When women come to my office with any one or all of the following complaints from no periods to excessive bleeding, difficulty losing weight, excessive hair growth and acne or infertility, I see this as an important opportunity to change a woman’s life for the better. Many of these women have seen many other health care providers, who more often than not aren’t able to provide a diagnosis or who may not be able to provide a comprehensive plan of care. Many women with PCOS have symptoms that impact their appearance, their self-esteem, sense of shame and guilt as well as fears of infertility.
Using the Rotterdam Criteria for diagnosis provides an objective starting point for evaluating women. A diagnosis of PCOS can be made if 2 out of the following 3 conditions are met: Signs of hyperandrogenism such as hirsuitism, acne, absence of regular ovulation and/or seeing 10 or more small cysts on 1 or both ovaries with an ultrasound.
When considering Polycystic Ovarian Syndrome, I like to explain to my patients that it’s important to think of the cysts in the ovary as only 1 aspect of a complex endocrine disorder that includes insulin resistance, an increased risk of pre-diabetes and diabetes, heavy bleeding, and infertility. With a diagnosis, treatment options can be offered to suppress the male type hormones, known as androgens, correct the insulin resistance and help relieve the irregular bleeding.
All throughout the evaluation and care, it’s also important to address and validate repeatedly that this condition is not the woman’s fault. No woman would ever choose to have increased hair growth, more acne and difficulty losing weight. All of these affect a woman’s self-esteem and many women wonder if they are causing this from their diet or perhaps lack of exercise.
In my talks at the upcoming Skin, Bones, Hearts and Private Parts continuing education meetings, I’ll be speaking about these important considerations and many others that can improve women’s quality of life when they have PCOS.
