

The diagnostic criteria for PCOS has evolved over the years and now a diagnosis of PCOS requires only 2 out of the following 3 criteria:

  • Menstrual irregularity 
  • Hyperandrogenism (ie. excess facial hair, acne, or elevated testosterone on lab tests)
  • More than 10 follicles per ovary (found on ultrasound)

This means that you do not need blood work results to confirm a diagnosis of PCOS. Lab tests are, however, helpful to use as markers for treatment progress. 

The Risks of Polycystic Ovarian Syndrome

 

Many women seek medical treatment when they are trying to lose weight or get rid of their acne. Unfortunately there are other risks associated with PCOS beyond those seeming to be exterior. 

 polycystic ovarian syndrome increases the risk of heart disease 1. Cardiovascular Disease

The excess androgens women with PCOS experience long-term can lead to an increased risk of high blood pressure and high cholesterol levels. This risk is the same for women who are overweight as well as those who are normal weight.

polycystic ovarian syndrome increases the risk of diabetes 2. Diabetes 

60-80% of women with PCOS  have insulin resistance (lack of blood sugar control), which can lead to a diagnosis of diabetes and a whole host of associated negative health outcomes. This insulin resistance is a contributor to the cardiovascular risks, anovulation, infertility, and hyperandrogenism these women experience. 

polycystic ovarian syndrome increases your chances of infertility 3. Infertility 

Due to unpredictable (or non-existent) ovulation, pregnancy becomes a challenge for those suffering from polycystic ovarian syndrome. 

Polycystic ovarian syndrome increases a woman's risk of endometrial cancer 4. Increased risk of endometrial cancer 

With irregular periods, women with polycystic ovarian syndrome experience what’s called “unopposed estrogen”. As a result, the uterine lining thickens too much, increasing the risk for endometrial cancer. 

polycystic ovarian syndrome increases the risk of mental health disorders 5. Anxiety, Depression & poor self perception 

Among those suffering from polycystic ovarian syndrome, there is a very high prevalence of anxiety & depression which negatively contributes to overall wellbeing. 

 

Has your adolescent acne turned into adult acne without an end in sight ? 

Are you tired of waxing those pesky hairs? 

Do you want to optimize your hormones & get your health on track?

Are you trying to get pregnant? 

 

Click here to grab the tools you need to start understanding and mastering your PCOS today 

 

Questions? 

lets Chat, fill out the contact form 

In health,

Dr. Laura, ND

References 

http://www.jogc.com/article/S1701-2163(16)32915-2/pdf

https://www.merckmanuals.com/en-ca/professional/gynecology-and-obstetrics/menstrual-abnormalities/polycystic-ovary-syndrome-pcos

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893212/table/T2/

http://www.cwhn.ca/en/node/44804

https://www.verywell.com/pcos-and-endometrial-cancer-2616643

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341818/