My entire life I’ve struggled with hormone imbalances. When I was 11, I remember my pediatrician running blood tests on me as a child and finding out that my testosterone and estrogen levels were abnormally high. However, at the time, they brushed it off and said it was probably because I would soon go through puberty. When I was 17, I went to the pediatrician again for intense cramping in my lower side; she ordered an ultrasound and it was discovered that I had cysts on my ovaries. She told me it was nothing to worry about and that they would go away. When I was 20, I went to the gynecologist with concerns about painful periods, weight gain, and excessive hair growth. She told me it was normal and that maybe I should try the birth control pill. I fought with her to prescribe me an ultrasound and hormone testing. My hormone levels were even more off-balanced than they were when I was 11 and my ovaries still had cysts. She told me that her only treatment option for me was birth control. I knew high testosterone and estrogen coupled with painful periods, excessive hair growth, and unexplained weight gain were not normal, but I had trouble finding a doctor who wouldn't brush off my concerns.
Finally, at 21 years old, I found a functional health doctor who understood and validated my concerns. He ran an extensive hormone analysis on me along with an organic acids test and the results were quite literally off of the charts. My testosterone and estrogen levels were sky high and I had an abnormal level of androgens in my blood. These test results coupled with my irregular periods, excessive hair growth, and ovarian cysts clearly spelled out one diagnosis: PCOS, or Polycystic Ovary Syndrome. Why had it taken me a decade to get diagnosed with a condition I had been suffering from since I hit puberty? Why is it so common for doctors to often brush off a woman’s concern regarding her health? These questions are ones that I ask myself daily, but they aren't the purpose of this blog post.
As someone who has been suffering from PCOS for over a decade and was just recently diagnosed at 21, I think it’s important to spread awareness about PCOS and to give hope to those women who may be suffering from the disorder in silence or without proper access to treatment. Too often doctors (including OBGYNs and gynecologists) will often claim that symptoms of PCOS are of little concern and they temporarily treat those symptoms with prescription birth control pills. PCOS is not a condition that should be taken lightly and health care providers should be providing their patients with comprehensive, effective treatment plans if they have hormone imbalances or symptoms of PCOS. Women with PCOS are more likely to develop endometrial cancer.; they may also be at a higher risk of uterine cancer, breast cancer, and ovarian cancer.
Because of these risks, it’s essential to properly diagnose and treat PCOS as soon as you begin to experience symptoms—properly treating the condition can help to lower the risk of cancers associated with the disease. Personally, I struggle with the irreversible damage that’s been done to my body as a result of my doctors brushing off my concerns and failing to diagnose me earlier. However, I am grateful that I finally do have a diagnosis and will now do everything in my power to help my body heal and function at the best level it can. This post is for anyone who thinks they may be struggling with PCOS, who has recently been diagnosed, or who is currently fighting for a diagnosis. You are not alone and, although PCOS may be a scary diagnosis, if we can all educate ourselves on what PCOS is and how to manage its symptoms our bodies will thank us.
What Exactly is PCOS?
Polycystic ovary syndrome (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. PCOS isn’t a new condition. Italian physician Antonio Vallisneri first described its symptoms in 1721. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form on the ovaries. Please note that some women with this disorder do not have cysts, while other women without this diagnosis r can develop cysts for other reasons. These cysts form because some women with PCOS do not make enough of the hormones needed to ovulate. When ovulation doesn’t happen, the ovaries develop small cysts, which produce hormones called androgens. Women with PCOS often have high levels of androgen, which can cause more problems with a woman’s menstrual cycle. The following are some common symptoms of PCOS:
Missed periods, irregular periods, or very light periods
Ovaries that are large or have many cysts
Excess body hair, including the chest, stomach, and back
Weight gain, especially around the belly
Acne or oily skin
Male-pattern baldness or thinning hair
Infertility
Small patches 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
The exact cause of PCOS is not clear. Many women with PCOS have insulin resistance, meaning their insulin levels build up in the body and can cause higher androgen levels. Obesity can also increase insulin levels and make PCOS symptoms worse. PCOS may also run in families. It's common for sisters or a mother and daughter to have PCOS. Unfortunately, though, many women have PCOS but don’t know it. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed.
How Does PCOS Impact the Body?
PCOS affects the body in different ways, which is why it’s important that it’s diagnosed early. The higher-than-normal androgen levels within the body can impact many aspects of your health. PCOS increases your risk for high blood sugar, high blood pressure, low HDL “good” cholesterol, and high LDL “bad” cholesterol. Together, these factors are called metabolic syndrome, and they increase the risk for heart disease, diabetes, and stroke. PCOS can cause the risk for certain types of cancer, prominently, endometrial cancer. During typical ovulation, the uterine lining sheds, yet if you don’t ovulate every month, the lining can build up. This thickened uterine lining can increase your risk for endometrial cancer.
Another concerning, though not deadly impact for PCOS sufferers who may be trying to get pregnant, is that PCOS can greatly affect fertility. PCOS is one of the leading causes of infertility in women. This is because many people with PCOS don’t ovulate properly or don’t ovulate at all. PCOS doesn't mean there's no chance of pregnancy though; your doctor can talk with you about ways to help you ovulate and to raise your chance of getting pregnant. If you are able to get pregnant with PCOS, as many women do, it’s important to note that the condition can increase the risk for pregnancy complications. People with PCOS are twice as likely as those without the condition to deliver their baby prematurely. They’re also at greater risk for miscarriage, high blood pressure, and gestational diabetes. This is why it’s important to get proper medical care if you become pregnant to ensure that you have as healthy a pregnancy as possible.
Living With PCOS
There aren’t many medical treatment options available for PCOS. Most doctors will prescribe birth control to help regulate hormones and combat PCOS symptoms like acne, excessive hair growth, and irregular periods. They may also prescribe Metformin, a type II diabetes medication that may help control insulin resistance by lowering one’s insulin levels. Your doctor may prescribe drugs like Clomiphene or Letrozole to help with ovulation. While this is a completely valid route for many when it comes to treating PCOS, it’s not always the right choice for everyone. Personally, I am not a big fan of medications, especially birth control and am therefore investigating current holistic treatment options for my PCOS. One of the most important things I’ve found through my research is the relationship between one’s diet and PCOS symptoms. Eating the right foods can help balance your hormones and reduce inflammation within your body. In turn, your PCOS symptoms may start to get better. Three diets that may help people with PCOS manage their symptoms are (always consult your doctor before switching to a new diet!):
A low glycemic index (GI) diet: The body digests foods with a low GI more slowly, meaning they do not cause insulin levels to rise as much or as quickly as other foods, such as some carbohydrates. Foods in a low GI diet include whole grains, legumes, nuts, seeds, fruits, starchy vegetables, and other unprocessed, low-carbohydrate foods.
An anti-inflammatory diet: Anti-inflammatory foods, such as berries, fatty fish, leafy greens, and extra virgin olive oil, may reduce inflammation-related symptoms, such as fatigue.
The DASH diet: Doctors often recommend the Dietary Approaches to Stop Hypertension (DASH) diet to reduce the risk or impact of heart disease. It may also help manage PCOS symptoms. A DASH diet is rich in fish, poultry, fruits, vegetables, whole grain, and low-fat dairy produce. The diet discourages foods that are high in saturated fat and sugar.
Exercise or regular physical activity is also important when it comes to living with PCOS. It does seem that developing healthy habits within your life can definitely make living with PCOS easier. It’s often difficult, though, to establish healthy eating and exercise habits, especially if you suffer from mental health issues. That’s why it’s also important to regulate your mental health if you have PCOS. You may find it useful to join a PCOS support group. You may be surprised at how healing it can be to talk with someone who understands exactly what you’re going through because they’ve lived it first hand.
If you don’t want to take prescription meds, or you’ve tried them and they didn't work, supplements are another valid choice. Although, thanks to the unregulated nature of the industry, not all supplements are created equal. This is why it’s so important to opt for those that are NSF-certified, as well as USP-certified, and are backed by research supporting their effects. Some supplements that are recommended are inositol, which can improve insulin resistance, vitamin D for ovulation regulation, and B vitamins to fight insulin resistance. Overall, living with PCOS is a different journey for everyone. There are many ways to manage this condition and you may need to do some trial and error to find what works for you. Find a doctor you trust who doesn't doubt you. From my personal experience, functional health doctors have been very helpful on my PCOS journey. No matter what, just try your best to prioritize your health and remember that the healing process takes time. There is no cure for PCOS but it can be managed and how you choose to manage the condition is up to you!
By Alyssa Morterud