All you need to know about PCOS

What Is PCOS?

Polycystic ovary syndrome, or PCOS, is a hormonal condition. In women who have it, it can affect your ability to have a child (fertility). It can also:

• Make your periods stop or become hard to predict
• Cause acne and unwanted hair
• Raise your chances for other health problems, including diabetes and high blood pressure

There are treatments for the symptoms, and if you want to get pregnant, that’s still possible, though you may need to try different methods.

Many women who have PCOS don’t have cysts on their ovaries, so “polycystic” can be misleading. You might have cysts, and you might not.

Hormones and PCOS

With PCOS, your reproductive hormones are out of balance. This can lead to problems with your ovaries, such as not having your period on time, or missing it entirely.

Hormones are substances your body makes to help different processes happen. Some are related to your ability to have a baby, and also affect your menstrual cycle. Those that are involved in PCOS include.

• Androgens: Often called “male” hormones, women have them, too. Those with PCOS tend to have higher levels, which can cause symptoms like hair loss, hair in places you don’t want it (such as on your face), and trouble getting pregnant.
• Insulin: This hormone manages your blood sugar. If you have PCOS, your body might not react to insulin the way that it should.
• Progesterone: With PCOS, your body may not have enough of this hormone. That can make you to miss your periods for a long time, or to have periods that are hard to predict.

Causes

Doctors don’t know all of the reasons why some women get PCOS.

You might be more likely to have PCOS if your sister or mother also has it. It could also be related to problems that make your body produce too much insulin, which can affect your ovaries and their ability to ovulate (release eggs).

What Are the Symptoms of PCOS

If you have things such as oily skin, missed periods, or trouble losing weight, you may think those issues are just a normal part of your life. But those frustrations could actually be signs that you have polycystic ovary (or ovarian) syndrome, also known as PCOS.

The condition has many symptoms, and you may not have all of them. It’s pretty common for it to take women a while — even years — to find out they have this condition.

Things You Might Notice

You might be most bothered by some of the PCOS symptoms that other people can notice. These include:

• Hair growth in unwanted areas. Your doctor may call this “hirsutism” (pronounced HUR-soo-tiz-uhm). You might have unwanted hair growing in places such as on your face or chin, breasts, stomach, or thumbs and toes.
• Hair loss. Women with PCOS might see thinning hair on their head, which could worsen in middle age.
• Weight problems. About half of women with PCOS struggle with weight gain or have a hard time losing weight.
• Acne or oily skin. Because of hormone changes related to PCOS, you might develop pimples and oily skin. (You can have these skin problems without PCOS, of course).
• Problems sleeping, feeling tired all the time. You could have trouble falling asleep. Or you might have a disorder known as sleep apnea. This means that even when you do sleep, you do not feel well-rested after you wake up.
• Headaches. This is because of hormone changes with PCOS.
• Trouble getting pregnant. PCOS is one of the leading causes of infertility.
• Period problems. You could have irregular periods. Or you might not have a period for several months. Or you might have very heavy bleeding during your period.

When to See a Doctor

If you have some, or several, of these symptoms, let your doctor know. There are treatments or things you may be able to do to ease these problems and find out if you have PCOS. The sooner you get started, the sooner you can start feeling better.

How Do I Know If I Have PCOS?

There’s no single test that, by itself, shows whether you have polycystic ovary syndrome, or PCOS. Your doctor will ask you about your symptoms and give you a physical exam and blood tests to help find out if you have this condition.

PCOS is a common hormone disorder that can cause problems with your period, fertility, weight, and skin. It can also put you at risk for other conditions, such as type 2 diabetes. If you have it, the sooner you find out, the sooner you can start treatment.

What Your Doctor Will ask

Your doctor will want to know about all the signs and symptoms you’ve noticed. This is an important step to help figure out whether you have PCOS, and to rule out other conditions that cause similar symptoms.

You’ll need to answer questions about your family’s medical history, including whether your mother or sister has PCOS or problems getting pregnant. This information is helpful — PCOS tends to run in families.

Be ready to discuss any period problems you’ve had, weight changes, and other concerns.

Your doctor may diagnose PCOS if you have at least two of these symptoms:

• Irregular periods
• Higher levels of androgen (male hormones) shown in blood tests or through symptoms like acne, male-pattern balding, or extra hair growth on your face, chin, or body
• Cysts in your ovaries as shown in an ultrasound exam

Physical Exam

Your doctor may check your blood pressure, and BMI (body mass index). She may also look at your skin to check for extra hair growth, acne, and discolored skin, which can all happen if you have PCOS.

Pelvic exam: This is just like what happens when you get a regular checkup. Your doctor may look at and feel areas of your body including the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum, checking for anything unusual.

Pelvic ultrasound (sonogram): This produces an image of what your ovaries look like. For the ultrasound, you lie down and the doctor briefly places an ultrasound device in your vagina. The doctor will check for cysts in your ovaries and how thick the lining is in your uterus. That lining may be thicker than normal if your periods aren’t happening when they’re supposed to.

Your ovaries may be 1½ to 3 times larger than normal when you have PCOS. The ultrasound can show ovary changes in about 90% of women who have PCOS.

Tests

Blood tests: Your doctor or other health care provider will take a small amount of blood from a vein in your arm. Lab tests will measure the levels of these hormones:

• Follicle-stimulating hormone (FSH) affects your ability to get pregnant. Your level might be lower than normal, or even normal, if you have PCOS.
• Luteinizing hormone (LH) encourages ovulation. It could be higher than normal.
• Testosterone is a sex hormone that would be higher in women with PCOS.
• Estrogens are group of hormones that allow women to get their periods. Your level may be normal or high if you have PCOS.
• Your level of sex hormone binding globulin (SHBG) may be lower than normal.
• A sex hormone called androstenedione may be at a higher-than-normal level.

Human chorionic gonadotropin (hCG): This is a hormone test that can check to see if you’re pregnant.

Your doctor may recommend a few more tests to rule out other conditions such as thyroid problems, tumors, and hyperplasia (organ-swelling due to too many cells) that have similar symptoms to PCOS.

After Your Diagnosis

If you have PCOS, you then may get a blood glucose and cholesterol test. Doctors often do these tests to check on your overall health and chance of having other conditions:

• Lipid profiles checks your cholesterol and triglycerides. PCOS can make you more likely to develop heart disease.
• Glucose test helps to see if you have diabetes. More than half of women who have PCOS get this disease.
• Insulin: Your doctor will want to find out how well your body responds to insulin, which helps control your blood sugar level. If your body doesn’t respond to the insulin it’s making, you may have insulin resistance. It’s common among women with PCOS and can lead to diabetes.

Your doctor will work with you to manage your PCOS symptoms and become as healthy as you can be.

What’s the Treatment for PCOS?

Treatments can help you manage the symptoms of polycystic ovary syndrome (PCOS) and lower your odds for long-term health problems such as diabetes and heart disease.

You and your doctor should talk about what your goals are so you can come up with a treatment plan. For example, if you want to get pregnant and are having trouble, then your treatment would focus on helping you conceive. If you want to tame PCOS-related acne, your treatment would be geared toward skin problems.

Healthy Habits

One of the best ways to deal with PCOS is to eat well and exercise regularly.

Many women with PCOS are overweight or obese. Losing just 5% to 10% of your body weight may ease some symptoms and help make your periods more regular. It may also help manage problems with blood sugar levels and ovulation.

Since PCOS could lead to high blood sugar, your doctor may want you to limit starchy or sugary foods. Instead, eat foods and meals that have plenty of fiber, which raise your blood sugar level slowly.

Staying active helps you control your blood sugar and insulin, too. And exercising every day will help you with your weight.

Hormones and Medication

Birth control is the most common PCOS treatment for women who don’t want to get pregnant. Hormonal birth control — pills, a skin patch, vaginal ring, shots, or a hormonal IUD (intrauterine device) — can help restore regular periods. The hormones also treat acne and unwanted hair growth.

These birth control methods may also lower your chance of having endometrial cancer, in the inner lining of the uterus.

Taking just a hormone called progestin could help get your periods back on track. It doesn’t prevent pregnancies or treat unwanted hair growth and acne. But it can lower the chance of uterine cancer.

Metformin (Fortamet, Glucophage) lowers insulin levels. It can help with weight loss and may prevent you from getting type 2 diabetes. It may also make you more fertile.

If birth control doesn’t stop hair growth after 6 months, your doctor may prescribe spironolactone(Aldactone). It lowers the level of a type of sex hormone called androgens. But you shouldn’t take it if you’re pregnant or plan to become pregnant, because it can cause birth defects.

Ovasitol supplement in PCOS

What is Ovasitol? Ovasitol is a supplement designed for women with PCOS. It is a combination of D-Chiro and Myo-inositol in a 40:1 ratio.

What is inositol/Myo-inositol? It seems that Inositol has two jobs really. The first one is that it is important in the insulin receptors of each cell. The receptor is on every cell wall and works as a lock and key mechanism. Insulin needs to fit just right for the receptor to open and let the insulin work its magic on the cell. If the receptor isn’t working very well, your body produces more insulin to compensate, leading to insulin resistance. Inositol helps the receptor work more efficiently so Insulin can bind properly the first time, causing your body to not produce too much insulin. Its second job involves the Insulin signaling pathway. As insulin attaches to the cell wall, it sets in a motion a series of changes within the cell. Inositol plays a role in this series of changes and it is important for insulin to be effective within the cell. Inositol is also involved in stopping insulin’s effect on the cell. In a sense, it helps to flip the off switch.

Inositol in PCOS:

Myo-Inositol

Increased progesterone

Increased SHBG (sex hormone binding globulin) – Deals with any free testosterone in our blood

Lowered testosterone levels

Improved insulin sensitivity

Decreased luteinizing hormone

Induced weight loss

Managing hirsutism

OVULATION!

Restore normal ovulatory activity and fertility in women with PCOS

Improve egg quality and pregnancy rate in women with failed IVF

Improve pregnancy rate and lower cancellation rate in women with PCOS

D-Chiro Inositol

blood pressure and cholesterol

serum levels of androgens (testosterone)

ovulatory function

Women with PCOS are thought to have a deficiency of DCI. DCI is formed from myo-inositol but women with PCOS struggle to make that conversion. We also lose more DCI in our urine than we should. Researchers suggest that this deficiency and impaired use of DCI may result in or at least contribute to insulin resistance in women with PCOS.

Women with PCOS have irregularities in the way the body responds to glucose and insulin so if you work on the insulin pathway, you are likely to see some improvements in PCOS symptoms. 

Weight Loss

When a healthy diet and regular exercise aren’t enough, medications can make losing weight easier. Different drugs work in different ways. For example, orlistat (Alli, Xenical) stops your body from digesting some of the fat in your food, so it may also improve your cholesterol levels. Lorcaserin (Belviq) makes you feel less hungry. Your doctor will prescribe the medication they think will be the most successful for you.

Weight loss surgery could help if you’re severely obese and other methods haven’t worked. The change in your weight afterward can regulate your menstrual cycle and hormones and cut your odds of having diabetes.

Hair Removal

Products called depilatories, including creams, gels, and lotions, break down the protein structure of hair so it falls out of the skin. Follow the directions on the package.

A process like electrolysis (a way to remove individual hairs by using an electric current to destroy the root) or laser therapy destroys hair follicles. You’ll need several sessions, and though some hair may come back, it should be finer and less noticeable.

Fertility

Your doctor may prescribe medication to help you get pregnant. Clomiphene and letrozole encourage steps in the process that trigger ovulation. If they don’t work, you can try shots of hormones called gonadotropins.With in vitro fertilization, or IVF, your egg is fertilized outside of your body and then placed back inside your uterus. This may be the best way to get pregnant when you have PCOS, but it can be expensive.

What Are the Complications of PCOS?

If you have polycystic ovary syndrome (PCOS), your ovaries may contain many tiny cysts that cause your body to produce too many hormones called androgens.

In men, androgens are made in the testes. They’re involved in the development of male sex organs and other male characteristics, like body hair. In women, androgens are made in the ovaries, but are later turned into estrogens. These are hormones that play an important role in the reproductive system, as well as the health of your heart, arteries, skin, hair, brain, and other body parts and systems.

If you have PCOS and your androgen levels are too high, you have higher odds for a number of possible complications. (These may differ from woman to woman):

Trouble Getting Pregnant

Cysts in the ovaries can interfere with ovulation. That’s when one of your ovaries releases an egg each month. If a healthy egg isn’t available to be fertilized by a sperm, you can’t get pregnant.

You may still be able to get pregnant if you have PCOS. But you might have to take medicine and work with a fertility specialist to make it happen.

Insulin Issues

Doctors aren’t sure what causes PCOS. One theory is that insulin resistance may cause your body to make too many androgens.

Insulin is a hormone that helps the cells in your body absorb sugar (glucose) from your blood to be used as energy later. If you have insulin resistance, the cells in your muscles, organs, and other tissue don’t absorb blood sugar very well. As a result, you can have too much sugar moving through your bloodstream. This is called diabetes, and it can cause problems with your cardiovascular and nervous systems.

Other Possible Problems

You might have metabolic syndrome. This is a group of symptoms that raise the risk of cardiovascular disease, such as high triglyceride and low HDL (“good”) cholesterol levels, high blood pressure, and high blood sugar levels.

Other common complications of PCOS include:

• Depression
• Anxiety
• Bleeding from the uterus and higher risk of uterine cancer
• Sleep problems
• Inflammation of the liver

Some complications of PCOS may not be serious threats to your health, but they can be unwanted and embarrassing:

• Abnormal body or facial hair growth
• Thinning hair on your head
• Weight gain around your middle
• Acne, dark patches, and other skin problems

Polycystic Ovary Syndrome (PCOS) and Weight Gain

Most women at some point have to contend with weight gain. But for women with polycystic ovary syndrome (PCOS), losing weight can become a constant struggle.

PCOS is the most common hormonal disorder in women of childbearing age and can lead to issues with fertility. Women who have PCOS have higher levels of male hormones and are also less sensitive to insulin or are “insulin-resistant.” Many are overweight or obese. As a result, these women can be at a higher risk of diabetes, heart disease, sleep apnea, and uterine cancer.

If you have PCOS, certain lifestyle changes can help you shed pounds and reduce the disease’s severity.

Why does polycystic ovary syndrome cause weight gain?

PCOS makes it more difficult for the body to use the hormone insulin, which normally helps convert sugars and starches from foods into energy. This condition — called insulin resistance — can cause insulin and sugar — glucose — to build up in the bloodstream.

High insulin levels increase the production of male hormones called androgens. High androgen levels lead to symptoms such as body hair growth, acne, irregular periods — and weight gain. Because the weight gain is triggered by male hormones, it is typically in the abdomen. That is where men tend to carry weight. So, instead of having a pear shape, women with PCOS have more of an apple shape.

Abdominal fat is the most dangerous kind of fat. That’s because it is associated with an increased risk of heart disease and other health conditions.

What are the risks associated with PCOS-related weight gain?

No matter what the cause, weight gain can be detrimental to your health. Women with PCOS are more likely to develop many of the problems associated with weight gain and insulin resistance, including:

• Type 2 diabetes
• High cholesterol
• High blood pressure
• Sleep apnea
• Infertility
• Endometrial cancer

Many of these conditions can lead to heart disease.

Experts think weight gain also helps trigger PCOS symptoms, such as menstrual abnormalities and acne.

What can I do to lose weight if I have polycystic ovary syndrome?

Losing weight not only cuts your risk for many diseases, it can also make you feel better. When you have PCOS, shedding just 10% of your body weight can bring your periods back to normal. It can also help relieve some of the symptoms of polycystic ovary syndrome.

Weight loss can improve insulin sensitivity. That will reduce your risk of diabetes, heart disease, and other PCOS complications.

To lose weight, start with a visit to your doctor. The doctor will weigh you and check your waist size and body mass index. Body mass index is also called BMI, and it is the ratio of your height to your weight.

Your doctor may also prescribe medication. Several medications are approved for PCOS, including birth control pills, anti-androgen medications and Metformin (Glucophage). The anti-androgen medications block the effects of male hormones. Metformin is a diabetes drug that helps the body use insulin more efficiently. It also reduces testosterone production. Some research has found that it can help obese women with PCOS lose weight.

In addition to taking medication, adding healthy habits into your lifestyle can help you keep your weight under control:

• Eat a high-fiber, low-sugar diet. Load up on fruits, vegetables, and whole grains. Avoid processed and fatty foods to keep your blood sugar levels in check. If you’re having trouble eating healthy on your own, talk to your doctor or a dietitian.
• Eat four to six small meals throughout the day, rather than three large meals. This will help control your blood sugar levels.
• Exercise for at least 30 minutes a day on most, if not all, days of the week.
• Work with your doctor to track your cholesterol and blood pressure levels.
• If you smoke, get involved in a program that can help you quit.

PCOS and Your Fertility – and What You Can Do About It

One of the most common reasons a woman has trouble getting pregnant is a condition called polycystic ovary syndrome (PCOS).

It’s a hormone problem that interferes with the reproductive system.

When you have PCOS, your ovaries are larger than normal. These bigger ovaries can have many tiny cysts that contain immature eggs.

Hormone Differences

PCOS causes a woman’s body to produce higher-than-normal levels of androgens. These are hormones that are usually thought of as male hormones, because men have much higher levels of androgens than women.

Androgens are important in the development of male sex organs and other male traits.

In women, androgens are usually converted into the hormone estrogen.

Ovulation Problems

High levels of androgens interfere with the development of your eggs and the regular release of your eggs. This process is called ovulation.

If a healthy egg isn’t released, it can’t be fertilized by sperm, meaning you can’t get pregnant. PCOS can cause you to miss your menstrual period or have irregular periods. This can be one of the first signs that you may have a problem such as PCOS.

Regulating Your Period

Fortunately, there are some treatments that can help women with PCOS have healthy pregnancies.

Your doctor may prescribe birth control pills that contain man-made versions of the hormones estrogen and progestin. These pills can help regulate your menstrual cycle by reducing androgen production.

If you cannot tolerate a combination birth control pill, your doctor might recommend a progestin-only pill.

You take this pill for about 2 weeks a month, for about 1-2 months. It’s also designed to help regulate your period.

Medicines to Help You Ovulate

You won’t be able to get pregnant while you’re taking birth control pills for PCOS. But if you need help ovulating so that you can become pregnant, certain medicines may help:

• Clomiphene is an anti-estrogen drug that you take at the beginning of your cycle.
• If clomiphene doesn’t help with ovulation, you may be prescribed the diabetes drug metformin.
• If clomiphene and metformin don’t work, your doctor may prescribe a medication containing a follicle-stimulating hormone (FSH) and a luteinizing hormone (LH). You get this medicine in a shot.
• One other drug that helps with ovulation is letrozole. It’s sometimes used when other medications aren’t effective.

If you have PCOS and you want to get pregnant, you should work with a doctor who is a specialist in reproductive medicine. This type of doctor is also known as a fertility specialist.

A specialist will help make sure you get the right dose of medicines, help with any problems you have, and schedule regular checkups and ultrasounds to see how you’re doing. (An ultrasound is a machine that uses sound waves to create images of the inside of your body. It’s a painless procedure that can track the growth and development of your baby). 

Lifestyle Changes

For some women, gaining a lot of weight can affect their hormones. In turn, losing weight, if you’re obese or overweight, may help get your hormones back to normal levels. Losing 10% of your body weight may help your menstrual cycle become more predictable. This should help you get pregnant.

In general, living a healthier lifestyle with a better diet, regular exercise, no smoking, less stress, and control of diabetes and other medical conditions should improve your fertility odds.

Remember, if your period isn’t happening when it should, or you’ve already been diagnosed with PCOS, work closely with your doctor to help get it under control. And if you want to get pregnant, talk with a fertility specialist.

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