Polycystic ovarian syndrome, commonly known as PCOS, is a genetic, hormonal disorder that affects females’ ovaries. PCOS is a complex condition to treat, characterized by irregular periods, acne, weight gain, insulin resistance, heightened testosterone levels and ovarian cysts. The exact cause is unknown, but a variety of factors heavily impact its extremities. With a combination of genetics, inflammation, insulin resistance and hormone imbalances, battling this condition is often emotionally taxing, and it is difficult to decrease the severity of symptoms.
Not everyone with a diagnosis has the same symptoms. According to WebMD, PCOS is classified into four types, reflecting its wide range of classifications. Doctors recognize Type A through the identification of high androgens–the male hormones that are present in high levels in women with PCOS, irregular periods and polycystic ovaries. Individuals with Type B PCOS experience hormonal imbalances and menstrual irregularities, but their ovaries do not show multiple small cysts, as seen in other PCOS types. Individuals with Type C have regular periods with high androgen levels and polycystic ovaries. Lastly, Type D has polycystic ovaries and irregular periods while having balanced hormones.
Doctors can diagnose PCOS through blood tests to examine hormone levels or by getting an ultrasound to inspect the ovaries. In addition to physical exams, doctors often follow the Rotterdam criteria to secure a diagnosis. Developed with input from the American Society for Reproductive Medicine and the European Society for Human Reproduction and Embryology, this criteria is more inclusive than the NIH criteria. If an individual meets two out of three criteria, anovulation, a lack of ovulation; hyperandrogenism; and the presence of polycystic ovaries, a diagnosis is in order.
There are different characterizations of the underlying causes of PCOS. Insulin resistance, inflammation, adrenal and post-pill PCOS can help provide valuable insight for individuals with this condition. Insulin resistance impacts the ability to manage blood sugar levels and weight. Managing this condition requires a whole-food diet, which can be challenging to maintain, and consistent exercise that avoids raising cortisol, the stress hormone. High cortisol levels can worsen insulin resistance, creating a vicious cycle, leading to higher insulin levels in the body, which can further intensify PCOS symptoms. Finding balance is difficult, as elevated insulin levels stimulate the ovaries to produce more androgens, worsening symptoms like excessive hair growth, acne and hair loss. While being in separate categories, both PCOS and high cortisol levels can contribute to chronic low-grade inflammation in the body. The stress of maintaining PCOS symptoms by living a demanding lifestyle can further increase cortisol levels. This cycle often promotes inconsistency mentally and physically. Doctors often advise PCOS patients to lose weight, but insulin resistance and high cortisol can contribute to weight gain, particularly around the midsection, and make it harder to lose weight. The combination of hormonal disruptions can also make it more difficult to conceive. Not only do hormone fluctuations impact the inner workings of the body, but they heavily affect mood, leading to increased irritability or mood swings. PCOS is not a cover-all diagnosis. The combination of these factors may increase the risk of developing other health issues, such as type 2 diabetes and cardiovascular problems.
Despite their name, polycystic cysts are not actually cysts but rather small follicles on the ovaries. These follicles are fluid-filled sacs that contain immature eggs and are typically 2-8 mm. in size. While being small, their function is crucial. They help to release an egg during ovulation, but in cases where an individual has PCOS, they are often unable to release this egg, leading to irregular or absent ovulation. If the egg does not release from the ovary, a condition called anovulation occurs. This failure to ovulate has several consequences: Follicle accumulation leading to the polycystic appearance of follicles, irregular or absent periods or infertility. Most women do not feel the presence of ovarian cysts, as they often do not cause any symptoms. However, some women may experience discomfort or pain if the cysts grow large or if complications occur. If symptoms do occur, many experience pelvic pain or pressure, which can range from a dull ache to sharp pain, bloating, or swelling in the abdomen, or changes in bowel movements or standard urination patterns. Complications can include sudden, severe pain in the lower abdomen or back if a cyst ruptures. If there is an ovarian torsion, the ovary and sometimes the fallopian tube twist on the tissues that support them, causing extreme pain and nausea. In sporadic cases, the cyst will grow very large, which can leave women with a feeling of uncomfortable pressure and fullness in the areas surrounding the uterus.
Treatment approaches for PCOS are often individualized, as the condition appears different in each person. Women typically choose between three main paths: pursuing natural remedies, lifestyle changes or medical interventions. Hormonal birth control is often an effective method in the regulation of androgen levels. In addition to hormonal birth control, a carefully selected range of supplements can significantly aid in managing PCOS symptoms. Key supplements such as inositol, magnesium, vitamin D, zinc, N-acetylcysteine (NAC), omega-3 fatty acids and B-complex vitamins show remarkable success in managing various aspects of the condition. These supplements work synergistically to help maintain blood sugar levels, improve glucose metabolism, support fertility and reduce inflammation. These supplements offer comprehensive support in managing PCOS symptoms. Discuss symptoms with a doctor to determine if hormonal birth control and/or these supplements would be safe and beneficial for your individualized condition.
While PCOS presents significant challenges, with proper management and support, many women with the condition lead healthy, fulfilling lives. By working closely with healthcare professionals and adopting specific lifestyle changes, individuals with PCOS can effectively manage their symptoms and reduce their risk of long-term health complications. Each person’s experience with PCOS is unique, and finding the right combination of treatments and lifestyle modifications is key to successful management.
