September was PCOS Awareness Month across the globe. 

What is PCOS?

PCOS stands for PolyCystic Ovarian (or Ovary) Syndrome. 

The name is a bit of a misnomer because you don’t actually have to have polycystic ovaries to be diagnosed with PCOS. You have to meet 2 or 3 of the following criteria* to be diagnosed with PCOS:

1. Infrequent cycles and/or anovulatory cycles – these can show up as irregular cycles

2. Symptoms of high androgens or elevated androgen levels on bloodwork – the androgens we’re looking at are testosterone and DHEA, and the signs and symptoms can look like hair loss, hirsutism, and cystic acne)

3. Polycystic ovarian morphology – this refers to having lots of immature follicles visualized using ultrasound and is not the same as having an ovarian cyst

*And none of these symptoms are caused by a different condition as high prolactin levels, thyroid disorders, and hypothalamic amenorrhea can look like PCOS. 

What can PCOS look like?

Apart from irregular cycles, elevated androgens, and polycystic ovaries, PCOS can show up as or be linked to: fatigue, anxiety, depression, infertility, subfertility, insulin resistance, fatty liver, cardiovascular disease, diabetes, pregnancy loss, gestational diabetes, gestational hypertension, IBS, obesity, vitamin D deficiency, thyroid disease, and acanthosis nigricans. 

What causes PCOS?

PCOS is a multifaceted condition and while there’s no specific cause for it, there’s a strong genetic link as it tends to run in families. You may be at a higher risk of developing PCOS, if you have a blood relative with PCOS, type 2 diabetes, non-alcoholic fatty liver disease, or a thyroid disorder. It can show up in your teens or it can show up as an adult. 

What can be done about PCOS?

PCOS can be managed conventionally, naturally, or with a combo of both approaches. A multimodal approach is best here so that you’re supporting your current and future health. That being said, I want to make sure I address the use of the birth control pill for PCOS. 

The pill is often prescribed for “regulating cycles”; however, the combination pill that has estrogen and progesterone suppresses ovulation entirely (which is why it’s great for preventing pregnancy but not so great for supporting your PCOS). It’s not going to cure or fix your PCOS, it’ll mask it. Once you come off the pill, the likelihood of your PCOS symptoms returning in full force is high unless you implemented other changes in your life. Ultimately, it’s your decision if you’d like to use the pill or not, but I want to make sure you have this info at your disposal as you weigh your options. 

There’s no one way to support and manage your PCOS. It all depends on who you are, where you’re at, what your symptoms and history are, how much time and resources you have, what your goals are, and what else is happening in your health and life. It’s always recommended that you consult with your healthcare team so you get the best care possible.