Most women with PCOS, Poly Cystic Ovarian Syndrome, see a health care provider for a few common reasons.
- They aren’t having periods
- They’ve skipped more than 3 months of periods
- They have been bleeding heavily for more than 1 week
- No matter what they do, they can not lose weight
- They are trying without luck to get pregnant
We used to think that the only issue with PCOS was the multiple cysts within each ovary, which prevented ovulation, normal periods and caused infertility. We now know that PCOS is a complicated endocrine condition with multiple challenges for women.
You can read about the typical menstrual cycle here. (link to The Normal Menstrual Cycle) And, you can read more about how the cycle is different with PCOS (link to Menstrual cycle with PCOS: It’s Different)
This is not an easy thing to wrap your head around. If you’ve just been diagnosed, let me first say that it’s normal to feel completely overwhelmed right now.
PCOS is not your fault. The weight gain and acne are mostly out of your control. It’s not because you had that one extra cookie, or didn’t exercise enough. Don’t despair, there are very simple, safe and effective treatments.
I’ll try to provide you with the same information that I give my patients so that you start to feel more empowered and can take steps to live with the challenge of PCOS. (link to Hormonal Treatments for PCOS)
This is what PCOS looks like with an ultrasound.
Notice that there are many small black circular areas within the ovary. Each of these black circular areas are follicles also known as cysts that are filled with fluid. It’s not unusual to see 11 – 15 of these cysts in each ovary. Each month more cysts begin as others slowly regress.
In an ovary without PCOS, there would be 6 -10 of these and they would be much smaller
Most women do not feel these cysts. They are usually small and rarely burst causing pain.
Poly = Many. There are many cysts within the ovary, hence the name Poly Cystic Ovarian Syndrome
Why this occurs
The ovaries are not producing the hormones estrogen and progesterone in the same patterns that will lead to ovulation and a normal cycle.
The reason for this imbalance is an underlying Insulin Resistance that’s the root cause of PCOS. (Link to blog post on Managing Your Weight with PCOS) The imbalance of hormones leads to higher amounts of androgenic or male type hormones than what is typically produced. All women have DHEA, DHEAS and Testosterone, but women with PCOS have a lot more. These cause oily skin, acne and hair growth.
The imbalance in hormones leads to:
- Irregular or absent menstrual periods from lack of ovulation
- Increased risk for Uterine Cancer
- More acne
- Excessive hair growth
- Difficulty losing weight
- Dark patches of skin on the neck and in the armpits
So to sum up, with PCOS women have an underlying insulin resistance that leads to an imbalance of hormones. They have more androgenic hormones and they don’t have the typical pattern of estrogen and progesterone, so they don’t ovulate regularly, leading to irregular periods.
2 Great resources for women with PCOS