Some of us may be familiar with polycystic ovary syndrome, or PCOS, the hormonal disorder that occurs when women’s bodies produce too much testosterone.
FemmePharma sat down with professor of medicine Dr. Katherine Sherif of Thomas Jefferson University to discuss how diseases such as PCOS represent a paradigm of women’s health in the changes in sex hormones that ultimately affect the whole body.
What are the common signs and symptoms of PCOS?
There are three common signs of PCOS:
The most common sign or symptom of PCOS are irregular periods – meaning they don’t come every 28 to 32 days like in a regular menstrual cycle. This includes shorter or longer periods, or even periods skipped altogether.
High testosterone levels
Another common sign of PCOS is high androgen – or testosterone – levels in women. These high levels of testosterone can cause alopecia, or hair loss; hirsutism, or growing hair in unusual places; and/or cystic acne.
In the case of hirsutism, women may develop hair growth in the form of facial hair or coarse chest hair, for example.
The final common sign or symptom of PCOS is excessive weight gain, typically indicated by a body mass index (BMI) of 25 or greater.
What causes PCOS?
Doctors are unsure what causes PCOS. However, proteins responsible for PCOS may help identify some of the genes responsible for the disease.
Another speculation on the cause is the intestinal microbiome theory. This theory postulates that women who don’t have diverse bacteria in their guts – a state known as dysbiosis – can cause inflammation, which leads to insulin resistance. This increased insulin, a growth hormone, can then lead to weight gain and an increased production in testosterone from the ovaries.
How do androgens impact ovaries?
Typically, our ovaries make a small amount of testosterone, but in the presence of insulin, the ovaries manufacture much more. When the ovarian follicles sense the presence of testosterone in the ovary, they stop maturing and develop into small fluid-filled sacs that appear as cysts.
This lack of mature ovarian follicles leads to fewer developed ovaries to release during ovulation, which may lead to infertility.
Irregular periods, birth control pills, and PCOS
Having an irregular menstrual cycle is an important symptom of PCOS that shouldn’t be discounted.
Women who begin taking birth control pills as teens (often to regulate their periods) often inadvertently mask symptoms of PCOS for years. This is due to the high levels of estrogen in the pill that suppress the production of testosterone in the ovaries.
Then, when these women stop taking birth control pills as an adult, their periods become irregular again and they may assume (or be told incorrectly) that it’s just their body trying to re-regulate itself.
So, if you’re a young woman with irregular periods, it may be worth getting checked out to determine a potential underlying cause before (or in addition to) using birth control pills as a form of cycle regulation.
What are the health risks of PCOS?
When left untreated, PCOS can develop into a metabolic issue that affects the whole body. “Women with PCOS are the canaries in the coal mine – they start to age faster,” says Dr. Sherif.
Women with PCOS may develop type 2 diabetes, and they are three times as likely to develop gestational diabetes. They also have a higher risk of coronary heart disease and fatty liver disease – a condition that, until recently, was rare among those not suffering with alcoholism.
How can women manage PCOS?
Though there is no cure, Dr. Sherif lists several recommendations for effectively managing it.
Modify your diet
Decrease your dependence on insulin. Instead, make yourself insulin-sensitive by reducing the amount of carbs you eat, as carbs lead to increased glucose levels. It may also help to consult a dietician who’s knowledgeable about PCOS to help you create a diet plan.
We all know that exercise is good for the body. And for those with PCOS, exercise in the form of resistance training is even better!
A regular regimen of resistance training may help combat insulin resistance due to the production of inositol, a bodily sugar.
Get enough sleep
It’s well documented that sleep deprivation causes extreme insulin resistance. Getting adequate rest is important to manage PCOS and its symptoms. If you find yourself struggling to fall asleep and stay asleep, you might want to explore a sleep supplement. Natural sleep supplements are an excellent alternative to prescription sleeping aids.
Certain supplements, such as Vitamin D, Omega-3 acids, inositol, and the antioxidant N-acetylcysteine may also help manage PCOS.
Ask about medications
Consult with your doctor about medications that may help treat your PCOS symptoms.
Does PCOS continue in perimenopause/menopause?
If not managed and treated, PCOS can continue into menopause in the form of the metabolic symptoms that affect the entire body, which can include symptoms like vaginal dryness.
It’s important to catch and diagnose PCOS early to avoid it accompanying you along each stage of life.
For a deeper dive into the content of this article, check out the podcast episode.