Things No One Tells You About PCOS

You're not alone if you or someone you know has polycystic ovarian syndrome (PCOS). About 10% of women in the U.S. discover they have PCOS during their childbearing years. In fact, it’s one of the most common hormonal conditions among people with ovaries. Many women experience irregular periods and may have trouble getting pregnant, making it one of the leading causes of infertility. Because PCOS involves your hormones, it also affects other areas of your body beyond your reproductive system.

There is currently no cure for PCOS, but options are available to help reduce some of the symptoms and increase your chances of getting pregnant. Let’s take a closer look at PCOS and talk about what you can do to manage your symptoms.

What is PCOS?

PCOS is a health condition that affects certain hormones in your body. No one knows for sure what causes PCOS, but your genetics and too much of a hormone called androgen may play an important role.

PCOS can cause little fluid-filled sacs, or cysts, to form on your ovaries. During ovulation, a follicle in your ovaries releases a mature egg. In some women with PCOS, these follicles become cysts instead, and an egg isn’t released. When you aren’t ovulating regularly, getting pregnant can be difficult. The cysts can also create an imbalance of the androgen hormone. One common misconception is that all women with PCOS have cysts. This isn’t always the case; many women with cysts do not have PCOS.

There are three hormones that are usually affected by PCOS:

Androgen – All women make androgen in their ovaries, but you make too much with PCOS. High levels cause many unwanted side effects like excess hair growth and acne.
Progesterone – PCOS can lower your levels of progesterone which can lead to irregular periods.
Insulin – Your pancreas makes insulin which your body uses to absorb sugar. Many women with PCOS become insulin resistant. This means your body can’t use all the insulin it makes and starts to build up. Too much insulin can then cause higher androgen levels.

Is PCOS an autoimmune disorder?

Technically, PCOS is an endocrine disorder because it affects certain hormones. There’s some debate on whether it’s also an autoimmune disorder. PCOS causes low progesterone, and some studies have found that low progesterone can overstimulate your immune system and produce autoantibodies. PCOS is often found in women with other autoimmune disorders, like lupus or Hashimoto’s disease, but more research is needed to determine if it’s an autoimmune disorder.

What are the first signs of PCOS?

The first signs of PCOS are different from person to person. Some women’s symptoms appear in adolescence when puberty starts, while others may not have any signs until their 20s or 30s. Many may not know they have PCOS until they start trying to get pregnant and have a hard time.

Some of the first signs of PCOS include:

Irregular periods
Moderate to Severe acne
Unwanted hair growth on chin, chest, back
Obesity
Inability to get pregnant
Cysts found in the ovaries

How to diagnose PCOS?

There is no single test that you can take to determine if you have PCOS. It’s considered a diagnosis of exclusion, meaning a healthcare provider will rule out other conditions that look like it.

After ruling out other conditions, you have PCOS if you show at least 2 of the following symptoms:

Irregular periods
Signs of high androgen levels or a lab test confirming it
Cysts on your ovaries

Sometimes, more than one check for PCOS is needed to get the right diagnosis. Genetics plays an important role in determining your risk. If someone close to you, like your mother or sister, has PCOS, you have a higher chance of having it too.

What are the treatments for PCOS?

Unfortunately, there is no cure for PCOS, but a combination of medication and lifestyle changes can manage your symptoms.

Eating healthy, exercising, and losing a little bit of weight can improve PCOS symptoms. Being overweight doesn’t cause PCOS, but it can add to insulin resistance. Lifestyle changes have the biggest impact on balancing your hormones and getting your period back on track.

If you are not trying to get pregnant, birth control pills can balance your hormones and make your periods more regular.

If you are trying to get pregnant, medications help stimulate ovulation.

Some other treatments for PCOS symptoms include:

Metformin for insulin resistance
Laser hair removal
Spironolactone or birth control pills for acne

Can I get pregnant with PCOS?

Yes, you can get pregnant with PCOS even though it’s one of the main causes of infertility. Don’t lose hope when it comes to achieving your pregnancy dreams. Having a baby may be harder to reach, but it’s still attainable.

Women with PCOS don’t have a regular period, which means they’re also not ovulating normally. Medications such as Letrozole or Clomid are available to help stimulate ovulation. Weight loss, even a small amount, can also help with ovulation by balancing your hormones. If other interventions aren’t working for you, you may want to consider IVF as an option.

Don’t wait…

PCOS often goes undiagnosed for many years, so it’s important to pay attention to your body. See your healthcare provider if you have any signs of PCOS, such as irregular periods, acne, or trouble getting pregnant. If left untreated, PCOS puts you at a higher risk for other health conditions like diabetes, high cholesterol, and infertility. Getting checked early and often is important for your health.