It is an American tradition: September is PCOS Awareness Month, a month during which the aim is to increase awareness for polycystic ovarian syndrome (PCOS) and problems associated with the disease.
Polycystic ovarian syndrome, or PCOS, is a condition in which a woman’s hormones are utterly out of balance. This can lead to the occurrence of the eponymous ovarian cysts and can cause problems with a woman’s menstrual cycle, fertility, metabolic function, and appearance.
The problem: even though PCOS affects about 1 in 10 women of childbearing age, experts believe that more than half of women with polycystic ovary syndrome don’t even realize they have it!
To shed some light on this silent disease, here are some of the most common signs of the hormonal disorder. If you’re experiencing any of these symptoms, bring them up with your gynecologist or general practitioner and get them evaluated – remember: knowledge is power!
You’ve skipped a period or two (and know you’re not pregnant):
although some women with PCOS have regular periods, PCOS is associated with high levels of androgens and altered LH/FSH ratio, disrupting the monthly cycle of ovulation and menstruation. Elevated insulin levels due to insulin resistance are present in about 40 % of patients too, further contributing to hormonal dysbalance. If you have PCOS, your periods may thus be irregular or stop altogether. An “irregular” period is defined as either eight or less menstrual cycles per year, or menstrual cycles longer than 35 days. Some women with PCOS also experience heavier or lighter bleeding during their menstrual cycle.
You gain weight and don’t know why:
about half of women with PCOS will have weight gain and obesity that is difficult to manage.
Can hardly make it past mid-morning?
Many women with PCOS report increased fatigue and low energy. Related issues such as poor sleep may contribute to this feeling.
Hair grows in unwanted places:
areas affected by excess hair growth (also known as hirsutism) may include the face, arms, back, chest, thumbs, toes, and abdomen. Hirsutism related to PCOS is due to hormonal changes in androgens.
… but disappears in others:
thinning hair on the head may be related to PCOS and may increase in middle age.
Pregnancy test is negative again:
PCOS is a leading cause of female infertility. Medical assistance may be required for conception. But don’t panic: very often small measures produce big results!
You have been breaking out like you’re a teenager again:
hormonal changes related to androgens can lead to skin issues. Acne, skin tags, and darkened patches are common signs.
Not feeling like yourself?
Having PCOS can increase the likelihood of mood swings, depression, and anxiety.
You need more pain killers than others:
hormonal changes may prompt headaches and pelvic pain.
Counting sheep just won’t do the trick:
women with PCOS often report problems such as insomnia or poor sleep. There are many factors that can affect sleep, but PCOS has been linked to a sleep disorder called sleep apnea. With sleep apnea, a person will stop breathing for short periods of time during sleep. Ask your partner: he/she will usually know much better than you yourself.
Do some of these signs and symptoms apply to you? Why not see your doctor about it and find out what it is all about. For diagnosis, your doctor will ask you some questions, make a blood test and an ultrasound scan of your ovaries. To actually be diagnosed with PCOS, usually the so-called Rotterdam criteria are applied, which require the presence of two of the following three criteria:
• hyperandrogenism, detected by clinical signs such as hirsutism or by biochemical results (raised FAI or free testosterone)
• polycystic ovaries on ultrasound
Other aetiologies must be excluded such as congenital adrenal hyperplasia, androgen secreting tumours, Cushing syndrome, thyroid dysfunction and hyperprolactinaemia.