Polycystic Ovary Syndrome or PCOS, as it’s commonly known, is a hormonal imbalance that affects up to 10 percent of women in their reproductive years.
According to The American College of Obstetricians and Gynecologists, PCOS is one of the most common causes of female infertility, yet awareness for this hormonal condition is only recently on the rise.
Lori Ham of Wallis said when she was diagnosed two years ago at the age of 40, she had never heard of PCOS, but she recognizes common PCOS symptoms when she remembers the severe menstrual period and painful cramping which kept her at home for days at a time as a teenager and young adult.
“Women’s health is often put on the back burner. When I had these symptoms as a teenager and young adult, we treated the symptoms with birth control, but I never knew it was something more serious,” Ham said.
According to Bellville Medical Center’s Dr. Shannon Juno, Board Certified in Obstetrics and Gynecology, a common first symptom of PCOS is frequently missed periods. PCOS is often present from the start of a women’s menstrual cycle in puberty but can also develop later in life in patients with substantial weight gain, according to MayoClinic.com.
PCOS affects all areas of the body, not simply the reproductive system and the list of symptoms are as varied as are the unique stories of the women behind the diagnosis.
When Anne* first heard she suffered from PCOS, she was 20 years old. In the same conversation, her doctor told her the devastating news that she would most likely never be able to get pregnant. PCOS causes infertility by producing elevated levels of the male hormone androgen, which prevents ovulation or the releasing of an egg by the ovaries each month. Androgen also causes excess facial and body hair, severe acne and thinning hair, which are common symptoms of PCOS.
Lori’s diagnosis was both uncommon and unexpected because she had a hysterectomy years before, which removed her cervix, uterus, fallopian tubes, but left her ovaries. At the time of her diagnosis, she was overdue for an annual gynecological exam and in an ultrasound discovered numerous cysts on her ovaries. Lori was diagnosed with PCOS right away. In researching it she learned that her thinning hair, low sex drive, acne, sleeplessness and even depression could all be traced back to PCOS.
“I think talking about things such as low sex drive or pain during sex is important. It’s not fun, but it’s important to talk about all of it because it takes away the stigma and improves women’s health,” Lori said.
Anne says she experienced irregular periods, but nothing too alarming. In fact, she went to the doctor because she and her husband were planning a family. Instead, she found out that she wasn’t ovulating.
As Anne said, tell her she can’t do something and she’s surely going to find a way to do it. That’s how she approached infertility. She took clomid, an ovulation-stimulating drug, before her first pregnancy and even though she was told during one cycle that she hadn’t produced any mature follicles and would not produce an egg that month, she did get pregnant. Years later through IUI (Intrauterine Insemination) she was able to conceive and carry another healthy baby.
“I feel very blessed. Yes, I have PCOS, but I have two healthy children. I don’t have a lot of the symptoms that a lot of other people have,” Anne said.
Dr. Juno says that PCOS has been diagnosed for years but is seeing a rise in cases because of an increase in awareness and while not all cases are caused by weight gain, an increase in obesity in the United States has also led to more diagnoses. The exact cause of PCOS is unknown, though genetics, excess insulin, low-grade inflammation and elevated levels of the male hormone androgen may play a role.
As the name states, polycystic ovaries are often a common symptom. Cysts form when numerous small fluid-filled sacs develop on the ovaries. This prevents ovaries from functioning regularly and releasing eggs. The cysts can also be extremely painful.
Every other year, Anne says she experiences painful cysts and visits the doctor for a checkup, but she has not had any additional complications because of the cysts. Lori also has cysts but hasn’t experienced the intense pain some women feel.
In addition to the immediate signs and symptoms, PCOS can increase the risk of serious, long-term health issues such as type 2 diabetes, cardiovascular disease, metabolic syndrome, endometrial hyperplasia and even endometrial cancer or cancer of the uterine lining.
There is no cure for PCOS, but treatment can ease some of the symptoms and long-term effects. Women who do not want to become pregnant are often prescribed combined birth control containing both estrogen and progestin. It regulates the menstrual cycle, decreases androgen levels and reduces the risk of endometrial cancer.
Metformin is also given to women with PCOS to treat insulin resistance, a condition where the body’s cells do not respond to the effects of insulin. This causes the level of glucose in the blood to rise, which in turn triggers the body to produce more insulin to move the glucose into the cells. This leads to weight gain and diabetes.
“I can run and exercise all day and lose one pound. I can lose that little just laughing,” Lori said about the difficulty of losing weight with PCOS.
Anne says that metformin and birth control help her manage PCOS. Lori’s doctor prescribed metformin and has discussed surgery to remove her ovaries and hormone therapy as options when the symptoms become painful or interfere with her life.
Because the symptoms of PCOS can change over time, both women also get regular check-ups and keep in communication with their doctors to manage PCOS.
PCOS is a serious condition but can be treated. If you would like more information, please visit WebMD.com or MayoClinic.com
*In an effort to maintain Anne’s privacy, we used an assumed name and not her real name throughout this article.