What is Polycystic Ovary Syndrome (PCOS)?
Illustration by Kelly Dern.
September is PCOS awareness month! But what exactly is PCOS anyway??
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The estimated prevalence of PCOS ranges from 10% to 18% of women, though some populations may have rates as high as 21%. PCOS is widely under-diagnosed, so it can be challenging to know just how prevalent it is among women in our society.
We don’t know the exact cause of PCOS (yet), but we do know that there are genetic and environmental factors that can contribute.
One of the reasons that PCOS is still widely under-diagnosed is because it can present with different symptoms from woman to woman.
Symptoms of PCOS include:
Absent or irregular periods
Infertility
Hirsutism (excessive hair growth in a male pattern, such as on face, chest, or back)
Thinning hair on head
Acne
Intense carb cravings
Anxiety or depression
Sleep apnea
Weight gain
Insulin resistance
What many don’t realize about PCOS is that you do not actually have to have “cysts” on your ovaries to be diagnosed!
PCOS Diagnosis Criteria:
Must meet TWO of the following three criteria for diagnosis:
Oligo- or an-ovulation (irregular or absent ovulation, often presenting as irregular or absent periods)
Clinical and/or biochemical signs of hyper-androgenism (acne, hirsutism, and/or blood tests showing high androgens)
Polycystic ovaries* (12 or more peripheral follicles)
*Technically speaking, they are not actually cysts, but are immature follicles.
Because you do not need to meet all three criteria in order to be diagnosed with PCOS, some women may have normal periods, and others may not present with any signs of high androgens (androgens are our male sex hormones, like testosterone. Everybody has them, but those with PCOS may just have them in higher amounts).
When working on managing your PCOS, it can be extremely valuable to have a picture of exactly what your body is going through. When possible, it can be helpful to ask your doctor for bloodwork that tests the following:
Testosterone
Blood Sugars: Fasting Insulin, Fasting Blood Glucose, Hemoglobin A1C, and possibly an Oral Glucose Tolerance Test
Total Cholesterol Panel, including LDL, HDL, and Triglycerides
C-Reactive Protein (a marker of inflammation)
Luteinizing and Follicle Stimulating Hormones
Progesterone
DHEA
TSH
As well as nutritional markers such as Vitamin D and Vitamin B12
PCOS Treatment
When working with you on your PCOS, my priority is understanding the root cause of your symptoms, so that our solutions are not just a band-aid.
Eating disorders are also more prevalent in women with PCOS, and so I always take a non-diet approach to your care.
Your treatment may include healing your relationship with food, increasing nutrient-dense foods, balancing meals in order to balance blood sugar and nutrient status, and adding supplements as needed.
There is a lot of information out there that can be misleading, confusing, and overwhelming. If you are ready for an evidence-based treatment approach to your health and nutrition, contact me to book an appointment today.
