A common hormone disorder for women in their childbearing years, PCOS affects 5% to 15% of women and can have an adverse impact on their fertility [1].
While there are telltale signs of PCOS, like irregular periods, there is also a fraction of the population with PCOS that might be unaware that they even have it.
Here’s your handy guide to understanding what PCOS is, the symptoms to look out for, how it can affect your chances of pregnancy and treatment options.
Disclaimer: The information provided in this post is not intended as medical advice.
What is Polycystic Ovary Syndrome (PCOS)?
Polycystic Ovary Syndrome, better known as PCOS, is a hormone disorder where a woman’s ovaries produce excess androgen — a higher than normal level of male hormones in your body [2]. PCOS can cause small cysts to form in a woman's ovaries, or along the outside of the ovaries, hence the name polycystic. However, not all women with PCOS develop these fluid-filled sacs [2].
This abnormal amount of androgen can cause irregular periods or even cause periods to stop completely [3]. Women with PCOS could also be at higher risk of other health problems such as diabetes, high cholesterol, heart disease and high blood pressure [3, 4].
What causes PCOS?
While there isn’t a specific thing in particular that causes PCOS, it can be linked to your genes [3]. For example, if your mother or sister has PCOS, you are more likely to have PCOS as well. PCOS is also more apparent in women who are overweight [7].
Insulin resistance, where your body is unable to use insulin properly, could also be a cause of PCOS, affecting up to 70% of women with PCOS [5]. This extra insulin can cause your body to produce excessive male hormone androgen, resulting in you having a higher than normal level of male hormones [7].
Symptoms of PCOS
The different symptoms of PCOS can appear as early as your first menstrual period, or could develop slightly later on, often apparent by your early 20s [3, 4].
Here are some of the key symptoms that women with PCOS might notice [3]:
- Irregular periods: With your hormones out of whack, you might face irregular periods, particularly when you don’t ovulate. Women with PCOS could miss periods or have fewer periods within the year. E.g. 8 or fewer periods in a year compared to the usual once a month [6].
- Very light, or very heavy bleeding during menstruation: With irregular periods, women with PCOS could also face heavier bleeding, as your uterine lining has a longer period of time to build up, between periods.
- Excessive hair growth: Called hirsutism, excessive facial and body hair growth is a key symptom that affects 65% to 75% of women with PCOS [1]. Sometimes, hair loss or male-pattern baldness can also happen.
- Acne or oily skin: With more male hormones in your body, you could experience oilier skin, which could in turn cause acne breakouts. Post-adolescent acne as a symptom affects between 12% and 14% of women with PCOS [1].
Other symptoms PCOS also include [5]:
- Weight gain
- Larger than normal ovaries
- Darkened patches of skin or excess skin at your armpits, neck or under your breast
- Headaches
If you have some of the symptoms listed above, especially if you are trying to conceive, it’s best to set an appointment with your fertility specialist to check if you have PCOS. Alternatively, you could consider using an at-home hormone test to get a comprehensive view on your reproductive health.
Complications of PCOS and how PCOS affects you
PCOS can be a cause of infertility, or difficulty to conceive. With PCOS, if you aren’t ovulating, that means there is no egg for the sperm to fertilise.
Besides fertility difficulties, potential health conditions that are complications of having PCOS include [7]:
- Risk of diabetes
- Metabolic syndrome (e.g. high blood pressure, high cholesterol, etc.)
- Higher risk of miscarriage or premature birth
- Higher risk of endometrial cancer
PCOS can also cause other lifestyle concerns such as sleep apnea, depression or anxiety [6].
The effects of PCOS on conception and pregnancy
If you’re struggling to get pregnant, PCOS might just be a reason behind that. In fact, many women find out they have PCOS only when they find it difficult to get pregnant and seek medical advice [6].
So, can you still conceive if you have PCOS? The short answer is yes, though it could be more challenging than someone else without PCOS [6].
How does PCOS affect pregnant mothers?
For pregnant mothers, PCOS increases the risk of a miscarriage or premature birth. More specifically, women with PCOS are 3 times as likely to have a miscarriage in the early stages of pregnancy compared to women without PCOS [8].
Other pregnancy complications that mothers with PCOS could face include having gestational diabetes, pre-eclampsia, pregnancy-induced high blood pressure, and requiring caesarean delivery [6].
Due to the pregnancy risks associated with PCOS, your doctor could schedule more frequent check-ups for you during the course of your pregnancy.
How will you know if you have PCOS?
While the symptoms listed above can indicate that you might have PCOS, these symptoms are also similar to other health conditions, such as having ovarian cysts.
Some women also don’t showcase any PCOS symptoms. In such a scenario, how will you know if you have PCOS?
While there isn’t a single test that solely helps to diagnose PCOS specifically, there are a handful of medical tests and checks that can be carried out to indicate the possibility of PCOS. These checks can include a discussion on your medical history, existing medical conditions and medications you might be on [9].
To help diagnose PCOS, the following tests and exams could be done [6, 9]:
- Blood tests to check on your androgen hormonal levels. This can also help detect other health problems similar to PCOS, such as menstrual problems in general, or thyroid disease [6]. Additional blood tests could also be required, such as tests for cholesterol levels [6], or a glucose tolerance test [9].
- Ultrasound to check your ovaries for cysts, while also checking on the thickness of your uterus lining and womb
- Pelvic exam to to check if ovaries are larger than normal, have unusual masses, or to check for other visible signs of higher levels of male hormones
Medical treatment options and remedies available
While PCOS can’t be cured, lifestyle and dietary changes can help to keep your symptoms under control. Hence, early diagnosis of PCOS can help to prevent metabolic and cardiovascular complications, while improving one’s long-term health [1].
Lifestyle and dietary changes
As with many other health conditions, one way to reduce symptoms is to ensure you maintain a healthy diet and put in a regular amount of physical exercise. This can help you to achieve a regular menstrual cycle, which in turn affects fertility.
As PCOS is more apparent in people with obesity, losing weight is a key factor for overweight women that have PCOS. Losing weight helps to regulate your hormone levels and also increase the effectiveness of PCOS-recommended medications [9].
Medication
Medication can be taken to help reduce PCOS symptoms, as well as help a woman induce ovulation, particularly if you are trying to conceive [6].
Other treatments for various symptoms of PCOS [9, 10]
- Hormone treatment to regulate your hormones
- Birth control pills to lower androgen production, or regulate oestrogen
- Laparoscopic keyhole surgery on the polycystic ovaries
- Fertility treatments like Intrauterine insemination (IUI) or In Vitro Fertilisation (IVF) if fertility issues continue to persist
If you have PCOS, you could also be required to get more tests done to check on the complications of PCOS, such as regular checks on your blood pressure, blood glucose levels and cholesterol levels [9].
To check on your hormone levels, you can do so from the comforts of your home simply by purchasing the twoplus Fertility Hormone Test Kit. While it might not tell you right off the bat that you have PCOS, you’ll get a better understanding of your hormone levels, and hence, fertility health. (Note: This Hormone Test Kit does not measure androgen levels.)