If you’re anything like us, polycystic ovary syndrome (PCOS) is something you obliquely fear, but don’t know much about. Since September is PCOS Awareness Month, we thought we’d do some digging as to what, exactly, this affliction entails. We enlisted the help once more of Dr. Hal C. Danzer of the Southern California Reproductive Center as well as that of Health and Wellness Coach Nicole Granato, who cured herself of PCOS symptoms naturally in just four months. Keep reading for your cheat sheet to this common health problem.
Your PCOS Cheat Sheet
According to WomensHealth.gov, the root cause of PCOS is a hormonal imbalance—women with PCOS typically have high levels of androgens, which are sometimes thought of as male hormones, as well as high insulin levels. "Polycystic ovary syndrome is an illness characterized by irregular (or no) periods, acne, obesity and excess hair growth," says Nicole. "Women diagnosed with PCOS typically have small to large cysts that grow on their ovaries that can affect fertility and ovulation."
Adds Dr. Danzer, "PCOS is a genetic disease, and it's very common—it affects as many as 15% of women."
"Some of the biggest signs of PCOS are lack of periods, excessive hair growth, sudden weight gain, pain in the pelvis or ovaries and acne," Nicole reiterates. "However, I have a problem with doctors diagnosing women with PCOS with no signs of cysts. I believe if there are no cysts, women should be diagnosed with a hormonal imbalance instead, as essentially that is what it is."
When a woman has PCOS, her ovaries don't make all of the hormones they need in order for an egg to mature, which means she will fail to ovulate. She will also fail to produce progesterone, which further disrupts or inhibits her menstrual cycle. This can lead to fertility issues. Additionally, studies have shown that 50% of women with PCOS will have diabetes or pre-diabetes by the age of 40, their risk of heart attack is between four to seven times greater than those who don't suffer from the syndrome, and they are also prone to high blood pressure, high cholesterol, sleep apnea, anxiety and depression. Many of those side effects, says Dr. Danzer, are due to weight levels, as opposed to the disorder itself. Women who have high androgen levels, like PCOS suffers, he says, will often find it difficult to maintain a healthy weight despite their best efforts.
According to Nicole, "Some doctors will have diagnosed PCOS without looking at the ovaries, and some do not diagnose it until they do an ultrasound. It really depends on your doctor!" Generally, a diagnosis will include some combination of the following: a thorough medical history, a physical exam, a pelvic exam, blood tests and a sonogram.
According to Dr. Danzer, there is no cure for PCOS. Nicole, however, disagrees. "I keep hearing there is no cure for PCOS, but I cured myself. I went from being diagnosed to being un-diagnosed—I would say I am cured. I do believe everybody is different, so while I have experience working with women who have been un-diagnosed, I also have experience with women who are not, but who greatly improve their symptoms and quality of life." This makes sense, since PCOS is generally treated with exercise and diet modifications that limit processed food intake and increase the consumption of whole foods—methods by which Nicole swears. Dr. Danzer agrees that diet and exercise are a significant part of the treatment plan when it comes to managing PCOS, and says that many women can return their cycles to normal via these means alone. Doctors will often prescribe a birth control pill as well, he says, since it will inhibit the production of androgens, regulate periods and reduce acne. Doctors may also use certain diabetes medications, fertility medications and anti-androgens to treat the side effects of PCOS.
In 2015, actress Jaime King spoke out about her struggles conceiving due to PCOS. She now has two children, but she suffered five miscarriages and went through five rounds of IVF to become pregnant with her first child. Nicole, however, does not see PCOS as a guaranteed barrier to conception. "I don’t think it's fair to look at statistics, because there are many women who can’t get pregnant but also don't have PCOS," she says. "I think there is a greater chance for women to get pregnant if they do the steps necessary to prepare for pregnancy, take care of their bodies, stay off medications and eat well. These changes and improvements to your lifestyle when trying to get pregnant with PCOS will be game-changers." Dr. Danzer agrees that the outlook for women with PCOS who want to conceive is good, and says that those who don't regain the ability to ovulate through diet and exercise can often be treated with fertility drugs such as Clomid, and, if that fails to result in pregnancy, IVF.
"PCOS is a genetic disease," Dr. Danzer says. "So if your mom has it, your chances of getting it are somewhere around 25 to 30%." Healthy diet and exercise habits can reduce symptoms though, and Dr. Danzer says it's important that women experiencing irregular periods or signs of high levels of the male hormone (facial hair, etc.) see their doctor to be evaluated. "Women with PCOS are at high risk for developing type 2 diabetes later in life," he cautions. "That's why they need the diagnosis, because there are long-term ramifications to the disease."