PCOS is a disorder in women in which we see three main components: polycystic ovaries, increased levels of androgens (male hormones), and ovulatory dysfunction. Although its cause in unknown, treatment is geared towards addressing symptoms and preventing long term health problems that can result from PCOS.
Why do women get PCOS?
There is no direct cause of PCOS, however insulin resistance has been shown to play a part. Obesity is also a comorbidity that can amplify the symptoms of PCOS, however approximately 20% of women with PCOS are not obese.
What do women with PCOS look like?
This totally varies, as women with PCOS can present to the doctor for a variety of reasons and can all look totally different. Some women may present due to ovulatory dysfunction and infertility, ie the egg is not releasing each month, therefore you find yourself unable to conceive. Other women may present for physical manifestations of excess androgens, like acne, hair overgrowth, and even hair thinning or balding. As mentioned above, some women with PCOS suffer from obesity, while others do not.
What are the management options for PCOS?
PCOS is managed by treating each symptom, with the underlying key to keeping hormones in balance. One of the best ways to manage PCOS is through lifestyle modification. It’s been shown that an increase in exercise combined with dietary changes can reduce the risk of diabetes equal to that of medications. Weight loss can also decrease the excess of male hormones produced by the body. In addition to lifestyle modifications, your doctor may prescribe you an insulin sensitizing agent, which is a medication that helps to regulate your blood sugar levels. This medication in combination with lifestyle modifications can decrease androgen levels, improve ovulation, and improve blood sugar levels.
For women who have menstrual disorders related to PCOS, one of the main stays of therapy include combination low dose hormonal contraceptive pills or OCPs. OCPs help to decrease the excess levels of androgens, while also allowing you to have a regulated period each month.
There is also a wide array of medications used to treat PCOS that target specific hormones within the body. It’s important that if you are experiencing symptoms of PCOS, that you speak with your doctor as to which specific regimen is the best for your body and its specific imbalances.
The bottom line with PCOS is that it's complex and each woman is different. Starting off with lifestyle modifications, including exercise and a healthy diet, is a great place to begin even prior to seeing your doctor. Although we can’t pinpoint why certain women suffer from this condition, it’s important to know that there are treatments options available to you. So, reach out to your Ob-Gyn and please post your questions/concerns here in the LW community!
Dr. Shweta Desai