PCOS: Hormones, Common Symptoms, Diagnosis & Management

Polycystic ovary syndrome, also known as PCOS, currently affects 5 to 18% of women worldwide and between 38 to 88% of women with obesity and overweight. Today, let’s talk about the hormones and common symptoms associated with PCOS as well as things healthcare providers will consider during diagnosis and management. 

What is PCOS?

Despite its name, polycystic ovary syndrome isn't just about having cysts on the ovaries. It's actually a complex hormonal issue that's mainly driven by elevated levels of insulin, the main hormone that regulates blood sugar in the body, and androgens, which are male sex hormones like testosterone and DHEA sulfate, just to name a couple.

polycystic ovary syndrome isn't just about having cysts on the ovaries

Let's dive into how these hormones contribute to the issues we see in PCOS.

HORMONES AND PCOS

Due to a multitude of reasons, in some people with PCOS, the body becomes insulin-resistant, which means their pancreas has to secrete more insulin to overcome this resistance and keep blood sugars under control. Unfortunately, this increased insulin level triggers the hypothalamus in the brain to release another hormone called luteinizing hormone (known as LH), which stimulates the ovaries to produce more androgens. Furthermore, the increased insulin levels signal the adrenal glands to secrete more androgens as well, creating an environment of elevated androgens and insulin. It's these elevated hormone levels that disrupt the body's normal function, causing the symptoms associated with PCOS.

It's the elevated hormone levels of insulin and androgens that disrupt the body's normal function, causing the symptoms associated with PCOS.

COMMON SYMPTOMS OF PCOS

The symptoms of PCOS can vary from person to person, but there are some common signs to watch out for, including: 

1. IRREGULAR MENSES

Irregular menstrual cycles are a hallmark of PCOS and are often characterized by either infrequent or absent periods. This happens because the elevated levels of insulin and androgens affect the normal development and release of eggs by the ovaries, a process known as ovulation, which can lead to the formation of cysts on the ovaries and even lead to infertility.

2. HIRSUTISM

People with PCOS can also experience excessive hair growth on their face, chest, and abdomen, which is called hirsutism.

3. ACNE

Because androgens stimulate sebaceous glands in the skin, acne and oily skin are also common symptoms seen in PCOS. 

4. METABOLIC ISSUES

Increased insulin levels affect other tissues and organs in the body, leading to metabolic disturbances like abnormal glucose metabolism, elevated cholesterol levels, high blood pressure, and even weight gain or difficulty losing weight, which can contribute to the increased risk of developing conditions like type 2 diabetes, cholesterol issues, and cardiovascular diseases like heart attacks and strokes.

DIAGNOSING PCOS

Diagnosing PCOS involves a comprehensive approach because it shares symptoms with other conditions, and individual experiences can vary. Since PCOS shares symptoms with other conditions, it's essential to rule out other health issues, such as other hormonal issues, thyroid problems, and even adrenal gland issues that can mimic some of the symptoms of PCOS. To start diagnosing this syndrome, a healthcare provider will take a detailed medical history including menstrual patterns, symptoms, and even a family history to see if there are any PCOS-related conditions before performing a physical exam to assess for hirsutism, acne, and signs of metabolic issues. Like with many other health issues, blood tests are usually done to measure hormone levels, including androgens and insulin, blood sugar tests to evaluate how the body processes sugar, and an ultrasound of the ovaries may be done to look for the presence of multiple small follicles or cysts. Then your healthcare provider will use the Rotterdam criteria to either confirm or rule out the diagnosis of PCOS.

PCOS MANAGEMENT

If PCOS is diagnosed, your healthcare provider will work closely with you to develop an individualized management plan, usually involving lifestyle modifications such as a balanced diet and regular exercise to address metabolic factors and promote weight management. In some instances, hormonal medications like birth control pills or anti-androgens may be prescribed to help regulate menstrual cycles, decrease the risk of uterine cancer, reduce the effects of elevated androgen levels, and manage symptoms like hirsutism and acne. Finally, in individuals trying to conceive, medications may be used to help stimulate ovulation, which increases the likelihood of pregnancy.

And there you have it, a quick introduction to the causes, symptoms, diagnosis, and management of PCOS. Stay tuned for more education on PCOS-related topics!