I wanted to do an in-depth series of posts on polycystic ovarian syndrome (PCOS), because it's so so common - we're talking 8-13% of women who are of reproductive age, with a high number of women still undiagnosed. The prevalence of PCOS among indigenous Australian women is thought to be even higher.
I've seen first-hand the lack of helpful & educational information given to women after being diagnosed with this condition. Following this, there is commonly a lack of treatment options offered to women, specifically options that target their individual contributing factors. I don't personally believe that the oral contraceptive pill is a solution for all the women dealing with this condition.
I want this series to clarify some of the confusion and misinformation around this condition and help you identify the best path for treatment - because this varies considerably depending on you and what's causing your PCOS.
What exactly is PCOS?
PCOS stands for polycystic ovarian syndrome. PCOS is a complex endocrine (hormonal) syndrome that commonly results in ovulatory dysfunction (issues with ovulation), fertility issues & hyperandrogenism (high androgens such as testosterone). Metabolic issues including elevated blood glucose levels, insulin resistance and weight gain are also commonly involved.
Being classified a syndrome, women may experience a wide range of symptoms - anything from menstrual symptoms to acne to hair loss to weight gain. It's important to remember that despite the name, you can have polycystic ovaries (also known as PCO) without having polycystic ovarian syndrome - keep an eye out for my next post discussing the diagnostic criteria used for PCOS.
Also an important note - please don't be tricked into thinking that the presence of cysts on the ovaries cause the condition, they are just one part of it. In fact, these "cysts" seen on the ovaries are actually follicles that are perfectly normal in women of reproductive age; they may just be in excess in women with PCOS. Some newer research suggests that the internal ultrasound usually used to assess for polycystic ovaries may not be necessary to diagnose PCOS in some women - because a lot of healthy women will have a higher number of these "follicles" at some point in their reproductive years, due to hormonal changes and fluctuations.
A higher number of follicles typically seen in PCOS usually coincides with anovulation - meaning the ovaries do not release an egg at ovulation. It is quite normal to see polycystic ovaries and anovulation during adolescence when the menstrual cycle is still being established, that is generally normal. This being said, we know that PCOS involves much more than ovulatory issues; we'll look at all of this in more detail later.
Symptoms of PCOS
Symptoms vary from person to person but generally include some of the following:
Oligomenorrhea or amenorrhea (late periods or no periods at all)
Anovulatory cycles (meaning you do not actually ovulate/release an egg)
Hirsutism (excess hair growth on the face, chest & stomach)
Acne (particularly along the jaw line)
Increase in oil production on the skin and hair
Hair loss or thinning (usually male pattern)
Weight gain or trouble losing weight
Fertility issues (usually subfertility meaning delayed conception - not infertility)
If you think you're suffering from PCOS, it's important not to self-diagnose based on any information you find on the internet - including this post (I want you to get the right diagnosis). Book an appointment with a trusted GP or specialist and discuss your symptoms with them to ensure the appropriate tests are carried out to accurately assess your health concerns. I will however be discussing the current diagnostic criteria for PCOS soon - because I know many women who have been diagnosed much later than they should have been.
Research into the various causes of PCOS is still very much evolving, but it's evident that there are various different factors contributing to the condition - hence why women with the condition can experience many different symptoms. Factors which contribute to the development of PCOS include:
Insulin resistance & blood sugar dysregulation
Stress & adrenal dysfunction
Chronic inflammation - meaning ongoing activation of our immune system associated with many different conditions
Discontinuation of the oral contraceptive pill (which may mean PCOS is temporary)
Gut dysfunction such as dysbiosis & intestinal hyper-permeability
I'll dedicate a more in-depth post discussing the different types of PCOS - but if you're curious check out this blog post by naturopathic doctor Lara Briden discussing the four main types of PCOS.
So, that's the basics, keep an eye out for further discussions. In the mean time, if you have been diagnosed and are looking for natural support to manage the condition - I offer naturopathic consults which look into your whole health history to determine the root issues. You can book here.