Polycystic Ovary Syndrome (PCOS) is a condition that many women have, but only a few understand. Depending on the country, the prevalence of PCOS ranges between 2.2% to 26% (Source:  Reproductive Biology and Endocrinology), and it is considered to be one of the most common causes of infertility in females.

Among Women of Colour, the frequency of PCOS is higher, but due to the range of symptoms associated with PCOS, and how they might manifest, it has been reported that up to 75% of women with PCOS have not been diagnosed (Source:  U.S. National Library of Medicine). It also means that many Women of Colour, in particular, may go on to experience metabolic and cardiovascular comorbidities associated with PCOS, such as such as insulin resistance, higher blood pressure and impaired glucose metabolism; but PCOS is not recognised as a key contributor to those conditions.

 

1.  So what is PCOS?

According to John Hopkins University, PCOS is

“…a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.”

Essentially, PCOS is a hormonal imbalance in which a female does not make enough of the hormones needed to ovulate. Moreover, when ovulation does not happen, the ovaries can develop many small cysts, and these cysts make androgens, or male sex hormones, an example of which is testosterone. As a result, many women with PCOS have high androgen levels, which is the cause of many of the symptoms associated with PCOS.

 

2.  So What Are The Symptoms Of PCOS?

The symptoms of PCOS are varied and may include the following:

• Ovaries that are large or have many cysts
• Missed periods, irregular periods, or very light periods
• Hirsutism, or excess body hair, including the face, chest, stomach, and back
• Weight gain, especially around the abdomen
• Mood changes
• Acne or oily skin
• Male-pattern baldness or thinning hair
• Infertility
• Skin tags (small pieces of excess skin) on the neck or armpits
• Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts

Generally, the onset of PCOS tends to occur during puberty, and around the time of the first menstrual cycle. However, it can also develop later.

It should be noted that there is no single test to diagnose PCOS. Your physician will need to investigate, which could include a physical and pelvic examination, along with requesting a variety of tests to be done. Usually, and to make a diagnosis of PCOS, at least two of the following signs must be confirmed:

• Polycystic ovaries
• Excess androgens, due to elevated male hormone levels, and may manifest physically as excess facial and body hair (hirsutism), severe acne, or male-pattern baldness
• Irregular menstrual cycles, which means that they could be infrequent, irregular or prolonged.

 

3.  So What Are Some Of The Complications Of Associated With PCOS

One of the big challenges with PCOS is the fact that in addition to the signs and symptoms that tend to be associated with the condition, many additional complications can occur in women who have PCOS. According to the Mayo Clinic, they include the following:

• Infertility
• Gestational diabetes or pregnancy-induced high blood pressure
• Miscarriage or premature birth
• Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver
• Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease
• Type 2 diabetes or prediabetes
• Sleep apnea
• Depression, anxiety and eating disorders
• Abnormal uterine bleeding
• Cancer of the uterine lining (endometrial cancer).

 

4.  How Is PCOS Treated?

First, it is important to note that there is no cure for PCOS, but symptoms can be managed. However, treatment for PCOS depends on a number of factors, including the patient’s age and overall health, and the severity of the symptoms. Also, treatment tends to focus on managing the concerns of the patient, such as if she wants to become pregnant, or wants her severe acne treated, or wants the excess hair managed or removed.

It is also highlighted that being overweight can increase the severity of the symptoms. So depending on the patient, weight management and the associated lifestyle changes, may be the focus in the first instance.

 

5.  Okay, So Now What?

As stated earlier, PCOS tends to go largely undiagnosed. Physicians tend to only go through the effort to diagnose it when patients present symptoms for which PCOS could be the cause, such as infertility or hirsutism. However, and in some respects, the greater concerns should be the complications of PCOS, which it may be possible to better manage, if PCOS is recognised as the source.

To that end, and if you believe you may have PCOS, do have a conversation with your doctor and express your concerns, as your quality of life and your long-term health may be at stake.

 

 

Image: Dasha Mak (Pexels)