Everything you need to know about PCOS

Can PCOS be cured? What are the symptoms of PCOS? Is there an effective treatment? Are there natural alternatives? How do you live with PCOS? Definitions, treatments, symptoms—Louloucup takes a closer look at this widespread hormonal disorder.

PCOS stands for Polycystic Ovary Syndrome. It’s a hormonal disorder, an endocrine condition that affects many women worldwide: about 1 in 10 women are affected.

PCOS is actually the leading cause of infertility worldwide because women with PCOS often have anovulatory menstrual cycles—that is, cycles without ovulation.

But don’t confuse infertility with sterility! Women with PCOS can get pregnant. However, it may be more difficult and take longer for them to conceive.

Even though the name is confusing, with PCOS, there aren’t actually problematic cysts. With PCOS, the issue is really a hormonal imbalance. This hormonal variation causes significant fertility problems. Androgens—male hormones—are present in excess in women’s bodies. Their presence disrupts the proper development of follicles in the ovary.

Quick reminder: Follicles are like tiny sacs that contain oocytes. During the follicular phase, these follicles grow. Only one, the strongest and most robust, reaches maturity. It contains the egg that can be fertilized.

At the time of ovulation, the mature follicle separates from the others and releases its egg, looking to be fertilized by a sperm. With PCOS, the follicle doesn’t reach maturity. Follicles accumulate in the ovary and ovulation doesn’t happen.

Find all the information about the menstrual cycle, especially ovulation, in our No-Taboo Guide to the Menstrual Cycle.

Researchers still aren’t completely sure. Genetics is one of the main suspected causes. If members of your family have PCOS, you’re more likely to develop it too.

Other doctors and researchers have suggested an environmental cause (endocrine disruptors), but nothing has been confirmed.

The list of PCOS symptoms is long. Not all women with PCOS experience the same symptoms, and symptoms can change over time.

In adolescence, girls may have irregular cycles, severe acne, or excess hair growth. Young adults (ages 25–30) may struggle with infertility. Around age forty, carbohydrate intolerance often appears. At menopause, women with PCOS are at higher risk for cardiovascular disease and type 2 diabetes.

Other symptoms are numerous and varied: hair loss, excess hair, anxiety, fatigue, insomnia, dark skin patches, high cholesterol, mood swings, low libido, pelvic pain, or even depression.

Hormonal fluctuations have a direct impact on weight. The vast majority of patients experience weight gain or weight loss. Some women with PCOS are obese, but not all. It’s also common for affected women to have a higher risk of developing eating disorders or Disordered Eating Behaviors (DEB).

Very often, the diagnosis is only made after adolescence. Acne and irregular cycles aren’t alarming at puberty and don’t prompt doctors to investigate. As a result, very few young girls are diagnosed.

On the other hand, the diagnosis is made very frequently for women who want to become mothers. They struggle to conceive and seek medical advice. If two out of three criteria are met, a PCOS diagnosis can be made:

• menstrual cycle disorders, long and then short cycles with missed periods—in short, highly irregular periods;

• clear hyperandrogenism ;

• the presence of 12 or more large follicles per ovary on ultrasound
.

Your healthcare provider (gynecologist, endocrinologist, or primary care doctor) can list your symptoms and also order a comprehensive blood test. This blood work should specifically check your androgen levels.

Prolactin, testosterone, and progesterone are among the hormones checked. A hormonal assessment is required to diagnose PCOS. That’s why seeing an endocrinologist (a hormone specialist), in addition to a gynecologist, is so important. A pelvic ultrasound can reveal a large number of immature follicles in the ovaries that haven’t developed into mature eggs.