What is PCOS? --Understanding the health problem affecting over 5 million women
By: Regina Taylor
Polycystic Ovary Syndrome (PCOS) is a condition affecting up to 26.7 percent of women between the ages of 15 to 44 years old (Watson, 2019). Triggered by a hormonal imbalance in which women have higher levels of testosterone than usual, PCOS causes symptoms and experiences that include increased facial and body hair, baldness, and even long-term complications like diabetes or heart disease (Watson, 2019). Despite PCOS being a condition that affects so many women around the world, the signs and symptoms of PCOS can carry stigma and are not talked about often. Even worse, when they are talked about, they can promote harmful misinformation about women and their bodies and lead to increased mental health issues in women with the condition (Watson, 2019). Studies show that there is a need for education at a broader level than just for the women with the condition in order to raise knowledge and awareness (Hadjiconstantinou et al, 2017). Together we can take the first step towards becoming better supporters and advocates for the health of all women.
Majority of women with PCOS do not receive an official diagnosis and often struggle with missed periods and infertility without knowing the root cause (Watson, 2019). To understand PCOS, you must first understand the process of hormone regulation in the body, and how these compounds contribute to the female reproductive cycle. PCOS affects the function of the ovaries, which are reproductive organs responsible for producing progesterone, estrogen, and a small amount of male hormones known as androgens (Watson, 2019). Together these molecules regulate the ovulation cycle many women experience, or the release of an egg to be fertilized by sperm each month (Watson, 2019).
“Polycystic” refers to the “many cysts” that develop on the ovaries as a result of PCOS. In a female body with PCOS, fluid-filled sacs grow inside the ovaries - each one containing an immature egg - and the eggs never mature to trigger ovulation (Watson, 2019). Since hormone regulation in the body is largely based on “signals,” this lack of ovulation alters levels of estrogen, progesterone, and other hormones necessary for female reproduction, causing an imbalance with androgen levels being higher than usual (Watson, 2019).
Doctors and scientists don’t understand exactly what causes PCOS, which can make it a difficult condition to manage. Some theories center on PCOS being caused by genetic predisposition, high levels of inflammation, or insulin resistance (Watson, 2019). Since up to 70% of women with PCOS experience insulin resistance, or the inability of their cells to efficiently use insulin, this is a strong supporting theory for understanding the causes of PCOS (Watson, 2019).
Along with the symptoms including heavy and irregular periods, excess hair growth, acne, weight gain, and thin and falling out hair, PCOS affects multiple systems of the body (Watson, 2019). Having higher androgen levels than normal can lead to metabolic syndrome and chronic diseases, sleep apnea, and even endometrial cancer (Watson, 2019).
Thankfully, there are effective ways to manage and lessen the symptom severity of PCOS. This includes healthy eating and exercise - as losing weight can greatly improve menstrual cycle regulation and insulin levels (Watson, 2019). Birth control and Metformin can also help women manage PCOS when other strategies are not working (Watson, 2019). While treatments begin with lifestyle interventions, it is important to see your doctor if you are experiencing symptoms of PCOS or are having trouble managing it.
Especially important to note is the association between PCOS and mental health problems, specifically depression and anxiety (Watson, 2019). Women with PCOS experience increased hormonal fluctuations and unwanted symptoms that can negatively affect their emotions and self-esteem (Watson, 2019). In a study on the psychological impact of PCOS on women, it was found that receiving an early diagnosis, providing women with educational resources on the condition, and raising knowledge about PCOS in the larger community all contributed to better mental health outcomes for patients with PCOS (Hadjiconstantinou et al, 2017).
Reference List:
Watson, S. (2019, March 29). What is PCOS? Healthline. https://www.healthline.com/health/polycystic-ovary-disease#what-is-pcos.
Hadjiconstantinou, M., Mani, H., Patel, N., Levy, M., Davies, M., Khunti, K., & Stone, M. (2017, July). Understanding and supporting women with polycystic ovary syndrome: a qualitative study in an ethnically diverse UK sample. Endocrine connections. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510451/.