Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) | Dr. Ali Ghahary

Polycystic Ovary Syndrome (PCOS) – sometimes referred to as Polycystic Ovarian Disease and Polycystic Ovarian Syndrome – is a hormonal condition that affects anywhere from 6 to 10 percent of Canadian women, and is due to an imbalance of reproductive hormones. This condition can also lead to the development of cysts in the ovaries, in addition to infertility. While PCOS can occur in women between the ages of 15 and 44, most do not find out they have it until they are in their early 20s or 30s; particularly if they are having trouble getting pregnant.

While experts aren’t entirely sure what causes PCOS, the risk of having it increases with genetics (i.e. if there is a family history of the disease, such as your mother, sister or aunt), as well as if you are obese. Another potential risk factor associated with PCOS is having high levels of insulin. It’s not uncommon for women with PCOS to develop a resistance to insulin, as insulin production tends to increase as a result of PCOS, which can then lead to type II diabetes. In addition, high levels of androgens can also be a contributing factor. While androgens are known as the male hormone, women also make a small amount. However, women with PCOS tend to have higher than normal androgen levels which can prevent ovulation, as well as cause things like acne and extra hair growth, which are also two common symptoms associated with PCOS.

Commonly, women with PCOS may have fewer periods (less than 8 per year), or may miss their periods all together. Alternatively, their periods may also occur more frequently and there may be excessive bleeding involved. Other symptoms include hair loss, weight gain and/or difficulty losing weight, darkening of the skin in areas such as the groin, under the breasts, as well as on the neck, skin tags, and even issues with mental health such as depression and anxiety. Given its name, cysts are also common with PCOS. These cysts can cause abdominal pain; however, pain does not tend to be a common symptom of PCOS directly. If you do happen to have pain and PCOS, then that pain may be the result of something else entirely and should be addressed with your family physician as well as brought up to your OBGYN for further investigation.

In order to diagnose PCOS, your physician will ask questions about your medical history in addition to your family’s medical history, as well as ask questions about your menstrual cycle. They will also look for any of the aforementioned physical symptoms (i.e. hair growth, acne, darkened skin.) A pelvic or vaginal ultrasound may also be ordered to see if you have any ovarian cysts, as well as if your ovaries have any follicles, in addition to thickening of the endometrium. Blood tests can also be ordered to measure certain hormone levels as well as insulin and gluclose levels. A blood test is a particularly good diagnostic tool as they can help diagnose or rule out PCOS and many other conditions, such as thyroid disease.

Normal ovaries vs. Polycystic ovaries | Dr. Ali Ghahary
Normal ovaries vs. Polycystic ovaries | Dr. Ali Ghahary

There is unfortunately no cure for PCOS, but the symptoms can be managed through various methods including medications and lifestyle changes. Medications that are commonly used to help manage symptoms of PCOS include hormonal birth control (such as the pill, patch, or a shot.) These medications can help regulate your menstrual cycle, can improve acne and reduce hair growth, as well as decrease your risk of developing endometrial cancer. However, it is important to note that if you plan on getting pregnant, then you should discuss this with your health team, as birth control is something you’ll want to avoid. Similarly, anti-androgen medicines are also used to manage certain symptoms of PCOS (including hair loss or facial and body hair growth); however, they are risky to take for individuals who are pregnant. Some medications used to treat type II diabetes can also help women with PCOS. Aside from medication, there are certain changes you can make with your lifestyle. Losing weight is important, and can be done through a combination of exercise and healthy eating habits. Weight loss can not only help regulate your menstrual cycle, but can also increase your chances of getting pregnant and ensuring that your pregnancy is a healthy one. If hair growth is a problem, you can try things like laser hair removal or facial hair removal creams that can be purchased from almost all beauty and cosmetic departments.

As mentioned, PCOS has been known to cause fertility issues, as well as issues with pregnancies. Therefore, if you do plan on getting pregnant, you need to be aware of the risks. Pregnant women with PCOS have a higher risk of developing things like preeclampsia, gestational diabetes, as well as miscarriage. C-sections are also more commonly performed in women with PCOS, and your baby also has a higher chance of spending time in a neonatal intensive care unit. In order to reduce your risk of having a problematic pregnancy, it’s recommended that you try to reach a healthy weight prior to becoming pregnant, in addition to making sure you have healthy blood sugar levels. It’s also recommended that you take folic acid, as this can help prevent against birth defects.

For more information on PCOS, visit the Canadian Women’s Health Network website at CWHN.ca.