6 PCOS Myths – and the Facts
How much do you really know about this damaging condition?
PCOS is a complex hormonal condition that involves multiple organ systems which makes it hard to diagnose and treat but affects 1 in 10 women.
It’s common for women to find out they have PCOS when they have trouble getting pregnant, but it often begins soon after the first menstrual period, as young as age 11 or 12 but can also develop in the 20s or 30s.
There is not a specific lab test that is “positive of negative” for the condition but is related to high androgen levels and insulin resistance.
It can be diagnosed if a woman has two or more of the following symptoms:
* Signs of too much male hormone such as excess dark hair growth on chin, cystic acne or elevated testosterone on blood tests
* Menstrual cycles more than 35 days apart
* Enlarged ovaries on ultrasound
As this is hormone related it is very important to check progesterone levels are sufficient, as a woman can be menstruating regularly but not ovulating and therefore producing no progesterone.
This is the key hormone to help with this condition, and it’s not surprising that there are a lot of misunderstandings about PCOS floating around.
Myth 1 – PCOS is caused by your ovaries
PCOS is caused by a full body hormonal miscommunication – the actual polycystic ovaries are merely a symptom. There are many different metabolic issues going on that contribute to PCOS.
The brain sends the ovary mixed signals causing it to secrete excess male hormones, which affects the delicate fluctuations of female hormone that trigger ovulation. At the same time, fat cells contribute to the problem by resisting insulin, triggering the body to make excess insulin when carbs are eaten.
This insulin increase not only prompts the ovary to produce too much male hormone, but also causes weight gain. The ovaries can’t manage to ovulate because the hormones are all wrong.
Myth 2 – Women with PCOS are infertile
Women with PCOS can have difficulty getting pregnant, but the infertility associated with PCOS is often easy to treat. Women who have PCOS and are overweight can often begin to ovulate regularly with very modest weight loss of even 10% of their body weight.
Medication can also help and often prescribed is clomiphene treatment and of women who conceive on clomiphene, the majority do so within 4 months, so it should not be taken for an extended amount of time.
Myth 3 – PCOS causes pain
During a normal menstrual cycle, the chosen egg of the month begins to grow within a small follicle cyst on the ovary. When ovulation occurs, the egg escapes the cyst and makes a run for the fallopian tube, and its former cyst usually dissolves over time.
In PCOS the ovaries are trying to ovulate but because of the body’s confused hormones, the ovulation cyst gets stuck and is unable to fully develop to the point it can spit out the egg, hence the ovary becomes swollen with underdeveloped cysts.
These cysts cause the ovaries to become enlarged, but the cysts do not usually rupture or cause pain.
Myth 4 – Women with PCOS are overweight
PCOS is often associated with obesity, but not always. At one time, PCOS was defined as having all three symptoms plus obesity, but we now recognize that there are different “types” of PCOS.
You only need two of the three symptoms of PCOS to have the condition. The treatment of PCOS is based on the sub-type and your goal, whether that is trying to conceive, regularising your cycle. or losing weight.
Myth 5 – PCOS patients have very high risk pregnancies
Once pregnant, PCOS patients are at an increased risk of gestational diabetes and high blood pressure, but most go on to have normal pregnancies. They do not have an increased risk of miscarriage as previously thought.
Around 10% of women meet the criteria for PCOS worldwide and our understanding of the condition and treatments has evolved over the last 20 years.
Myth 6 – Medication is the only option
The Pill or IUD is often the first step to help with this condition, or drugs for conditions such as diabetes and insulin resistance relating to treating symptoms such as excessive hair growth, irregular periods and fertility problems.
If overweight, the symptoms and overall risk of developing long-term health problems from PCOS can be greatly improved by losing excess weight so looking at diet and lifestyle factors can be helpful as a weight loss of just 5% can lead to a significant improvement in PCOS.
This condition is also related to low hormone levels and many have certainly found help rebalancing with progesterone. Women with PCOS need higher levels of progesterone to slow the frequency of GnRH pulse secretion, resulting in insufficient plasma follicle-stimulating hormone (FSH) synthesis and persistent plasma luteinizing hormone (LH) stimulation of ovarian androgens.
Unfortunately this is a condition that can often be undetected for some time, as it often starts in the teens/early twenties when its symptoms such as irregular periods or no periods at all, excessive hair growth, weight gain, thinning hair and hair loss from the head and oily skin or acne can all seem ‘just hormonal change’.
If you believe that you, or a young relative, might be affected then this article can also be very helpful.