What is PCOS?

Learn more about Polycystic Ovary Syndrome

So what is Polycystic Ovary Syndrome?

Polycystic ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a hormone-related condition caused by an imbalance of reproductive hormones that affects millions of women, most without their knowledge. Whereby normal ovaries make the egg that is released each month as part of a healthy menstrual cycle; but with PCOS, the egg may not develop as it should or it may not be released during ovulation as it should be.

 

Estimates suggest that between 5 and 10 percent of the female reproductive population may have PCOS, being most prevalent in women under the age of 50. Shockingly, nearly 70% of cases are presumed to be undiagnosed, especially amongst younger women, as infertility is the primary clue that leads to most diagnoses. Although infertility is commonly the result of PCOS, if left untreated, PCOS may lead to more far-reaching health concerns, such as diabetes, heart disease, and endometrial cancer.

Polycystic ovary syndrome (PCOS):

  • affects millions of women and AFAB individuals worldwide

  • runs in families

  • is one of the leading causes of fertility problems in women

  • if not properly managed, can lead to additional health problems in later life

  • can have an impact on appearance and self-esteem

What causes PCOS?

The exact cause of PCOS is still unknown, but there do seem to be connections with family history and genetics, lifestyle or environment, and increased levels of two hormones in the body: insulin and androgens.

High levels of androgen.

Androgens are known to some as "male hormones," although all women make small amounts of androgens. Women with PCOS have more androgens than normal, which in turn prevents the ovaries from releasing an egg (ovulation) during each menstrual cycle. This results in extra hair growth and acne, two signs of PCOS.

High levels of insulin.

Insulin is a hormone the pancreas produces to help the body convert sugar from foods into energy. Insulin resistance is when your body’s cells stop responding normally to insulin, and instead block the entry of glucose into the cells. As a result, there is instability in your insulin blood levels which become higher than normal. Many women with PCOS have insulin resistance, especially those who are overweight, have unhealthy eating habits, do not get enough physical activity, and have a family history of diabetes. Over time, insulin resistance can lead to type 2 diabetes.

PCOS & Hormones

Hormones are chemical messengers secreted directly through the bloodstream, taking them to organs and tissues to control many functions in your body, such as growth, energy, sexual function, reproduction, digestion and temperature. 

 

The name ‘polycystic ovary syndrome’ is rather misleading, suggesting that the problem lies in the ovaries, and that you might have multiple ‘cysts’ on your ovaries. However, a woman can have PCOS with or without ovarian cysts and, even if she does have ovarian cysts, it does not necessarily mean that she has PCOS. These cysts associated with PCOS are actually eggs that do not get released from the ovary because of abnormal hormone levels. 

 

Thus, the cause of PCOS is typically hormone-related. A woman with PCOS means her body has an imbalance of two hormones, insulin and androgens. Higher than normal levels of these hormones are responsible for the symptoms and signs of PCOS. It is thought that increased levels of insulin in the body cause the ovaries to work differently, which then produce excessive levels of androgens which in turn cause many of the symptoms of PCOS. Controlled hormone levels can lead to symptom improvement and normal functioning of the ovaries.

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PCOS Symptoms

For many women, PCOS is a life-long disease. Symptoms usually manifest during late teens or early 20s, persisting through the reproductive years and into menopause. However, as with all other conditions, all women are different and will have different degrees of symptoms ranging from mild to severe. 

 

The most common indicators of PCOS and other androgen disorders generally fall into one of three categories: changes in appearance, menstrual abnormalities, and metabolic or systemic disorders:

1.

Changes in appearance
include:
  • Acne on the face, chest, and upper back

  • Darkening of skin, particularly along neck creases, in the groin, and underneath breasts

  • Hirsutism or excessive hair on the face, chest, abdomen, or other parts of the body

  • Alopecia or hair loss 

  • Unexplained weight gain or fluid retention

2.

Menstrual abnormalities
include:
  • Severe menstrual pain

  • Amenorrhea or absence of menstruation

  • Irregular menstrual cycles

3.

Metabolic or systemic disorders linked with PCOS include:
  • Infertility or reduced fertility

  • Diabetes or insulin resistance

  • Obesity

  • Hypertension

  • Heart disease

  • Hyperlipidemia 

  • Endometrial cancer

  • Ovarian cancer

  • Breast cancer

PCOS Types

To manage PCOS, it is imperative to know the root cause. This is done through determining the type of PCOS you have. There are four types of PCOS including insulin-resistant PCOS, inflammatory PCOS, pill-induced PCOS, and adrenal PCOS.

1. Insulin-Resistant PCOS

This is the most common type of PCOS and is the result of high levels of insulin in the body – it is often also referred to as metabolic syndrome or pre-diabetes. Insulin resistance is what happens when the cells in your muscles, fat and liver stop responding well to insulin, thus increasing blood sugar levels and forcing your pancreas to pump out even more insulin. High levels of insulin prevents ovulation and activates the ovaries to produce more androgens. Insulin resistance is thought to be caused by the intake of excess sugar, smoking, environmental toxins, and eating trans-fats.

3. Inflammatory PCOS

Inflammatory PCOS is when chronic inflammation harms normal body functions including ovulation and results in elevated androgens. This can cause visible body changes and irregular periods. Someone with inflammatory PCOS tends to have symptoms such as extreme fatigue, infections, skin issues like eczema or psoriasis, joint pain, bowel difficulties, or chronic headaches.