PCOS – Polycystic Ovary Syndrome- is a metabolic condition that affects women of childbearing age. It’s so common that 1 in 10 women is said to have PCOS. However, the name alone is misleading as it is more than just having cysts on the ovaries. You don’t need to have ‘cysts’ -as it’s so called- to be said to have PCOS. Some women have polycystic ovaries without having PCOS and some women have PCOS without having polycystic ovaries. So, the Rotterdam criteria is the best way to diagnose PCOS.
Symptoms of PCOS
For a woman to be said to have PCOS, the woman must have at least 2 out of the following 3 most common symptoms;
- Polycystic ovaries – 12 or more follicles on the ovaries. This can be seen in an ultrasound. Looks like a ‘string of pearls’. Polycystic ovaries are not the same with Ovarian Cysts.
- Irregular or missing periods or delayed ovulation. Having less than 9 cycles a year or periods longer than 35 days.
- High Testosterone- characterized by acne, hair loss and hair growth around the chin, chest, upper lip and jaw or by bloodwork (DHEA and Testosterone).
It is also possible to have all 3 symptoms including other symptoms such as;
- Weight gain
- Anxiety and Depression
- Mood swings
- Skin pigmentation
- Belly fat and more.
Being overweight is not a common symptom because not every woman with PCOS is obese. We have lean women with PCOS.
POSSIBLE CAUSES OF PCOS
Researchers know that Genetic and Environmental Factors contribute to the development of PCOS but they don’t know exactly what causes PCOS.
The mutation of one or more genes tend to run in families and passed on from one generation to the other. So if a female in the lineage of the woman had/has PCOS, there is a higher chance of it passing down through the genes to any female born in that lineage.
Also, our DNA changes its functions according to the environment.
Recent research suggests that in some cases, PCOS may be caused by chemical changes that occur while in the womb. When a baby develops in the womb if there is excess androgens, excess insulin or exposure to endocrine disruptors (from plastics, pesticides, toxins from beauty products and fragrances) these can be the starting point that allows PCOS to arise later at puberty.
ROOT DRIVERS OF PCOS
When treating PCOS, there are underlying causes responsible for the symptoms you may be having.
- Insulin Resistance – This is the most common root cause of PCOS. About 70% of women with PCOS is said to be insulin resistant. This root cause happens when the body is resistant to the effects of insulin -a hormone that regulates blood sugar. Your pancreas keeps releasing insulin and when your cells don’t recognize the insulin, it leads to high insulin levels overtime, driving the symptoms.
Insulin resistance affects ovarian function leading to excess androgens. Symptoms of insulin resistance- Skin pigmentation, irregular periods, cravings, brain fog, weight gain, facial hair, acne, weight gain, fatigue etc
- Inflammation – Affects digestion, gut health and impairs absorption of nutrients and food. Symptoms – Constipation, bloating, PMS,
- Adrenal Dysfunction- this is majorly caused by chronic stress. There are 2 types of stress- Acute stress and Chronic stress. Acute stress is the good type of stress that helps us in our day to day life e.g if you saw a dangerous snake and tried to run away from it, you can agree with me that your heart beats faster, your breathing increases, it’s the stress (cortisol) and adrenaline hormones that causes this. After you are out of danger, your heartbeat slows down and your breathing normalizes. While chronic stress is that which makes our body feel like it’s constantly under threat.
When your body is continuously under a fight-or-flight state, that’s chronic stress, and it can have serious implications on your physical and mental health. Chronic stress can cause inflammation, depression and other diseases. It can affect fertility, weight, hormones, gut and all aspects of your life. Symptoms – High Androgens, insulin resistance, insomnia, mood swings, weight gain and fatigue.
If you, dear reader, know anyone living with this condition, please do all you can to support them. Don’t give up on them, or call them lazy or tell them they are just looking for excuses or offer unsolicited advice. Be there for them. Living with PCOS is a daily struggle and we need all the support we can get.