What is PCOS?

PCOS is a complicated medical disorder which can and does wreak havoc on women’s lives. PCOS stands for Polycystic Ovarian Syndrome and the illness is sometimes (though rarely nowadays) referred to as Stein-Leventhal Syndrome after the husband and wife team who discovered it in 1935. It is a syndrome rather than a disease because there is no single set of identifying symptoms present in all sufferers. In fact, even though most patients present with cysts on their ovaries, not all women with this condition have these cysts. Conversely, women may have cysts on their ovaries but not have PCOS. In essence then, even the name of this illness is quite misleading and can cause confusion. 

PCOS is very common affecting about 5-10% of all women. In fact, 90% of women with irregular periods have PCOS. The symptoms of PCOS are many and varied which may be one of the reasons why it often goes undetected and the diagnosis can be difficult to make.

Common Symptoms

Irregular periods (consequently irregular ovulation)

 Infertility

Acne

Excess body hair (i.e. on the face, stomach, thighs)

Male pattern baldness 

Insulin Resistance (symptoms of this include constant hunger, tiredness, cravings for sweets, inability to lose weight even on a low calorie diet )

Migraines

Pelvic Pain

Serious Complications

Type 2 Diabetes (40% of sufferers develop Type 2 diabetes by age 40)

Endometrial Hyperplasia (i.e. abnormal pap smears)

Cancer of the Endometrium

Depression

Hypertension

Heart Disease

Obesity

As you can see from the above list this condition must be treated seriously and managed properly so as to avoid serious health risks. Unfortunately it is chronically under diagnosed and, in Ireland anyhow, many doctors are not knowledgeable about this syndrome so are only willing to prescribe birth control pills. The pill may have its place in the management of symptoms for some women but it is not suitable for all women. Certain pills can also worsen insulin resistance in women making it next to impossible for them to lose weight.

The name 'Polycystic' means 'many cysts' and most women with this disorder have cysts on their ovaries. These cysts are not cancerous. They are simply underdeveloped follicles out of which an egg should have been released. There are also hormonal alterations of androgens such as testosterone and generally an abnormal LH:FSH ratio. In an ovulating woman without PCOS the LH:FSH ratio should be 1:1. However, in Polycystic women the ratio is more usually 2:1 or 3:1.

Insulin resistance occurs in 40-80% of PCOS patients. Insulin is the body’s fat storage hormone. When a meal is consumed insulin is released from the pancreas and aids in pushing glucose (sugar) into cells. Glucose is the body's main fuel. When a person is insulin resistant however, cells are resistant to insulin so glucose (sugar) cannot enter cells. Consequently more and more insulin has to be produced until eventually it succeeds in pushing some sugar into cells. However, there remains a high level of insulin in the bloodstream and, since insulin stores fat it is not difficult to predict what will happen when there is an excess amount of it floating around in a persons system. 

Also, because the insulin has to work so hard to get sugar into the cells, oftentimes an insulin resistant person suffers episodes of hyperglycemia. Hyperglycemia simply means high blood sugar levels, and can cause symptoms such as excessive thirst, fatigue and dry mouth. It has been hypothesised that when symptomatic women don't test as insulin resistant it may be due to the fact that their body produces a smaller amount of this hormone than other women's bodies do. Also, because there are so many undiagnosed sufferers with insulin resistance, lab values may be set too high. Therefore, if a women has PCOS and/or the symptoms of insulin resistance then she most likely does indeed have PCOS. Insulin resistance also occurs in thin women as does PCOS. According to Thatcher (2001), thin women may even have a more severe form of PCOS with more entrenched insulin resistance and infertility. 

According to recent theories, Type 2 diabetes develops from insulin resistance because the  pancreas becomes exhausted at pushing out all that insulin and eventually stops. Then diabetes occurs. Because insulin levels are so important in controlling weight, blood sugar, and satiety and have a knock-on effect on other hormones such as testosterone it is vitally important that insulin levels are kept at a steady level. Also, high levels of insulin are implicated in practically every disease of civilisation such as heart disease, high blood pressure and cancer. Many women find that following a low carbohydrate or low G.I. diet keeps these insulin levels in check and consequently their symptoms improve. There is further information about nutrition in the diet section.

No single cause of PCOS has been identified so therefore it has been difficult to find a solution to the problem. Currently there is no cure for PCOS and symptoms must be managed and controlled instead. Much research however is indicating that many of the symptoms of the disorder are related to the body’s use of insulin and the very latest research indicates that PCOS may be caused by a fault in the hypothalamus.  

It is essential that all women with PCOS keep a careful watch on their health status so as to prevent serious complications (as above) arising from the disorder. The best way for a women to stay healthy is to be an informed patient and not just a passive recipient of doctor’s orders. As the old adage goes 'knowledge is power' and it is my wish that this website helps you on your vital journey to better health.

Do you have PCOS?  http://www.pcosupport.org/support/quiz.php