Do you struggle with irregular periods? If so, you might be one of the 5 to 10% of women impacted by polycystic ovarian syndrome (PCOS). PCOS is a hormonal disorder caused by elevated levels of male hormones, which can lead to irregular periods and a lack of ovulation. If ignored, PCOS can have a lasting impact on a woman’s health and fertility.
Unfortunately, many women struggle with PCOS for years (and in some cases, decades), before they seek treatment. CCRM Fertility, a global pioneer in fertility science, research and treatment, has compiled a list of the top five things every woman and young girl should know about PCOS to ensure she gets the support and care needed to keep her PCOS in check:
1. PCOS is commonly misdiagnosed or goes undiagnosed.
The most common sign of PCOS is irregular periods. It’s also one of the earliest signs, making it difficult to recognize in teenage girls who are still experiencing unpredictable menstrual cycles. Other signs include acne and weight gain, neither of which are uncommon in young women. One study found nearly 70% of women with PCOS hadn’t been diagnosed.
“Oftentimes I hear from women who tell me they asked their doctor about irregular periods and their doctor was not concerned,” said Dr. Stephanie Dahl, a board certified reproductive endocrinologist at CCRM Fertility. “The truth is, if you’re having irregular periods and there is not another underlying hormonal issue, like pregnancy, breastfeeding or being on birth control, there is cause for concern.”
Unfortunately, there is no single test to diagnose PCOS. Rather, doctors use The Rotterdam Criteria to determine if a woman has PCOS. Two of the three symptoms must be present to meet the criteria: irregular menstrual cycles or the complete absence of cycles, hyperandrogenism, which is characterized by acne or excessive hair growth on the face, chest and back or high androgen levels in the blood, and finally, the ultrasound appearance of the ovaries, specifically multiple small cysts on the ovaries.
2. Women with PCOS can get pregnant naturally.
Because women with PCOS frequently have difficulty ovulating, PCOS is often associated with infertility. However, not everyone who has PCOS has fertility issues. For women with PCOS who are struggling to get pregnant, oftentimes weight loss is enough to help regulate menstrual cycles.
“Women with PCOS who lose 5 to 7% of their body weight can develop regular menstrual cycles, and their chance of getting pregnant on their own, without the assistance of fertility treatment, doubles,” comments Dahl.
3. PCOS is not curable, but its symptoms can be managed.
Normally, the brain sends hormones to the ovary each month, which signals the egg to grow. When the egg has matured, it is released into the fallopian tube — a process known as ovulation. “In women with PCOS, the brain is sending these messages, but the ovaries are not listening so well because high insulin and testosterone levels are making too much background noise,” explained Dahl. For many women, weight loss through improved diet and exercise can help to improve insulin levels, alleviating the symptoms associated with PCOS.
For women with insulin resistance as a result of PCOS, doctors may prescribe a medication like Metformin, which is more commonly used to treat type 2 diabetes, to bring insulin levels down. Birth control may also be prescribed to decrease testosterone levels and regulate the menstrual cycle. For women who are trying to get pregnant, fertility experts find alternative medications, such as Clomid or Femara, work to help women ovulate.
4. Not all women with PCOS are overweight.
While it is more common for women with PCOS to be overweight or obese (a body mass index greater than 30), women who are lean or of healthy weight can also have PCOS. This is referred to as “lean PCOS.” These women are still faced with high androgen levels and the resulting symptoms, such as irregular periods, acne, unwanted hair growth and fertility issues. Maintaining the right diet and exercise can reduce the symptoms of women with lean PCOS.
5. Ignoring PCOS can lead to long-term health issues.
Younger women may tend to disregard gynecological issues. However, PCOS can have long-term health and fertility implications, so it’s important to seek medical help if you notice something is wrong. Anytime the uterine lining is not shedding normally through menstruation, it becomes abnormal and can cause problems like endometria hyperplasia, which can lead to uterine cancer. Women with PCOS have a higher risk of developing diabetes and high blood pressure. PCOS is associated with sleep apnea, which can lead to additional health problems. It’s also worth noting women with PCOS often experience higher levels of depression and anxiety.
The bottom line: If you’re having an irregular period, make sure you see someone who takes it seriously. “Beyond PCOS, you’ll want to rule out other hormonal problems as a cause of the symptoms,” adds Dahl. “Anyone worried about this should be evaluated by a doctor. The sooner you can get a correct diagnosis, the better.”
If you think you might have PCOS or if you’ve been diagnosed with PCOS and are struggling to conceive, it’s important to speak with a fertility specialist.