pcos - the hidden condition you may not know you have

September has been designated as PCOS (Polycystic Ovarian Syndrome) Awareness month and I want to share with my readers some important information about this condition that afflicts only women. ​

In this article I am only going to touch of some of the more topical aspects in an effort to bring awareness, but know that it is very complex and has long-reaching implications.  It is a condition that affects millions of women around the world and the incidence is growing.

What PCOS Is
It is a highly complex condition involving metabolic, hypothalamic, pituitary, ovarian and adrenal hormonal interactions that result in significant health issues.

Here are some of the signs and symptoms

• Acne (particularly the cystic form) and skin tags
• Excessive hair growth on the face, arms, back, chest, thumbs, toes, and abdomen
• Absence of menstrual period or irregular periods
• Rapid weight gain and weight loss resistance (although you can be thin and have PCOS) with fat depositing mainly in the mid-section. Think of an apple-shaped figure
• Multiple cysts on the ovaries
• Depression
• Infertility
• Fatigue
• Hair loss or thinning hair on the head
• Pelvic pain
• Headaches
• Sleep problems
• Dark velvety discoloration on neck, underarms, body folds and creases (Acanthosis Nigricans)

The diagnostic criteria has changed over time, but is currently based on the Rotterdam Criteria which is requires the presence of two of the following: absent or irregular menstrual cycle (oligo / anovulation)) , high male trait hormones (hyperandrogenism) or many cysts on one or both ovaries (polycystic ovaries).

Despite the name “polycystic” it is possible to have no evidence of multiple cysts, but the presence of the other two conditions already mentioned need to be diagnosed.

Some important Statistics

• PCOS is a condition that affects about 10 percent of reproductive aged women, that means 1 out of 10 women have it
• Less than 50 percent of women who have it are not properly diagnosed, thus millions of women are left at risk for developing other conditions related to it.
• 20 percent of women with PCOS are not overweight & may be overlooked for PCOS because of not fitting the “weight” component
• More than 50 percent of women with PCOS will have pre-diabetes or Type 2 diabetes before age 40.
• Women with PCOS have four to seven times higher risk of heart attack.
• Women with PCOS are three times more likely to develop endometrial cancer.

Typically Insulin levels will be high, even when fasting.  Androgen hormone levels of DHEA and Testosterone are elevated, estrogen and progesterone levels are present at lower levels and overall there is an imbalance of sex hormones and insulin, a fat storage hormone.
Experts have not yet discovered the cause, but there may be both genetic and environmental factors at play.  Not all women who have this condition experience the same symptoms and it is believed that because it can be challenging to diagnose, there may be many women who go undiagnosed.
It is a condition that can be managed through diet, certain supplements, medication, hormonal contraception, lifestyle practices and combinations of these, but it cannot be cured.
How it affect Womens Health
Having PCOS is a serious thing as it is implicated in a number of chronic health conditions like: Insulin Resistance and Pre-diabetes, Type 2 Diabetes, Heart Disease, Mood disorders and Mental Health Conditions, and Cancer of the Uterine Lining.

That you can do

If you or a woman in your life have any of the signs and symptoms described in this article, do seek out further medical evaluation.  Remember, because it is difficult to diagnose at times, you may have to seek out a specialist.  Do start with your family practitioner, alert them to any of the signs and symptoms noted here that you may be experiencing, especially if you see multiples of these.   
Others that can evaluate you or help include

• A medical endocrinologist, a specialist in hormones and considered to be the specialist for PCOS
• A reproductive endocrinologist who specializes in fertility and hormones
• A gynecologist.
• And always consider working with a Registered Dietitian Nutritionist (RDN) who works with PCOS patients or is expert in metabolic and hormone disorders since nutrition is a powerful intervention in managing PCOS.

​Proper diagnosis, care and  management can help you have a healthy body when living with PCOS.