How Do I Know If I Have PCOS? I Symptoms and Treatments I Golden Gate

Introduction

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting approximately 10% of women of reproductive age globally. More than a reproductive disorder, PCOS is a complex symptom with metabolic, cardiovascular, and psychological implications. Awareness and timely diagnosis are paramount for several reasons. They facilitate early intervention, which can mitigate long-term health risks associated with the syndrome, such as infertility, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Moreover, understanding and managing PCOS symptoms can significantly improve a woman’s quality of life and self-esteem, reducing the psychological burden often carried by those affected. 

In a world increasingly focused on women’s health issues, shedding light on conditions like PCOS is essential. By fostering an environment of knowledge and support, we can empower women affected by PCOS to seek the care they need and lead healthier, more fulfilling lives. Recognizing the signs and symptoms of PCOS and advocating for comprehensive healthcare can make a significant difference in the lives of millions of women and their families. At Golden Gate, we understand the importance of PCOS and are here to guide you through the process.

What Are the Key Symptoms of PCOS to Watch For?

Recognizing these symptoms is a critical step toward seeking help and receiving a diagnosis. It’s essential for women experiencing these signs to consult with a healthcare provider for a comprehensive evaluation and personalized management plan.

1. Irregular Menstrual Cycles: 

A hallmark symptom of PCOS is menstrual cycle disruption. Women may experience  irregular periods, commonly fewer than nine cycles in a year, (oligomenorrhea), absence of periods for three or more consecutive months (amenorrhea), impacting fertility.

2. Excessive Androgen Levels: 

Elevated levels of male hormones, aka hyperandrogenism,  can lead to physical signs such as excessive facial and body hair (hirsutism), severe acne, and male-pattern baldness (androgenic alopecia). These symptoms stem from the ovaries overproducing androgens. Most women with PCOS have both clinical and biochemical evidence of hyperandrogenism. Asian women with PCOS, have lesser degree of hirsutism than do non-Hispanic White or Black women. Serum total testosterone is the best way to assess androgen level, more accurately by liquid chromatography-tandem mass spectroscopy (LC-MS/MS). The upper limit of normal for serum testosterone in women is in the 45 to 60 ng/dL range (1.6 to 2.1 nmol/L) depending on laboratory calibration. 

3. Polycystic Ovaries: 

Many women with PCOS have enlarged ovaries containing numerous small, fluid-filled sacs known as follicles, detectable via ultrasound, typically transvaginal ultrasound. Note that having polycystic ovaries alone does not confirm PCOS; symptoms must also be present.

4. Weight Gain and Obesity: 

A significant proportion of women with PCOS struggle with weight gain and obesity, especially around the waist, exacerbating insulin resistance and leading to further health complications. Approximately 40-85% of women with PCOS are overweight or obese., 

5. Insulin Resistance: 

A condition where the body’s cells do not respond effectively to insulin, leading to elevated blood sugar levels and subsequently increased risk of diabetes. Though an underlying issue, it significantly contributes to PCOS symptoms.  Insulin resistance is present in both lean and obese women with PCOS (30% and 70%, respectively)

6. Infertility: 

A common issue face by women with PCOS, this is due to the absence of ovulation, anovulation nature of PCOS. For women who wants to get pregnant, TVS (transvaginal scan) is used in those anovulatory infertility to monitor follicular growth and number, as well as to document occurrence of ovulation.

7. Skin Changes: 

Besides acne, women may notice darkening of the skin (acanthosis nigricans) in body creases and small skin tags in these areas.

8. Fatigue: 

Increased fatigue and low energy levels may be linked to poor sleep, sleep apnea and metabolic disturbances.

9. Mood Disorders: 

Hormonal imbalances can contribute to mood swings, depression, and anxiety, affecting mental health and quality of life.

Why Does PCOS Affect Women Differently?

1. Genetic Diversity

• Genetic Factors: The genetic makeup of an individual plays a significant role in how PCOS manifests. Specific gene variations associated with PCOS can influence the severity of symptoms. Since these genetic predispositions vary widely among individuals, the expression of PCOS symptoms can also vary significantly.
• Family History: Women with a family history of PCOS are at a higher risk of developing the condition. The interplay of multiple genes inherited from parents can affect the risk and presentation of PCOS, leading to variations in symptoms among family members.

2. Environmental and Lifestyle Influences

• Diet and Nutrition: Dietary habits can influence the severity of PCOS symptoms. High intake of processed foods, sugars, and unhealthy fats may exacerbate symptoms, while a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage them.
• Physical Activity: The level of physical activity significantly affects insulin resistance, weight management, and hormonal balance in women with PCOS. Those who are more active may experience milder symptoms compared to those with a sedentary lifestyle.
• Exposure to Environmental Toxins: Emerging research suggests that exposure to certain environmental toxins may play a role in the development and severity of PCOS symptoms. These toxins can interfere with hormonal balance and metabolism.

3. Hormonal Variations

• Androgen Levels: The degree of androgen excess can vary greatly among women with PCOS. Those with higher androgen levels may experience more severe symptoms such as hirsutism, acne, and androgenic alopecia.
• Insulin Sensitivity: Variations in insulin sensitivity and the degree of insulin resistance can affect the severity of PCOS symptoms. Women with higher insulin resistance may struggle more with weight gain, metabolic issues, and anovulation.

4. Obesity and Weight

• Impact of Obesity: Obesity exacerbates many PCOS symptoms, especially insulin resistance, hormonal imbalances, and menstrual irregularities. The distribution of body fat, particularly increased abdominal fat, is closely linked to the severity of PCOS symptoms.
• Weight Fluctuations: Changes in weight over time can also influence the manifestation of PCOS symptoms. Weight loss can improve symptoms for many, while weight gain may worsen them.

5. Age and Life Stages

• Variability Over Time: The impact of PCOS on a woman’s health and reproductive system can change with age. For instance, menstrual irregularities may become more pronounced during adolescence and perimenopause.
• Post-Menopausal Changes: The risk factors and symptoms of PCOS can evolve as women age, especially after reaching menopause. While the risk of endometrial cancer may increase, other symptoms such as menstrual irregularity and acne may subside.

Treatment Options for PCOS

The management of PCOS is highly individualised, with treatment plans tailored to address the specific symptoms and goals of each woman. Successful management of PCOS often requires a combination of lifestyle changes, medication, and sometimes alternative therapies. Regular follow-ups with your doctors are essential to monitor progress and adjust treatments as necessary. Women with PCOS should be encouraged to adopt a proactive approach to their health, seeking support from a multidisciplinary team of healthcare professionals, including gynecologists, endocrinologists, dietitians,mental health providers and TCM fertility practitioners .

1. Lifestyle Modifications

• Diet and Nutrition: Adopting a healthy diet that emphasizes whole foods, lean proteins, and vegetables can help manage weight and reduce insulin resistance. Low glycemic index (GI) foods are particularly beneficial in stabilizing blood sugar levels.
• Physical Activity: Regular exercise, including both aerobic and resistance training, can help lose weight, improve insulin sensitivity, and reduce cardiovascular risk factors. Even a modest weight loss of 5-10% can significantly improve PCOS symptoms.
• Weight Management: For overweight or obese women, weight loss is often the first line of treatment recommended. Reducing body weight can help decrease insulin levels, lower androgen levels, and improve ovulation and menstrual regularity.

2. Medications

• Hormonal Contraceptives: Birth control pills, patches, or vaginal rings that contain oestrogen and progestin can help regulate menstrual cycles, reduce androgen levels, and manage acne and excess hair growth.
• Metformin: This medication is primarily used to treat type 2 diabetes but can also be prescribed for PCOS to improve insulin resistance, regulate menstrual cycles, and assist with weight loss.
• Clomiphene (Clomid): For women with PCOS who wish to become pregnant, Clomiphene can stimulate ovulation. Letrozole (Femara) might also be used for this purpose.
• Spironolactone: This anti-androgen medication can help reduce hirsutism and acne by blocking the effects of androgens on the skin. Due to its potential effects on a developing fetus, it’s crucial to use effective contraception while on this medication if sexually active.
• Hair Removal Treatments: Options such as laser hair removal and electrolysis can be used to manage unwanted hair growth, although they may require multiple sessions and can be costly.

3. Traditional Chinese Medicine (TCM) Treatments

• Herbal Therapies: TCM utilizes various herbal formulas to target different aspects of PCOS, aiming to restore balance and improve ovarian function. Spearmint tea, for instance, has been studied for its potential to reduce androgen levels in women with PCOS.
• Acupuncture: Some studies suggest that acupuncture can help improve menstrual frequency, manage symptoms of PCOS, and could be beneficial for fertility by improving blood flow to the ovaries and reducing stress levels.
• Dietary Modifications in TCM: TCM emphasizes dietary adjustments that align with an individual’s specific constitutional needs, potentially aiding in managing PCOS symptoms. Foods that are believed to nourish the body, support the spleen, and regulate Qi are often recommended.

When to Seek Medical Advice for PCOS Symptoms

Seeking early medical intervention is crucial if you’re experiencing symptoms suggestive of PCOS, particularly if they interfere with your daily life or you’re trying to conceive. Early diagnosis and treatment can reduce the risk of long-term complications.