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