Polycystic ovarian syndrome (PCOS) impacts an estimated one in 10 women worldwide. This common endocrine disorder can lead to a constellation of symptoms that can come and go throughout a woman’s reproductive years.
“Managing the symptoms of PCOS is a journey, not a sprint,” says Christopher Simons, DO, Obstetrician and Gynecologist at Atlantic Health. “It can take time to understand what treatments are most effective for you. Working with your OB/GYN will help you find the answers you need to improve your condition.”
What is PCOS?
Polycystic ovarian syndrome is a metabolic condition that can cause irregular periods, signs of hirsutism (acne, irregular facial hair and hair loss), infertility and metabolic dysfunction. PCOS can involve multiple systems and causes dysfunction in the feedback loop between your brain and your ovaries. This can result in atypical or irregular hormone patterns, most notably with estrogen and testosterone.
You can develop PCOS at any time throughout your childbearing years, but providers are diagnosing the condition in younger patients more often. PCOS can run in families, but other risk factors include obesity and insulin resistance. While your symptoms can fluctuate over time, Dr. Simons explains that PCOS doesn’t flare up like other conditions, such as autoimmune disorders.
Signs and symptoms of PCOS
Because a hormone imbalance causes the condition, the symptoms of PCOS can differ for each woman. The signs are typically more severe in women with a high body mass index (BMI). For a clinical diagnosis of PCOS, you must have at least two of the following three diagnostic criteria:
- Irregular menstrual cycles. Most women with PCOS have cycles lasting more than 35 days.
- Signs of elevated androgen production, including excess facial or body hair, severe acne or male pattern baldness.
- Signs identified by an exam or ultrasound, such as multiple stimulated ovarian follicles.
Dr. Simons says that many patients will fall on the spectrum of the syndrome and may still benefit from interventions or treatment. In addition to the symptoms outlined above, women with the condition might also have sleep apnea, depression or infertility. PCOS can also increase your risk for cardiovascular disease, high blood pressure and type 2 diabetes.
Treatments for PCOS
Treatment for PCOS targets three things: lifestyle changes, addressing symptoms of excess androgen, and regulating periods and hormones.
“The most effective lifestyle changes include weight loss for women with a higher BMI and a healthy diet focused on high-quality whole food sources,” says Dr. Simons. “Even a five to 10% weight loss can help reduce or reverse your symptoms.”
A diet high in processed foods, sugars and fats can lead to weight gain and worsening of PCOS symptoms. Dr. Simons recommends a Mediterranean-style diet that’s high in lean protein, whole grains, fruits and vegetables to improve your overall health and meet your body’s nutrition needs.
PCOS treatment should help you meet your family planning goals. For some women, difficulty getting pregnant can be the first sign of PCOS. If you are hoping to get pregnant, Dr. Simons says he often prescribes medications that cause ovulation. If you do not want to get pregnant, hormonal birth control is a first-line treatment to regulate both menstrual cycles and hormone production. Medications that address the symptoms of too much androgen, such as acne and excess body hair, are available.
“If you have concerning symptoms, don’t hesitate to reach out to your OB/GYN for an evaluation,” says Dr. Simons. “Treatment for PCOS can be very simple and straightforward. You don’t have to struggle with uncomfortable symptoms.”