September is PCOS awareness month, so there’s never been a better time to learn the basics of Polycystic Ovary Syndrome (PCOS). PCOS is an endocrine disorder and invisible illness that impacts the ovaries, hormones, and menstrual cycle. It’s pretty misunderstood, yet very common (1 in 10 people with a menstrual cycle have PCOS!).
So let’s dive into it — what is PCOS?
PCOS signs and symptoms
There are three main signs that someone has PCOS. These are the symptoms that doctors will look out for:
1. "Cystic" ovaries
Despite the name “polycystic” suggesting multiple ovarian cysts, someone with PCOS may not necessarily have cysts on their ovaries. Rather, they might have immature or undeveloped egg follicles. The ovaries also tend to become unusually large.
2. Excess androgens
With PCOS, the body often overproduces androgens (A.K.A sex hormones such as testosterone). This explains some of the more specific effects that PCOS has on the body, but we’ll go into more detail on this later.
3. Irregular cycles
PCOS can make periods (along with the other stages of the cycle) very painful. A person with PCOS is likely to have an irregular and inconsistent menstrual cycle. Their periods are often late.
What causes PCOS?
Unfortunately, like many other similar conditions, we don’t know exactly what causes Polycystic Ovary Syndrome at this stage. However, there are a few things PCOS has been associated with:
1. Genetics
Studies show that PCOS is genetic and can be passed down through families. It’s worth having a chat with older family members to see if it runs in your genes!
2. Insulin levels
Many, but not all, people with PCOS experience insulin resistance. This can lead to high blood sugar and excess androgens.
3. Inflammation
Some research shows that increased inflammation in the body is related to the androgens and polycystic ovaries that occur with PCOS.
How is PCOS diagnosed?
1. Assessment of symptoms
The first step to getting a PCOS diagnosis generally involves chatting to a doctor or healthcare professional about your symptoms. If they believe your symptoms are consistent with the signs of PCOS (for example, irregular cycles), they’ll do further testing or refer you on to see a specialist.
2. Pelvic examination
A pelvic examination generally involves a healthcare professional such as a physio or gynaecologist using their fingers to assess the pelvic muscles through the vagina. When searching for signs of PCOS, the healthcare worker will try and find growths on the ovaries or uterus.
3. Vaginal or abdominal ultrasound
A key part of the PCOS diagnosis process is the external abdominal or internal vaginal ultrasound (or both). An ultrasound can give great visual insight into the development of the egg follicles and identify abnormalities.
4. Blood tests
Blood tests that are done to investigate PCOS will assess testosterone levels along with Free Androgen Index (FAI). This is how someone would find out if their androgens levels are high.
5. It’s not always diagnosed
Unfortunately, PCOS is underdiagnosed. Some people who suspect they might have PCOS have trouble being taken seriously by doctors if they only present with minor symptoms. Others may not even realise they have PCOS and only find out if they start having irregular menstrual cycles or are trying to get pregnant. This is why it’s important to take any abnormal signs and symptoms seriously and follow through with healthcare professionals.
The effects of PCOS
Polycystic Ovary Syndrome can have the following effects on the body:
1. Irregular periods
Periods are likely to be inconsistent and painful. Cycle length can be longer than average, with some people going weeks waiting for their period to come. Other times, they can come too frequently or last longer than average.
2. Pregnancy trouble
People with irregular cycles can find it very difficult to fall pregnant. An irregular cycle means ovulation may not be happening every month (ovulation is the most fertile stage in the menstrual cycle). Luckily, there are a lot of professionals and resources available dedicated to PCOS and pregnancy.
3. Acne
The excess androgens that occur with PCOS can lead to oily skin and acne. PCOS acne is generally cystic or under the skin, rather than surface-level spots. The acne is not limited to the face, and can be found on the back, chest, and more.
4. Hair growth
The excess androgens are also responsible for extra hair on the face or body, also known as hirsutism. This can be facial hair, arm hair, back hair, or chest hair. PCOS hair loss (on the head) is also a common symptom.
5. Weight changes
The relationship between PCOS and insulin can mean some people with PCOS gain weight. However, it is important to note that this is not always the case, and anyone of any size can be diagnosed with PCOS.
6. Sexual desire
Because of the impact PCOS has on the body’s hormones, the condition can affect sex drive. People with PCOS may report low libido, which makes sense given PCOS is a chronic illness often involving a lot of pain. Sex drive often suffers when health and safety becomes the body’s priority.
7. Depression
PCOS is associated with high rates of depression and anxiety. This can be because of all the things going on in the body with PCOS, or the social and emotional response to the health concerns.
8. Poor sleep
People with PCOS can find it hard to get to sleep at night and experience sleep apnea. They can also experience a lot of fatigue during the day. Unfortunately, this is a bit of a cycle, as poor sleep habits can increase the stress hormone which can exacerbate PCOS symptoms.
PCOS treatment
While Polycystic Ovary Syndrome can’t be cured, there are a few medical and natural methods that can alleviate pain, reduce symptoms, and help manage the condition on a day-to-day basis.
1. Regular exercise
Lifestyle change is always a good thing to consider when dealing with an incurable chronic health issue. Non-strenuous movement, such as yoga or a gentle walk, can temporarily help soothe pain by releasing endorphins. However, please don’t put pressure on yourself or your body if you’re not feeling up to exercise during a PCOS flare up.
2. Diet changes
There is no special PCOS diet. Some people find that increasing their greens, fibre, and anti-inflammatory foods, while decreasing processed foods, can help reduce some symptoms. Simple additions like spearmint tea can be good for reducing hair growth, or cinnamon to improve insulin resistance. Always chat to a doctor, dietician or naturopath before making big diet changes.
3. Supplements
Some people with PCOS try supplements to support their health and menstrual cycle naturally. Supplements such as B12, folate, inositol, omega-3, and chromium are just a few that could be considered, but before adding any supplements to your diet, talk to a doctor, dietician, or naturopath to ensure they are right for you.
4. Medication
Medications like clomiphene and letrozole can help trigger ovulation. This can be helpful for people with PCOS with irregular cycles who are trying to get pregnant. If you wish to trial a medication to manage PCOS symptoms, speak to your doctor.
5. Birth control
For people with irregular periods, birth control can make their cycle feel more consistent. It can also alleviate some menstrual pain and reduce symptoms such as acne and hair growth. However, birth control should not be considered a treatment for PCOS as it can only offer a temporary reduction of some symptoms.
6. TENS machine
A TENS device can make life with PCOS a little easier by alleviating some of the pain. Try our pain relief device, Aura for a compact, cordless, everyday option. Learn more about TENS machines by reading our 5 reasons to invest in a TENS device.
When to see a doctor
See a doctor if your periods are irregular or painful, you’re having trouble getting pregnant, or you’re regularly experiencing any of the signs and symptoms mentioned in this article.
Everyone has the right to seek medical advice for the slightest discomfort in their body. Even if you only have one of these PCOS symptoms, or you’ve managed your symptoms just fine in the past, consider talking to your doctor. You know your body better than anyone, and you deserve to live a pain-free life with fewers signs of PCOS.
And remember, there are a wide range of healthcare professionals that can help with Polycystic Ovary Syndrome — GPs, gynaecologists, endocrinologists, sexual health nurses, pelvic health physiotherapists, dieticians, and naturopaths (just to name a few).
Read more from VUSH Wellness:
To read about another common silent illness, learn how to relieve endometriosis pain. Here’s how to support a loved one with a silent illness.
For more on the menstrual cycle, read about the four phases of the cycle, what causes period pain, and our guide to surviving your period.
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