Polycystic ovarian syndrome (PCOS) affects more women than we think. In fact it affects an estimated 400,000 Australian women, which makes it the most common endocrine disorder in reproductive aged women.
Polycystic ovarian syndrome is a misleading name for what is essentially a multi-faceted metabolic condition with a broad range of symptoms. The key symptom of PCOS is the failure to ovulate regularly. Lack of ovulation is why women with PCOS are deficient in the hormones oestradiol and progesterone. It is why they have high testosterone, and why they develop secondary symptoms such as acne, hair loss, and infertility.
What are the signs and symptoms of PCOS?
Common signs are symptoms of PCOS include
- Menstrual irregularities or amenorrhoea (absence of menstrual periods)
- Weight gain
- Infertility. It is a leading cause of female infertility. However, not every woman with PCOS is the same and while some may need fertility treatment, others are able to conceive naturally.
- Excess hair growth (also known as hirsutism). Areas affected may include the face, arms, back, abdomen and chest.
- Thinning hair on the head
- Acne. Hormonal changes and an increase of androgens can lead to acne. Other skin changes may include darkened patches of skin or the development of skin tags.
- Pelvic pain may occur with periods, or may occur when a woman isn’t bleeding.
- Sleep problems such as insomnia or poor sleep.
- Mood changes such as anxiety, depression and poor self-esteem.
- Insulin resistance
How do I get diagnosed for PCOS?
Despite the very deceiving name, women with PCOS may not have ovarian cysts. A lot of women with PCOS don’t have any ovarian cysts.
There is not one special test that can diagnose PCOS, instead it is based on your presenting symptoms and medical history. Your doctor will ask you about your menstrual cycle, weight changes, hair changes, acne and fertility history. They may also ask about your family history. Your doctor will do a physical examination and may order some pathology tests that could include:
- blood sugar (glucose) levels,
- hormonal profile (oestrogens, progesterone, testosterone, DHEA, FSH, LH),
- cholesterol and triglycerides,
- thyroid hormones.
The results from the blood tests combined with your symptom presentation will determine your diagnosis.
What causes PCOS?
The cause of PCOS still remains poorly understood. There is no single triggering factor for PCOS and instead is a result of interactions between genetics and environment
Known risk factors include:
- Family history of PCOS
- Family history of diabetes
- Vaproate use in women (an anticonvulsant medication used in epilepsy and bipolar disorder)
- Low birth weight and a history of early puberty
- Androgen exposure in utero
- Overweight & obesity
Similar to other complex conditions, there is no one quick fix for PCOS. Your doctor may prescribe you certain medications that reduce androgens, or reduce blood glucose (sugar) levels. Unfortunately, many pharmaceutical medications can cause unwanted side effects or act as only a temporary solution.
When diagnosed with PCOS, your doctor may prescribe you:
- The oral contraceptive pill. While the pill can mask the symptoms of PCOS like acne and menstrual irregularities the underlying factors are still there and once you stop taking the pill, PCOS symptoms come back (often more severely than to start with).
- Androcur- known side effects include fatigue, headache, nausea, and decreased libido.
- Spironolactone (Alactone)- used in hirsutism. Known side effects include dizziness, headache, stomach cramps, diarrhoea and vomiting.
- Metformin- known side effects include nausea, diarrhoea, vomiting and abdominal bloating.
- Clomid (Clomiphene)- used in infertility to induce ovulation.
A natural approach is what we recommend for treatment of PCOS as you can achieve safe & effective long-term results. There are many different powerful natural treatment options for PCOS so it is best to seek advice from a naturopath to determine the best diet, herbs & supplements for you. If you would like to read more about diet and supplements for PCOS – click here.