Living with PCOS
• PCOS Symptoms Explained
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|PCOS Symptoms Explained
PCOS or polycystic ovary syndrome is a common disorder affecting up to 10 percent of women of reproductive age (and an estimated 20 percent with a tendency to PCOS). Although PCOS was traditionally associated with cosmetic problems and infertility, recent studies indicate that hormone imbalances associated with the disease also put women at risk of serious health issues like obesity, type 2 diabetes, heart disease and endometrial cancer. PCOS usually develops within a few years of menarche (first menstruation) but it can suddenly appear mid-life as well. A significant portion of women with PCOS are obese, but it is not clear whether PCOS predisposes a woman to obesity or vice versa. Women who are olive skinned of Mediterranean descent are more at risk. PCOS is also known as polycystic ovary disease and hyperandrogenism.
What Are The Symptoms?
The symptoms of PCOS can vary from woman to woman but some 10 to 38 percent of women with PCOS are obese. Symptoms are closely related to hormone imbalances, in particular to excess levels of the male hormones androgens.
Problems with menstruation or ovulation are common with PCOS. This includes irregular periods (medical term oligomenorrhea) where bleeds occur at greater intervals of 35 days with only 4 to 9 periods per year. While periods may become irregular, they may also become heavy or prolonged (medically known as menorrhagia). Heavy periods do not usually cause a problem unless they lead to embarrassing leakages or anemia due to blood loss. Menorrhagia exists where a tampon or pad is soaked every hour or bleeding is longer than 7 days. Some women experience a complete stoppage of periods, a condition known as amenorrhea. Alternatively PCOS could prevent a young girl from starting her periods in the first place. Primary amenorrhea is where menarche has not started by the age of 16 (see, when should my periods start?). In most cases a doctor will prescribe the contraceptive pill to start or restart monthly bleeds.
The majority of women with PCOS are infertile as they do not ovulate. A combination of problems, tiny cysts on the ovaries, hormone imbalance, low levels of progesterone and a high level of luteinizing hormone (LH) make it difficult for an egg to mature and be released. The good news is that the majority of women with PCOS can receive treatment to increase chances of pregnancy, although there are some who do not respond to treatment. Some gynecologists prescribe medications, such as Clomid, to stimulate ovulation. Many women with PCOS report that it is easier to become pregnant second time around, and that their menstruation cycle regulated naturally after pregnancy. See also, how long does it take to get pregnant with PCOS?
Reports indicate that at least 75 percent of women who receive a diagnosis of PCOS have insulin resistance, a biochemical condition which is linked to excessive weight gain. This excess of insulin in the blood stream stimulates the ovaries to produce large amounts of the male hormone testosterone, which can prevent the ovaries from releasing an egg, and so causing infertility. Insulin also upsets the balance of the male hormones (androgens) to female hormones (estrogens) resulting in ovarian cysts or cystic follicles.
All women are born with at least one hundred thousand immature egg cells in their ovaries. As soon as puberty begins the egg cells start to develop into viable eggs for fertilization. If the process of the egg maturing fails, the egg is not released and turns into a cyst. The cyst sends out hormones and signals to other egg cells, in turn messing up their development, leading to even more cysts. As this cycle continues, multiple ovary cysts occur, and so PCOS is diagnosed. See also, what is the difference between ovarian cysts and PCOS?
More than 70 percent of women with PCOS experience hirsutism, a condition which results in excessive hair growth. Hirsutism involves the growth of dark coarse hair in areas where they ordinarily only occur in men. It is normal for women to have a few hairs on the upper lip, breasts, inner thighs and the line between the navel and the pubic bone. With hirsutism, hair can grow on the back, chin, cheeks, chest, and excessively on the arms and legs. It is usually caused by an excess of the male hormone androgen.
Nearly 50 percent of women with acne display evidence of excess androgenic hormones. Acne is a collection of blackheads, whiteheads, pustules and sometimes cysts on the face, chest or back (image). Traditionally acne occurs in adolescence, but where PCOS exists it may appear during adulthood. Oily skin and dandruff may also be a problem with PCOS as well as patches of darkened skin on the neck, breasts, arms or thighs (which is linked to insulin resistance).
Male patterned baldness (image) is a common sign of polycystic ovaries and is called androgenic alopecia. Women with this problem may find hair thins on the head but becomes coarser on the face. It should not be confused with estrogen alopecia which has the opposite effect and results in thicker, glossy hair. This is why a woman's hair may improve during pregnancy when estrogen levels surge. On the other hand estrogen deficiency alopecia typically starts around perimenopause and can also result in hair thinning. See also does PCOS cause hair loss?
Studies show that women with PCOS need to ingest fewer calories than a same size 'ordinary' woman in order to remain the same weight. The fact that the majority of women with PCOS have insulin resistance may be a contributory factor. For this reason the Low GI Diet is the most popular for women with PCOS as it helps to regulate blood sugar levels. See also Natural treatment for PCOS.
PCOS is associated with skin tags (image), thick lumps of skin which look like warts and often appear on the neck, eyelids, bra area or armpits. Usually benign, they are quite harmless and can be removed by a dermatologist if desired for cosmetic reasons. The medical name for skin tag is acrochordon.
Women report conflicting advice from medical practitioners on whether pelvic pain is a common symptom of PCOS or not. What cannot be denied is that some women with PCOS do experience chronic pelvic pain. Possible causes for this could be due to pelvic crowding from enlarged ovaries. Or it could be due to prolonged periods and PMS type symptoms, which include pelvic and lower back pain. See also, can PCOS cause pain?
Studies show that women with PCOS have an exceptionally high risk of developing Obstructive Sleep Apnea (OSA). Sleep apnea causes the airways to close involuntary while sleeping and so preventing breathing. This leads to sleep disruption, stress, mood swings and irritability. Symptoms of Sleep Apnea include: intense loud snoring, gasping episodes during sleep, feeling excessively sleepy during the day and personality changes. The condition is so closely linked to PCOS that some doctors go as far to diagnose a woman with sleep apnea as also being likely to have PCOS. It is no surprise then that research now links sleep apnea to insulin resistance.
Exhaustion is a problem women complain of with polycystic ovary syndrome. This may be related to insulin resistance or the fact that many women with PCOS also have hypothyroidism (low thyroid function). See also, why am I so tired all the time? and does PCOS cause fatigue?
Other Risk Factors
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