PCOS is the most common hormonal disorder among women of reproductive age. Globally, 1 out of 10 women of childbearing age suffers from PCOS. Despite such a prevalence, there is no single, definite cause of PCOS.
However, there is vague evidence that genetics play a central role. Further, hormonal imbalance, environment, and lifestyle are also major contributing factors to PCOS.
Besides, this endocrine hormonal disorder can’t be cured completely. The best you can do is manage the numerous symptoms via many methods. But to do this, you need to know a few key things about PCOS.
What is PCOS? How is it caused? What are the symptoms of PCOS you need to look out for? When is the time to seek help? And so much more!
In the following sections, we’re going to uncover answers to all these questions and simplify it all for you!
So, let’s start with understanding PCOS!
What is PCOS?
Your ovaries produce sex hormones - estrogen and progesterone - that regulate your menstrual cycle. They also release a small amount of androgens a.k.a male sex hormones.
When there is a hormonal imbalance in the ovaries, it leads to numerous symptoms. And the cluster of these symptoms is known as PCOS. But, what EXACTLY triggers this hormonal imbalance is not known.
Want to know more about PCOS in greater detail? Check out our complete PCOS guide.
Before we move to understand the causes of PCOS, it’s crucial to know the difference between PCOS and PCOD.
Because both these terms sound quite similar and are often used interchangeably. However, there’s a subtle but important difference.
Difference between PCOS and PCOD
The main difference between PCOS and PCOD is that in PCOD, the ovaries start releasing immature eggs. This leads to hormonal imbalances and swollen ovaries. Whereas PCOS causes increased resistance to insulin and as a result, increases the androgen levels in your body. This makes your ovaries prone to developing cysts.
PCOS is considered to be more severe than PCOD. In fact, a few experts don’t even consider PCOD as a disease. It can be easily managed by a few dietary changes and exercises. However, in PCOS, you require more comprehensive treatment as it’s a hormonal disorder.
This guide covers the symptoms of PCOS, not PCOD (although there definitely is some overlap).
But first, let’s start with knowing the underlying causes of PCOS.
Causes of PCOS
As mentioned earlier, no exact cause of PCOS is known so far. As per studies done by the Office on Women’s Health, two potential causes of PCOS are:
- high levels of insulin
- and androgens
Further, a mixture of genetic and environmental factors have also been found to be contributing factors.
Let’s have a closer look at the causes of PCOS.
Generally, women suffering from PCOS have excessive inflammation in their bodies. This is due to two prime reasons:
- Being overweight and/or
- Improper dietary habits like eating too much carb-rich food
About 71% of women suffering from PCOS are also found to be insulin resistant. This means that their cells can’t optimally produce insulin in the body.
When your body can’t use insulin properly, it demands more and more of it. Due to this, your pancreas produces more insulin to meet these demands. All of this together triggers the ovaries to produce more androgens, further worsening PCOS.
Genetics have a strong link to your chances of developing PCOS. Some experts believe that PCOS is a ‘family affair’. This means that there is a HIGH chance that someone in your family tree (before you) has also suffered from it.
Further, it’s also likely that many genes - not just one - contribute to this condition. However, more studies are required in order to state anything with complete surety.
Poor Dietary Habits and Lifestyle
Poor dietary choices such as eating too much junk food and consuming too many calories lead to obesity. Obesity is a major cause of insulin resistance which in turn leads to PCOS.
A sedentary and lazy lifestyle also contributes to extra calories being stored as fat. This leads to increased body weight and ultimately PCOS.
If you suspect you’re suffering from PCOS, you need to look out for the following symptoms of polycystic ovarian syndrome :
7 Symptoms of Mild PCOS
You might start seeing the initial signs of PCOS as early as during your first period. Or you may notice it in your mid-late twenties if you're either overweight and/or have trouble getting pregnant.
Some of the initial symptoms of PCOS you need to look out for include:
- Irregular Periods
- Excessive acne
- Coarse hair growth on the face, back, and chest
- Weight gain (despite controlled eating)
- Darkening of skin under/around the neck, groin, and pelvic area
- Severe and prolonged headaches
- Hair loss
If you suffer from any of the above-mentioned symptoms for a long time, you should seek medical help.Other than these, there are many other symptoms of PCOS that develop slowly over time.
Keep in mind that these are the common symptoms of PCOS and there are chances that you might suffer from these due to some different reasons.
PCOS Symptoms Checklist
Irregular periods due to the absence of ovulation is the prime indicator of PCOS. But as your PCOS worsens and if you don’t take any measures, you may also observe the following symptoms:
- Heavy bleeding (whenever you get your period)
- Fatigue and low energy
- Increased mood swings
- Unwanted hair growth
- Thinning of hair and male pattern baldness
- Less frequent periods (fewer than 8 in a year)
- Excessive weight gain or obesity (Up to 80% of women with PCOS are obese)
- Skin tags
- Breathing stops during sleep (apnea)
- Severe daytime sleepiness
- Desire to binge eats or overeat
- Severe feeling of anxiety
- Reduced fertility
- High stress and a general feeling of discomfort
- Insulin resistance
- Low sex drive
- Pelvic pain
- Bloating and constipation
These PCOS symptoms and signs may vary from person to person depending on various factors like age, sex, height, and weight. In addition, if you’re suffering from PCOS, you’ll mostly experience a combination of these symptoms.
But that’s not all!
PCOS has also been found to be related to various other chronic mental and physical health conditions. Let’s find out more about this in the next section.
PCOS and Other Health Problems
PCOS is not limited to only a certain number of symptoms that worsen if not managed properly. As per the Office on Women’s Health, there are several chronic diseases that are related to PCOS.
PCOS and Diabetes
As we’ve seen earlier, PCOS is related to an imbalance of the hormone - insulin. This hormone plays a key role in managing glucose levels in your body. In addition, a disturbance in its production is related to diabetes.
Type 1 diabetes is caused by the absence of insulin, while type 2 diabetes is due to insulin resistance.
Out of both these types, PCOS can be a risk factor for type 2 diabetes. This is because, with PCOS, your body develops insulin resistance. Besides, women with PCOS are generally overweight. This again is a contributing factor to type 2 diabetes.
Other evidence to support this argument includes:
- As per studies by the OWH, around half of PCOS women develop diabetes or prediabetes before the age of 40.
- PCOS women are more likely to suffer from diabetes than similar peers without the disorder.
- An extensive study done on 8,000 women, found that women with PCOS are more likely to develop type 2 diabetes. This study was independent of body mass.
All in all, if you’re suffering from PCOS, you must go for regular diabetes screening. This will help you identify initial symptoms of diabetes like:
- blurry vision
- a frequent need to urinate
- frequent urination at night
- increased thirst
- increased hunger
- patches of especially dark skin
- cuts that do not heal quickly
- numbness in the hands or feet
PCOS and Depression
There is a very prominent relationship between depression and PCOS. As many as 40% of women suffering from PCOS also experience depression symptoms. In addition, suicide rates are 7 times higher in women with PCOS.
There are three prime reasons PCOS is linked to depression:
- An imbalance in various female sex hormones or insulin.
- Worsening metabolic complications of PCOS like poor heart health, diabetes or prediabetes, and metabolic syndrome.
- High levels of androgens (male hormones).
Other than these, the efforts and struggle to manage the symptoms of PCOS can not be overlooked. Struggling with weight loss and dermatological issues also play a major role in building frustration and stress.
Thus, it’s in your best interest to keep in touch with a mental health expert. In addition, learn various ways to manage your overall emotional and mental health.
PCOS and Infertility
PCOS can affect fertility in different ways and is also one of the prime causes of infertility in women.
When you suffer from PCOS, your body starts experiencing disrupted ovulation cycles. This means that there’s no ovulation due to an increased level of testosterone or because the follicles on your ovaries do not mature.
Even if ovulation takes place, an imbalance in hormones prevents the lining to be compatible enough for the implantation of an egg.
Further, an imbalance of hormones also leads to a sporadic menstrual cycle, making it harder to get pregnant.
However, with treatment, a well-maintained lifestyle, and expert guidance, this can be cured.
PCOS and Endometrial Cancer
If you have PCOS, you’re at a higher risk of endometrial cancer. This is because of a prolonged state of high estrogen levels.
At the time of ovulation, estrogen levels fall and progesterone levels increase. As women with PCOS do not ovulate, their bodies do not keep these estrogen levels in check.
During the early stages, about 90% of women experience abnormal periods, bleeding, or discharge. As the situation worsens, you may also feel a lump, have pelvic pain, or lose weight without trying.
These symptoms might be similar to various other conditions. Thus, it’s wise that you go to an expert as soon as you start experiencing them.
Now that you know the various symptoms of PCOS and other medical conditions related to it, it’s time for you to know how PCOS is diagnosed.
There is no specific or definitive way to diagnose PCOS. However, experts believe that if you have two of the following three symptoms, then you’re suffering from it:
- Cysts in the ovaries
- High androgen levels
- Irregular or no menstrual cycles
Your doctor would generally start by asking about your medical history. This includes your menstrual cycles and weight changes.
Next, is a physical examination. This might include checking your body for excessive hair growth, acne or bacne, and insulin resistance.
After this, you might undergo the following three examinations:
1. Pelvic Examination
In this, a Gynaec visually and manually inspects your reproductive parts. This is done in order to check any abnormal growth inside your vaginal tract or around the ovaries.
2. Blood Test
The goal of this test is to check the levels of various hormones and pick out if any are present in excessive amounts. You might also undergo additional testing in order to check the levels of triglycerides, insulin, and cholesterol.
This is done in order to check the appearance of your ovaries and the lining of your uterus. In this, a wand-like device is placed inside your vagina. This produces sound waves that are translated into images on a computer screen.
If all these tests show that you have PCOS, your doctor might also suggest you undergo the following additional tests:
- Screening for obstructive sleep apnea
- Screening for clinical depression
So, now that you know the plausible diagnosis of PCOS, are there ways to solve this problem? Or is it all just hopeless?
Well, let’s answer that in the next section!
The very first step to treating PCOS is to bring crucial lifestyle and dietary changes.
Losing only about 5 to 10% of your body weight helps to regulate your menstrual cycle and improve PCOS. In addition, weight loss also helps in managing:
- Healthy levels of insulin
- Appropriate levels of cholesterol and
- Reduces the risk of numerous heart diseases
To improve PCOS, you need to opt for a diet that helps in weight loss. And for this purpose, low-carb diets such as the keto diet are considered to be the best. This is because it’s effective both in weight loss and maintaining healthy levels of insulin.
If you want to get started on your keto journey, check out our complete keto diet plan for women guide.
Further, it’s imperative for you to add exercise to your life. Working out for at least 3 days a week can help to lose weight and manage insulin levels.
Once you work on your diet and include workouts in your daily routine, you can move to the next levels of treatment.
PCOS Birth Control Pill
Hormone birth control pills are the ‘first-line medical treatment’ for managing PCOS symptoms.
It’s suggested that you use a pill that consists of both oestrogen and progestin (two synthetic female hormones). This is because:
- These both help in regulating the menstrual cycle
- Lower the effects of high levels of androgen like excessive hair loss and acne
- Reduce your risk of developing ovarian cancer.
Metformin is a drug that is popularly used in the treatment of type 2 diabetes. However, it also helps in treating PCOS by managing the levels of various hormones.
A study observed that taking metformin along with dietary and lifestyle changes can help in numerous ways. Some of these include:
- Lowered blood sugar levels
- Improved weight loss and
- Restored menstrual cycle
This drug is mainly used to stop excessive hair fall and reverse the effects of androgens. However, this medication is only suggested when you’re not pregnant or are planning to. This is because it could lead to birth defects and can be harmful to the womb.
This is the final step of treatment and must be considered ONLY when other methods don’t work at all. In this, expert surgeons perform ovary drilling using a laser or needle in order to make holes in the ovary. This helps in restoring normal ovulation.
And that sums up all the important symptoms of PCOS and treatment methods along with its underlying causes. Knowing all of this will help you to make the right choices to deal with PCOS.
Finally, let’s wrap up the symptoms of PCOS guide by understanding when exactly you need an expert’s assistance.
When to Seek Help?
The advice given in this guide including all the measures to identify and treat the symptoms of PCOS will help almost everyone to keep PCOS under control.
HOWEVER, if your condition worsens despite following all these measures dedicatedly; then you MUST seek an expert’s help.
Visit your doctor if:
- You frequently miss your periods and you’re not pregnant.
- You have more than one symptom of PCOS like excessive hair growth on the face and body, pelvic pain, and so on. Remember, common symptoms like headaches, fatigue, and irritability might not be precisely indicative of PCOS.
- Tried to get pregnant for more than a period of 12 months but without any results. Remember, if your periods are already absent and you’re trying to get pregnant for a while, don’t wait for 12 months.
- Symptoms of diabetes like excessive thirst or hunger, blurred vision, or unexplained weight loss start showing up.
Further, if you get diagnosed with PCOS then it’s best that you plan regular visits with your primary care doctor. You’ll need regular tests to check for diabetes, high blood pressure, and other possible complications.