Polycystic Ovary Syndrome (PCOS) is a disorder due to hormonal imbalance and affects approximately 10% of women of reproductive age. Patients with the syndrome generally complain of irregular menstruation, acne, weight gain, fertility problems and other disorders; usually, they also have benign cysts on the ovaries that can be detected by ultrasound. The disease can develop as early as in girls around the age of eleven, but it can arise later in adolescence, at twenty or even later. Since PCOS can seriously affect hormones, menstruation, appearance and fertility, it is essential to get a diagnosis early. Recognizing symptoms early and getting medical attention can reduce complications over the long term.
Steps
Part 1 of 3: Knowing the Key Diagnostic Symptoms
Step 1. Keep track of your period
If you suffer from this syndrome, bleeding is likely irregular, infrequent or absent at all. Look for visible signs of irregularity, take note of the time between menstruation, how many months they do not appear, if the flow is very heavy or light and any loss of blood between one menstrual cycle and another. Pay attention to the following aspects:
- The period between two menstrual cycles exceeds 35 days;
- You have less than 8 menstruation in a year;
- They don't show up for four months or more;
- The duration of very light or very heavy menstruation.
- Studies have shown that about 50% of women suffering from this syndrome have prolonged intervals between menstruation (the medical term is oligomenorrhea); about 20% do not menstruate at all (in this case we speak of amenorrhea), while the case of irregular or infrequent ovulations is defined as oligo-ovulation; on the other hand, anovulation is the total absence of ovulation. If you suspect that you are not ovulating - regardless of whether the source of the problem is PCOS or some other disorder - you should see your gynecologist.
Step 2. Look for an increase in facial or body hair
Women have a limited amount of androgens ("male" hormones); polycystic ovaries, however, tend to produce a large amount of it, due to the higher level of luteinizing hormone (when the levels of this hormone are normal, they regulate the menstrual cycle and the production of eggs) and insulin. This problem can cause some rather distressing symptoms, including hirsutism, an increase in facial and body hair.
You may have excessive hair on your face, abdomen, toes, thumbs, chest, or back
Step 3. Check for hair loss and signs of baldness
An increase in androgens in the body can also cause hair loss, hair thinning or male pattern baldness; you may lose your hair gradually. Pay attention if you notice, for example, more hair than normal in the shower drain.
Step 4. Look for signs of oily skin, acne or dandruff
Hyperandrogenism (excessive androgen production) can also cause these symptoms; you may have oilier skin than usual, acne and even dandruff, which are flakes of scalp that peel off.
Step 5. Ask your doctor for more details of this syndrome
We speak of polycystic ovary when there are more than 12 cysts, each with a diameter of 2 to 9 mm; cysts develop in the peripheral area of the ovary, thereby increasing its volume. In some cases, surgery may be required to remove them. To determine if you actually have polycystic ovary syndrome, your gynecologist must perform an ultrasound.
To obtain the results of the ultrasound, it should be analyzed by an endocrinologist, a doctor who specializes in female reproduction and fertility problems, such as PCOS, endometriosis, in vitro fertilization and other abnormalities of the uterus. If the ultrasound is examined by a doctor who does not specialize in this area, the ovary could be considered "normal", that is, no cancers are noticed; this is because the general practitioner does not have specific training in the pathologies of the female sexual organs and is unable to identify any anomalies. Sometimes, doctors may misdiagnose or suggest that patients train more to lose the excess weight that is secondary to PCOS
Part 2 of 3: Recognizing the Symptoms Associated with PCOS
Step 1. Pay attention to hyperinsulinemia
This disorder consists of an excessive amount of insulin in the blood; sometimes, it is confused with diabetes or hypoglycemia, but it is a different disease. For women with PCOS, it is the consequence of the body's tendency to resist the effects of insulin. See your doctor if you have any of the following symptoms:
- Weight gain
- Desire to eat sugar
- Intense or frequent hunger;
- Difficulty concentrating or staying motivated
- State of anxiety or panic;
- Exhaustion.
- When hyperinsulinemia is a symptom of PCOS, it is associated with an increase in androgen production; this can cause oily skin, acne, and facial and body hair; Additionally, you may notice weight gain in the abdominal area.
- If your doctor suspects you have this condition, they can take you for an oral glucose tolerance test (OGTT).
- Treatment for hyperinsulinemia typically involves a specific diet, an exercise program, and also taking metformin, a drug that lowers insulin levels in the blood. Regardless of whether your doctor prescribes the medicine or not, ask him to refer you to a dietician; proper nutrition plays a fundamental role in the treatment plan.
- Get tested for insulin, blood sugar, hemoglobin A1c, and fasting C-peptide levels. While there is no single test to diagnose insulin resistance, these values are often higher than normal in PCOS patients with insulin resistance.
Step 2. Pay attention to infertility
If you have trouble getting pregnant and have irregular periods, you may be suffering from polycystic ovary syndrome. This disease is in fact the most common cause of infertility in women, since absent or irregular ovulation makes conception difficult, if not impossible.
Higher hormone concentrations can sometimes increase the risk of miscarriages in women with PCOS who are managing a pregnancy; go to the gynecologist if you can't get pregnant
Step 3. Take the problem of obesity seriously
It is always a health concern, but it can also be a symptom of this disease. Due to the increase in insulin, patients often accumulate fat around the waist; in this way, they take on a "pear" shape and generally have difficulty losing weight.
About 38% of women with PCOS are obese; an obese adult woman usually has a body mass index (BMI) of 30 or more
Step 4. Look for signs of skin changes
If you have PCOS, you may develop velvety, brown or black patches of skin on your neck, armpits, thighs and breasts (this is called "acanthosis nigricans"). You may also notice skin tags, small skin growths that often form in the armpits or neck.
Step 5. Monitor pelvic and abdominal pain
Some women with PCOS complain of pain or discomfort in the abdominal or lumbar area; it could be a dull or stabbing pain and can vary in intensity from mild to very severe; the pain or discomfort may be similar to what you feel at the start of your period.
Step 6. Pay attention to the quality of your sleep
Some patients may suffer from sleep apnea, a disorder that leads to snoring and interrupting their breathing periodically during sleep; this pathology can be a consequence of increased estrogen and testosterone or even obesity, both problems associated with PCOS.
Step 7. Be aware of the psychological symptoms
Women affected by polycystic ovary syndrome are quite susceptible to anxiety and depression, symptoms due in this case to physical problems, such as hormonal imbalance; however, they could also be a reaction to other symptoms, especially infertility.
Step 8. Review your family history
The syndrome can be a disease of hereditary origin; if your mother or sister has it, you may develop it too. Also take this factor into consideration to determine if you are predisposed to this condition.
- It is quite common for women suffering from PCOS to have diabetic family members.
- PCOS is a disease that can affect women who were particularly petite or exaggeratedly large at birth.
Part 3 of 3: Knowing the Complications of PCOS in the Long Term
Step 1. Go to the gynecologist
If you suspect that you have this syndrome, you should see your doctor for a check-up; he will review the situation and ask you questions about your symptoms and medical history.
- Regarding the medical history, the doctor will ask you for more information about your family and your life habits, in particular regarding physical activity, smoking, nutrition and stress levels; he will also want to know if you tried to get pregnant without success.
- The doctor will also perform a physical examination: he will check the weight and check the body mass index; will check your blood pressure, examine the glands, and do a pelvic exam.
- He will likely take a blood test to assess your glucose, insulin, cholesterol, and androgen levels, as well as check for other values.
- He will also perform a transvaginal ultrasound to check for cysts on the ovaries.
Step 2. Keep your weight under control
If you are overweight or obese, you may experience more PCOS symptoms; a healthy lifestyle can spare you most of the serious consequences of this syndrome.
- Eat nutrient-rich foods, avoid "junk" food, get plenty of physical activity and don't smoke.
- Learn about the glycemic index. This value indicates a food's ability to trigger a high release of insulin when consumed. It is recommended that you eat more foods with a low glycemic index and avoid those with a high index. You can find the glycemic index of the main foods in many online sites, an example is: www.montignac.com/it/ricerca-dell-indice-glicemico.
Step 3. Pay attention to your blood pressure
Hypertension is a fairly common feature among women with PCOS; check this parameter regularly.
The normal values in women are between 120 maximum and 80 minimum
Step 4. Don't overlook cardiovascular problems
Patients with polycystic ovary syndrome are at an increased risk of developing disorders of this nature; undergo regular medical checks, including a visit to the cardiologist.
Eating a healthy diet, exercising and losing weight can all reduce the chances of developing cardiovascular problems
Step 5. Pay attention to the signs of diabetes
If you suffer from PCOS you are more likely to develop this disease; the most common symptoms include:
- Frequent urination;
- Very intense thirst or hunger
- Extreme sense of fatigue;
- Slow healing from bruises or cuts
- Blurred vision
- Tingling, numbness, or pain in the hands or feet.
Step 6. Be aware of the risk of cancer
The syndrome can put you at risk of developing cancer of the endometrium (lining of the womb), especially if your period is infrequent or absent and you do not bring the problem to the attention of a gynecologist. When hormone levels are abnormal, a woman is at a significantly higher risk of having cancer; hormonal imbalance can in fact be caused by an increase in estrogen and androgen levels, with a reduction in progesterone.
It is possible to reduce this risk by inducing regular menstrual flows thanks to the birth control pill or through the periodic administration of a synthetic form of progesterone. You can also use an intrauterine coil (IUD) that contains a progestin, such as Mirena
Advice
- If you have been diagnosed with PCOS, read this article for more information on how to live with the disease and manage it.
- An early diagnosis can help you avoid most of the troubling symptoms. If you notice any suspicious signs, seek medical attention. Be sure to report any symptoms you have to your doctor; you don't have to focus only on aspects like infertility or obesity, but you have to give them a complete picture of your health status.
- Women who suffer from PCOS (or who suspect they have this syndrome) may feel uncomfortable, depressed, or anxious about the symptoms they experience. Make sure these feelings don't interfere with the treatment you need and try to lead a fulfilling life. If you start to feel very depressed or anxious, talk to your family doctor or see a psychologist.
