Though it’s highly likely you know someone with Polycystic Ovary Syndrome (PCOS) (PCOS affects about one in 10 women), many people may not even be aware that they have it. They may write off painful or irregular periods as just part of their normal cycle because they’re so used to them and might not be able to pin weight gain or acne, both possible symptoms, to any specific reason. Many myths about PCOS circulate, like that everyone who suffers from it has unwanted facial hair or is unable to get pregnant, but it’s important to be educated about the facts and know that every case is different. We talked to a few OB/GYNs who gave us the lowdown on what we need to know about PCOS.
1. You may only have some of the symptoms of PCOS. The main cause of PCOS is a hormonal imbalance, which you likely can’t detect on your own. “Anti-Müllerian Hormone, or AMH, a hormone produced inside our ovaries that helps cells mature into eggs, and testosterone, the male sex hormone, are two hormones that can be measured in the blood and play a role in detecting PCOS,” says OB/GYN Nataki Douglas, chair of the medical advisory board at Modern Fertility. “Although the hormones alone can’t diagnose the condition, it can help doctors understand if you may be at risk,” she explains. A few of the other signs to be on the lookout for? Irregular or missed periods, unexplained weight gain, and significant hair growth on your face or chest, Douglas says.
And, Douglas points out, you may not actually have ovarian cysts to have PCOS, but commonly, high AMH levels do cause polycystic ovaries. To be diagnosed with PCOS, you must have two of three medical conditions: irregular ovulation (which usually means infrequent periods), an influx of hormones like AMH and testosterone, or numerous cysts within the ovaries, found via ultrasound, Douglas explains. If you have any combination of the above symptoms, it’s best to check with your OB/GYN for an official diagnosis.
2. It may show up later in your reproductive life. PCOS can be diagnosed soon after you start your first period, but often women notice the signs a bit later on, once they are trying to start a family and have a hard time getting pregnant (because PCOS may cause you to ovulate less often), Douglas says. And your birth control might be concealing the symptoms too. “This is especially true if a woman started taking oral contraceptives as a birth control method when she was young, because if she’s on the pill, she may not know the frequency of her natural menstrual cycle,” she says.
But not all PCOS patients are the same when it comes to their ovulation and menstrual timelines. “Some women may miss periods, have a shorter or longer cycle, or have no periods altogether,” Douglas states. PCOS doesn’t automatically signify infertility either, but may just call for a little bit more regulation with your ovulation schedule, which your doctor can help with.
3. You can still get pregnant with PCOS. If you’ve heard that PCOS prevents you from having children, it’s a myth, doctors say. “PCOS patients who want to get pregnant can get pregnant, but sometimes it means getting a little help medically,” says OB/GYN Asima Ahmad, co-founder and chief medical officer of Carrot Fertility. Ahmad suggests consulting your OB/GYN for certain medications that can aid your fertility by helping you ovulate more regularly, and taking them exactly as recommended by your doctor.
Be advised that if you are not trying to get pregnant, you still can if you have PCOS, Ahmad adds. “Even in women who rarely ovulate, spontaneous ovulation can still occur,” she says, so it’s best to continue with your regular birth control or contraceptive routine to be safe.
4. Birth control might make a difference. Hormonal contraceptives can be one of the solutions for controlling some of the troubling symptoms of PCOS like painful periods (especially if you’ve already tried these natural period remedies). “Birth control pills work as contraception, but have an added benefit of helping with the clinical signs of PCOS, like improving your acne,” Ahmad says. Or, Ahmad adds, certain IUDs can be the best solution for protecting your uterus from something called endometrial hyperplasia. “This is a thickening of the uterine lining, which PCOS women are at increased risk for if they are not ovulating and shedding their lining regularly,” she says. Talk to your doctor about the best solution for you.
5. Weight gain may or may not occur. Your Body Mass Index (BMI) might be affected by PCOS in some cases. One main factor is insulin, the hormone responsible for keeping your blood sugar regular. “Difficulty with weight gain or inability to lose weight is often related to the hormone insulin, which can be elevated in patients with PCOS,” Douglas explains. “In an attempt to maintain a normal blood sugar level, the body will sometimes over-produce insulin, which can result in weight gain.” Insulin imbalances can possibly lead to diabetes or heart disease, Douglas adds, so it’s key to closely monitor what you’re putting in your body if you have PCOS.
6. Diet and exercise are two of the most important factors in coping. Weight and overall health can be crucial for carrying a healthy baby; research shows that maintaining a healthy weight, in particular, can help prevent complications during pregnancy. But regardless of whether or not you’re planning to get pregnant, diet and exercise are a significant part of a healthy lifestyle. “It’s important for all women to maintain a healthy weight, ideally a BMI of 18-25; a diet lower in carbs; and consistent exercise, but particularly those with PCOS,” Ahmad says. A pilot study of women with PCOS found that with a lower-carb diet, they showed improvement in weight loss and fertility, for those who had difficulties getting pregnant. More research has shown that exercise can be a valid form of therapy for PCOS patients, in helping regulate their metabolism and menstrual cycles. (A fitness routine can help you start feeling your absolute best.)
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