Polycystic Ovary Syndrome (PCOS): What it is and how it can be treated

According to the CDC, PCOS is a condition affecting 6% to 12% of women in the U.S. in their reproductive years, and is one of the most common reasons for infertility in women. ¹ That means that 1 in every 10 women have PCOS, which is a condition that includes hormonal imbalances as well as metabolism problems.

            The name Polycystic Ovary Syndrome comes from the many small cysts (fluid-filled sacs) that form, what looks like a chain, in the ovaries. As the ovaries are the organs that produce and release the egg each month as part of a menstrual cycle one of the symptoms of this condition are irregular or missed menstrual periods. Additionally, women with PCOS have higher levels of androgens (male sex-hormones) than normally found in women, which can lead to various symptoms.

What are the symptoms of PCOS?

Many women do not know they have PCOS until they actually try to get pregnant.

Plus, the symptoms are so diverse that many see different health care professionals like dermatologists, gynecologist, family medicine doctors, or a dietitian before getting the diagnose that links all these symptoms together.

Some of these symptoms are: ^2,3

• Irregular menstrual cycle (often times women with PCOS have missing periods or fewer than 8 in a year)
• Excess body hair, including the chest, stomach, back, and face
• Weight gain (especially around the belly)
• Acne on the face, chest and upper back
• Thinning scalp hair
• Infertility
• Enlarged ovaries with many cysts

How is PCOS diagnosed?

To diagnose PCOS doctors typically check if two of the following three symptoms are present:¹

• High levels of male hormones
• Irregular periods or no periods
• Multiple cysts on the ovaries

To determine these three symptoms doctors perform:

• A medical history
• A physical exam
• A pelvic exam
• A pelvic ultrasound, to check your ovaries for cysts
• And a blood test to check the hormone levels

What are the risks of having PCOS?

Studies show that PCOS is linked to several other health problems, including:^1,2,3,4

• Diabetes – women with PCOS are often insulin resistant, which means that their bodies are still producing insulin, but that it cannot be used effectively, which is one of the main characteristics of Diabetes Mellitus Type 2
• Gestational diabetes – diabetes during pregnancy
• Increased risk for heart disease
• High blood pressure
• High cholesterol
• Increased risk for strokes
• Sleep apnea – difficulties breathing regularly during sleep
• Depression and anxiety – the reason for that linkage is still unknown
• Endometrial cancer – the lack of regular periods can lead to an accumulation of endometrium (inner lining of the uterus), which can develop to cancer

How can it be treated?

While there is no cure for PCOS it is possible to manage the symptoms. The good news is that it is treatable and that many women are able to get pregnant after sticking to a treatment plan with their doctor and dietitian.

The most important step for treating PCOS is achieving a healthy weight. Most women with PCOS are overweight or obese and a decrease in 5-10% of body weight can already help to improve the symptoms and getting a more regular period. Exercising regularly and lowering blood sugar levels through a balanced diet, ideally accompanied by a registered dietitian, has also shown to be essential in order to prevent the progression of insulin resistance. ⁵

Medical treatments include birth control pills, and diabetes medication like Metformin, which may be necessary if the lifestyle modifications did not bring sufficient results.

Conclusion

PCOS is a very common condition that rattle women’s menstrual cycle and can lead to infertility. Additionally, symptoms like weight gain, and male pattern hair growth can occur due to elevated male hormones. While it is a chronic condition that cannot be cured, lifestyle interventions like an adapted diet, exercise and weight loss can help to improve the symptoms and help getting a regular menstrual cycle back.

Resources:

1.         CDC. PCOS (Polycystic Ovary Syndrome) and Diabetes. Centers for Disease Control and Prevention. Published March 24, 2020. Accessed March 1, 2021. https://www.cdc.gov/diabetes/basics/pcos.html

2.         Polycystic ovary syndrome. womenshealth.gov. Published November 29, 2016. Accessed March 1, 2021. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

3.         Polycystic Ovary Syndrome (PCOS). Accessed March 1, 2021. https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos

4.         Polycystic ovary syndrome (PCOS) – Symptoms and causes. Mayo Clinic. Accessed March 1, 2021. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439

5.         Barr S, Reeves S, Sharp K, Jeanes YM. An Isocaloric Low Glycemic Index Diet Improves Insulin Sensitivity in Women with Polycystic Ovary Syndrome. Journal of the Academy of Nutrition and Dietetics. 2013;113(11):1523-1531. doi:10.1016/j.jand.2013.06.347

Written by:   Veronika Monteiro Kisslinger, Dietetic Intern, Hunter College

Reviewed by: Nazirber Maduro, RDN, CDN, CDCES