Polycystic What?! The Truth about PCOS

Women should know the truth about PCOS or Polycystic Ovarian Syndrome.

• It is actually a diagnosis of exclusion.

• It is a misnomer. You don't even have to have "polycystic ovaries" to have PCOS.

• The original name was Stein-Leventhal Syndrome for the physicians who first described it in 1935.

• Women think they have PCOS when they don't or think they don't have PCOS when they do.

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So I'm sure a lot of you mujeres have heard of polycystic ovarian syndrome or PCOS. Everyone knows a friend who has this. But what are the symptoms? Well, you usually have to have at least two out of three symptoms to meet the criteria and they include:

#1 menstrual abnormalities ranging from heavy, irregular, infrequent or absent menstrual cycles

#2 excess hair on your face, chin, lower abdomen or in other words excess androgens or increase in male hormones

#3 one or two polycystic ovaries depending on the number of follicles or volume of ovary per ultrasound

So if you think you have at least one of these symptoms it may be worth going to get checked out by your doctor for further evaluation and to understand the disease and what your future implications are. Now mujeres, if you look up what Dr. Google has to say, he describes the typical PCOS patient as obese, hairy, full of acne and infertile. But as you all know, he doesn't know the real 411 on this syndrome so if you think you could fall into this category, don't freak out, breath and let's learn about PCOS.

So at one of the most recent American College of OB/GYN Conferences, an expert in PCOS has described that this syndrome is not always just the female that was described above. There are actually four types of mujeres that can fall into the syndrome but each has its own symptoms and implications associated with their type.

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PCOS Phenotypes include:

Phenotype A. A female that meets all 3 of the above criteria. This is usually your typical patient.

Phenotype B. Excess androgens and menstrual abnormalities

Phenotype C. Excess androgens and polycystic ovaries meeting criteria on ultrasound

Phenotype D. Menstrual abnormalities and polycystic ovaries meeting criteria on ultrasound

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So what does all this mean for the PCOS patient?

#1. Well, of course, the first thing to consider is how to treat your disease. Usually, the first line of treatment will start with hormonal options such as low dose birth control pills or progesterone containing IUDs to help regulate your hormones and get your cycles back on track or at least protect your endometrial lining, which can thicken and cause risk for growth of precancerous cells in the uterus. This treatment can also work to decrease androgens and help minimize excess hair growth.

#2. Well, most of the phenotypes include excess androgens and this actually increases your risk for diabetes and cardiovascular disease, so working on diet and exercise is key. There is not a specific diet for PCOS patients but we know high protein and low carbs, as well as restricting calories, will help you decrease your weight and in turn, decrease your risks. Sometimes weight loss can be more difficult for PCOS patients, so metformin can be a treatment to decrease insulin resistance and in turn help weight loss sometimes.

#3. And of course, something that is always on a PCOS patient's mind...What about my future fertility? Yes mujeres, because this syndrome usually affects your ability to ovulate it may be difficult to conceive but this does not mean you can't have a baby!! Certain criteria per your doctor must be met before you can consider an ovulation induction agent, but if you are a good candidate there is hope for having a baby one day.

Well, those are the basics of PCOS. I hope it clears some things up and helps you realize what PCOS truly means and how you can help yourself!

Dr. Erica

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