Millions of women are affected by Polycystic Ovarian Syndrome (PCOS), a common hormonal disorder affecting individuals with ovaries. Yet it remains one of the most underdiagnosed and misunderstood health conditions, often leaving women struggling with its hidden challenges.
It is estimated that about 5 to 10 million women in the United States have PCOS, making it one of the most common hormonal disorders among individuals of reproductive age. This equates to approximately 6-12% of women of reproductive age (ages 15 to 44), although the condition can affect individuals of all ages, from adolescence to menopause. The true prevalence of PCOS is estimated to be higher since many women with the condition have not been diagnosed and may not know they have it.
PCOS can occur shortly after puberty, in later teen years, or early adulthood and can present a wide range of symptoms. The most common symptoms include:
Irregular Periods:
- Infrequent, irregular, or prolonged menstrual cycles
Excess Androgen Levels:
- Elevated levels of androgens (male hormones) can lead to physical signs such as:
- Hirsutism: Excess hair growth, typically on the face, chest, back, or abdomen
- Acne: Severe or persistent acne, especially on the face, chest, and upper back
- Male-pattern Baldness: Thinning hair or hair loss on the scalp
Polycystic Ovaries:
- Ovarian cysts or enlarged ovaries and follicles around the ovaries
Weight Gain or Difficulty Losing Weight:
- Weight gain, especially around the abdominal area, and difficulty losing weight despite efforts
Fertility Issues:
- Infertility due to irregular or absent ovulation, making it harder to conceive
Insulin Resistance:
- Insulin resistance, which can lead to elevated blood sugar levels and increase the risk of developing type 2 diabetes.
Skin Conditions:
- Dark patches of skin, particularly in body creases such as the neck, groin, and under the breasts (a condition known as acanthosis nigricans)
- Acne
Mood Changes:
- Mood disorders such as depression, anxiety, and mood swings
These symptoms can vary in severity, and some women may have only a few signs, while others experience a combination of several. Women who notice any of these symptoms should consult a healthcare provider for diagnosis and management.
Symptoms of PCOS can overlap with other health issues, leading some women to be unaware that they might have PCOS. For instance, a woman may think her irregular periods are just a normal part of life rather than a sign of PCOS.
Women are most often diagnosed in their 20s and 30s, especially those who report trouble getting pregnant to their health care providers, since PCOS is a leading cause of infertility.
Various tools are used to diagnose PCOS, including clinical symptoms, physical exams, blood work, and ultrasounds. It is often underdiagnosed and frequently takes more than a year to get a diagnosis, as the process includes multiple provider visits, referrals to medical specialists, and ruling out oconditions like thyroid disease.
There is not currently a cure, but PCOS can be well-treated and managed. The first line of treatment typically involves lifestyle changes, such as adopting a healthy diet, engaging in regular physical activity, managing stress, and achieving weight loss if necessary. While weight loss can be challenging, medications may be prescribed if lifestyle interventions prove insufficient. For many women with PCOS, losing just 5-10% of their body weight can significantly reduce symptoms.
Medications are also available to help address irregular menstrual cycles, excess androgens, and glucose intolerance. If lifestyle changes don’t improve fertility, fertility drugs may be considered.
Women with PCOS usually work closely with their primary care providers, but multidisciplinary teams may also be involved. Your care team may also include specialists like gynecologists, dermatologists, behavioral health consultants, and registered dietitians. For those trying to conceive, referrals to fertility or reproductive specialists can be made when necessary.
Women with PCOS each have their own unique journeys, and it’s essential to work closely with your health care team to diagnose, treat, and help manage the condition over time. Utilizing all available resources is important to help manage symptoms, optimize health, and decrease the risk of developing long-term complications. It is also necessary to be aware of the psychological impact of PCOS, including anxiety, depression, and body image issues. Mental health professionals are becoming more involved in the treatment process, encouraging more holistic care for those affected by the condition.
For women experiencing symptoms related to PCOS, the first step is to contact their health care provider. With early diagnosis and treatment, symptoms can be well managed, and long-term health risks can be minimized.