The 14 most common questions about Polycystic Ovary Syndrome (PCOS)

PCOS meaning / what is PCOS

Polycystic Ovarian Syndrome is a disorder in which there is primarily a hormonal imbalance in the female body. Women with PCOS may have infrequent or prolonged periods or excessive levels of male hormones (androgens). Numerous small collections of fluid (follicles) may form in the ovaries, which are unable to release eggs on a regular basis.
Many symptoms appear, which depending on the severity can make daily life very difficult. How common is PCOS? What are the most common symptoms of Polycystic Ovarian Syndrome? Is it possible to get pregnant with PCOS?

Here are the 14 most common questions about Polycystic Ovarian Syndrome:

1. How common is PCOS?

Polycystic Ovarian Syndrome is a very common problem among women of reproductive age. It is estimated that 1 in 10 women may suffer from PCOS. Polycystic Ovarian Syndrome is one of the most common causes of hormonal imbalance and ovulation problems in women.

2. Is PCOS an ovarian disease?

No. PCOS is a syndrome of endocrine as well as metabolic disorders. Moreover, just because a woman has a characteristic polycystic ovarian appearance on ultrasound does not mean she has PCOS. Abnormal ovarian appearance is not the only diagnostic criteria for Polycystic Ovarian Syndrome. Cysts on the ovaries may (but do not have to!) be a symptom, not a cause, of PCOS. Moreover, cysts that occur with PCOS are unlikely to be harmful, unlike other cysts, which often grow, rupture, and cause pain.

3. Is PCOS dangerous?

PCOS in itself is not a dangerous condition, but depending on the severity of the symptoms, it can be very disabling, and in addition, it can lead to the development of more serious diseases (such as type 2 diabetes).

PCOS can be mild, with some women experiencing no symptoms associated with the disease. It can also have a more severe course, in which symptoms can significantly impede daily functioning. If this is the case, you may want to seek treatment, and be under the care of a specialist.

4. What are the causes of PCOS?

Unfortunately, the causes of PCOS have not yet been discovered. Among the most common are the influence of lifestyle, environment, but also genetics.

5. What are the most common symptoms of PCOS?

The most common PCOS symptoms include:

Irregular menstrual periods,
Abnormal menstrual periods, e.g., too little or too much bleeding, so-called "missed" periods,
Non-ovulatory cycles,
Infertility,
Polycystic ovaries on ultrasound image - 12 or more follicles,
Metabolic disorders such as insulin resistance,
Abnormal hormonal test results - pituitary hormone disorders, LH to FSH ratio,
Excessive levels of androgens, or male hormones in the female body, which can cause:

- excessive hairiness,
- low voice,
- skin problems such as acne,
- increased sweating,
- greasy skin and hair,
- problems with maintaining normal body weight.

6. Can PCOS be asymptomatic?

Yes, PCOS can be completely asymptomatic in some women.

7. Why is it important to diagnose PCOS? How is PCOS diagnosed?

PCOS is worth diagnosing because if left undiagnosed and untreated it can lead to more serious conditions. Among the most common are:

Insulin resistance / type 2 diabetes,
Infertility,
Obesity,
Cardiovascular disease,
Depression,
Non-alcoholic fatty liver disease (NAFLD).

Early and accurate diagnosis can significantly reduce the risk of developing more serious disorders. In the case of PCOS, medical history is the basis. A woman should tell the specialist about all her complaints and symptoms, menstrual periods and regularity of menstrual cycles. The doctor may order additional tests, including blood tests to determine the concentration of individual hormones (e.g. thyroid hormones, testosterone, prolactin) and blood sugar tests. Your gynecologist will also perform an ultrasound to assess the appearance of your ovaries (if there is an image of polycystic ovaries) and uterus.

8. Can irregular cycles be a sign of PCOS?

They may or may not. Irregular menstrual cycles can be caused by many other factors such as thyroid hormone imbalance. Lifestyle has a huge impact on the hormonal balance and thus on the regularity of menstrual cycles. Too little sleep, a stressful lifestyle, strenuous exercise, rapid changes in body weight can all affect menstrual regularity.

9. Do women with PCOS always have anovulatory cycles?

No. It is true that women with PCOS have more anovulatory cycles than healthy women, but this is not a rule (healthy women have 1-2 anovulatory cycles per year). Another issue is that women who have PCOS often have prolonged cycles and therefore ovulate less frequently. What is the reason for this? Healthy women ovulate once a month on average. Women with PCOS, who often have longer cycles, sometimes as long as 40-50 days, may ovulate once every 2 months or less.

10. Is it possible to get pregnant with PCOS? (PCOS and pregnancy / PCOS and fertility)

Yes. Although Polycystic Ovary Syndrome is a common cause of infertility and can prolong the process of trying for a baby, getting pregnant with PCOS is entirely possible. Due to the symptoms and discomforts associated with PCOS, irregular menstrual cycles, hormonal imbalances, and thus less frequent ovulation, trying to have a baby may take longer. In such a situation, consultation with a reproductive medicine specialist who can provide an accurate diagnosis and effective therapy is crucial.

11. Is PCOS treatment possible?

Of course, it all depends on the course of the disease, the symptoms present, and their severity. Hormonal therapies (e.g. anti-androgens) to restore hormonal balance in the female body, contraceptive pills (not suitable for women trying to have a baby), anti-diabetic drugs, and drugs to stimulate ovulation are all used. A popular drug is metformin, whose task is to balance glucose levels in the patient's blood.

12. Can PCOS be fully cured?

Unfortunately no. The treatment of PCOS is mainly based on symptomatic treatment, rather than on treating the cause of the disorder. However, if the treatment is appropriately chosen by a specialist, and if the woman maintains a healthy lifestyle (healthy diet, exercise), she may not feel the effects of the disease on a daily basis at all.

13. Is lifestyle and diet really that important in PCOS?

The lifestyle of a woman with PCOS is of great importance to the course of the disease. A healthy diet, especially reducing the intake of simple carbohydrates (white bread, pasta, sweets), can help maintain appropriate blood insulin levels, but also reduce the risk of inflammation. Thus, the best PCOS diet is a low glycemic index diet and an anti-inflammatory diet.

Adequate physical activity can help maintain a healthy body weight or lose a few extra pounds, which is especially important if you have ovulation problems. Being overweight or obese with PCOS increases the risk of ovulatory infertility.

An important issue in leading a healthy lifestyle with PCOS is avoiding stimulants, especially cigarettes. The nicotine in cigarettes increases the activity of male hormones (smokers often have increased testosterone levels). Women who smoke often have increased levels of free testosterone and insulin, which can be a direct cause of insulin resistance.

14. Why is it important to record symptoms and track cycles in PCOS?

First of all, tracking your periods and symptoms during your menstrual cycle can help in making an accurate diagnosis of PCOS. One of the primary diagnostic tools is a thorough medical history. A woman who keeps track of her menstrual cycles, noting her periods, spotting, symptoms, but also her mood, has an accurate picture of her fertility. This makes it much easier for the specialist to make the right diagnosis or to order the appropriate tests.

For women who have already been diagnosed with PCOS, tracking menstrual cycles allows monitoring the regularity of menstruation or the frequency of ovulatory/anovulatory cycles. A woman can compare which symptoms associated with the disease (and not only!) recur from cycle to cycle, which intensify, and which are alleviated by treatment, for example. With irregular cycles, which often accompany PCOS, it is important to reliably determine the fertile days and the date of ovulation, which is particularly important for women who are trying to have a baby.