Unlike the name suggests Polycystic Ovarian Syndrome is a metabolic disorder that affects many body systems. Despite its name, it is not caused by cysts on the ovaries.
Polycystic Ovarian Syndrome
Did you know that 1 in 10 women and teenage girls suffer with a metabolic disorder called PCOS?
Causes of PCOS
The cause of PCOS is not fully understood but here is what we know through scientific research.
Excess insulin production in the body
Individuals with PCOS show higher levels of circulating insulin
As you may know, when we eat food the stomach turns that food into energy which is turned into sugars through the stimulation of the hormone insulin which is produced in the pancreas. When we eat, we produce insulin which acts to on the body to store that energy in muscles, fat and other body cells.
Individuals with PCOS produce higher than normal levels of insulin in response to food and are therefore are very good and sometimes too good at storing energy. The higher circulating levels of insulin in individuals with PCOS cause the ovaries to stop performing one of their functions which is to ovulate approximately each month.
Hereditary
Research suggests that PCOS may be linked to certain genes. However, it is usually influenced by a combination of genetics, lifestyle and environmental factors.
Excess Androgens
Woman and teens with PCOS tend to produce higher than normal levels of androgens (male hormones) in the body. Because the ovaries of someone with PCOS are exquisitely sensitive to androgens—specifically, testosterone—higher than normal levels of androgens account for hirsutism (excess hair growth), male pattern baldness and acne in individuals with PCOS.
Some research suggests that high insulin levels contributes to the increased production of androgens in the body.
Low grade inflammation and androgen production
Some research shows that individuals with PCOS demonstrate a type of low grade inflammation in the body. Low grade inflammation is a term used to describe the white blood cell production in response to a substance to fight infection. In the context of PCOS this ‘low grade inflammation’ is also thought to contribute to androgen production in the ovaries of women and teens with PCOS.
What are the symptoms of PCOS?
PCOS is characterized by:
- Irregular menstrual periods
- Hirsutism (excess hair growth in women)
- Acanthosis (darkening of skin due to high insulin)
- Abnormal weight gain
- Severe Acne
- Male pattern baldness
- Infertility
The above symptoms can also occur in normal weight women and teens
Co-Occurring Conditions
Women and teens with PCOS are more likely than their non-PCOS peers to suffer from:
- Anxiety
- Depression
- Mood disorders
- Sleep disorders
- Eating disorders
What is Lean PCOS?
Although abnormal weight gain is common in PCOS some women and teens have PCOS in the context of normal weight. This is called ‘Lean’ PCOS.
Why is it important to diagnose and treat PCOS?
Untreated PCOS can lead to health complications such as:
- Infertility Issues
- Gestational Diabetes and or gestational hypertension
- Miscarriage and/or premature birth
- Type 2 Diabetes or pre-diabetes
- Non-Alcoholic Fatty Liver Disease—severe liver inflammation cause by fat accumulation in the liver
- Sleep Apnea
- Depression
- Anxiety
- Eating disorders
- Endometrial Cancer
If you or your teen have any of the following symptoms, it could be PCOS.
There is no one test used to diagnose PCOS.
The diagnosis of PCOS is made through evaluation of:
- Health history including menstrual cycle irregularities
- Family history
- Physical exam for evidence hirsutism and acanthosis
- Weight assessment, Waist Hip Ration and BMI
- Lab tests for metabolic function and androgens
- Anxiety
- Depression
- Acne
- Mood and sleep disorders
- Sleep Apnea
Diagnostic criteria for PCOS include:
1. Irregular Menstrual Periods
- missed periods
- not having a menstrual period
- having too few menstrual periods
- or having a period too often
2. Excess hair growth, a condition called hirsutism in women.
Excess hair growth results from too many circulating androgens (male hormones) in the body. Although men and women both have androgens higher levels in women can result in unwanted hair growth.
For those women who do not have excess hair growth specialized laboratory testing often shows higher than normal androgen levels circulating in the blood. This can manifest as oily skin or acne.
3. Ovarian Cysts
The ovaries of women with PCOS have a cystic appearance on ultrasound. The ‘cysts’ are actually many small fluid filled follicles in the ovary. In the setting of PCOS the follicular sacs often fail to fully develop or release an egg on ovulation.
PCOS in Women
Women and Conception
It is not uncommon for women to learn that they have PCOS during reproductive years. Because PCOS can interfere with conception, the diagnosis of PCOS is sometimes made during the investigation of infertility.
It is important to note that many women with PCOS who experience difficulty becoming pregnant do conceive with hormonal and lifestyle support.
If you suspect you may have PCOS book a consult now!
Our providers and staff at Integrative Health and Preventive Medicine are knowledgeable, skilled and take your concerns seriously. We will work collaboratively with you to find answers to your health concerns.
PCOS in Teens
The diagnosis of PCOS is commonly missed in teens because during adolescents fluctuating hormone levels and immature hypothalamic-pituitary-ovarian (HPO) axis can result in irregular periods in the first year after menses. This is normal in developing teens.
However, if you or your teen continues to experience irregular menses it could be a sign of PCOS. PCOS is a metabolic disorder that affects many body systems and can lead to Type 2 Diabetes, non-alcoholic fatty liver disease and is a risk for endometrial cancer. So early detection along with targeted interventions is necessary.
Accompanying PCOS Symptoms include:
Abnormal weight gain
Do you or your teenage daughter suffer from abnormal weight gain? Do you or your teenage daughter seem to gain more weight than your peers?
Although abnormal weight gain is common in women and teens with PCOS, PCOS can also exist in normal weight individuals. If you suffer from severe acne or hirsutism and have irregular menstrual cycles call now to book a consult.
If you or someone you know suffers from any these symptoms in the context of irregular menstrual cycles book a consult now.
At Integrative Health and Preventive Medicine Clinic we specialize in the diagnosis, treatment and long-term follow-up of PCOS in adolescents, young and older adults.
I’m already in Menopause. Why get tested for PCOS?
Some women learn later in life that their symptoms match the diagnosis for PCOS but they have never been formally diagnosed.
It is important to get a formal diagnosis in menopause because untreated PCOS can lead to endometrial cancer, non-alcoholic fatty liver disease, Type 2 Diabetes and other serious health conditions.
What You Can Expect
Dallis Michelle Martin, Nurse Practitioner specializes in the diagnosis, treatment and management of PCOS in women and teens. She will work collaboratively with you in conducting a comprehensive health history and health assessment. She will perform a comprehensive functional lab assessment and take all information into consideration in making the diagnosis of PCOS. She will provide you with information and functional lab analysis in non-medical terms to support your knowledge and understanding of PCOS. She will also support you in long-term follow-up and management of PCOS symptoms.
Dallis Michelle Martin, Nurse Practitioner will get to know you and your teen and assist you in understanding how the body works in the context of PCOS.
Michelle works in a positive and motivational way to help you and your teen gain the confidence and skills needed to manage PCOS symptoms.
