In my high school sex ed class, we were taught briefly about sex hormones. These hormones are responsible for growth of hair, breasts, and muscles, as well as production of the reproductive organs. Predominantly, females have the sex hormone estrogen, and males have testosterone. The picture painted seemed clear as day; your body either had one or the other. What I didn’t realize was that women also have androgens, a male sex hormone, in addition to estrogen. And, when cisgender women have an imbalance of those hormones, as statistically as many as one out of 10 women do, that can be polycystic ovary syndrome, commonly known as PCOS.
“It is important to understand that PCOS is not a disease, it is a syndrome,” explains family physician Dr. Angela Kerchner, MD. “A syndrome is when a person has certain characteristics that, when put together like pieces of a puzzle, cause certain things to happen in the body.”
Read on to learn more about PCOS—what it is, the signs, and how it’s treated.
How common is PCOS?
PCOS is an endocrine disorder that affects people with ovaries; the condition is quite common, affecting as many 5 million women in the United States.
What is PCOS, exactly?
In addition to estrogen, women have androgens, which are male hormones that females also make. With PCOS, the ovaries make more androgens than normal, and the high levels of these hormones then affect ovulation. The imbalance of estrogen and androgens can also be seen via physical symptoms. Many people with PCOS also have cysts in their ovaries.
While the exact cause of PCOS is not entirely known, there are some factors that are known to play a role. Extra insulin—which is the hormone that the pancreas produces for your cells to use glucose—could increase the amount of androgen hormones produced in the body, thereby affecting the ability of the ovaries to ovulate, according to the Mayo Clinic. Low-grade inflammation is also suspected to be a culprit, and the condition is believed to have some genetic basis.
What are the signs of hormone imbalance?
Hormone imbalance “can be found with blood tests, or might be seen on your body,” Dr. Kerchner says. “Some of the most common things found are male-pattern hair growth, meaning hair on your chin, upper lip, chest, belly, or back. Some people may have hair loss, known as alopecia, which is also a sign of too many male hormones. Severe acne is also common.”
PCOS can also have symptoms beyond acne and facial hair. Sherry Ross, MD, an obstetrician-gynecologist, says that irregular periods are a common sign: “Your periods can come every two weeks, every three to six months, or once a year. When your periods come less often, they tend to be heavier, last longer and with more painful cramping.” Some other signs include weight gain, depression, anxiety, and infertility. “Many women with PCOS have difficulty getting pregnant,” Dr. Kerchner says. “This is because in order to get pregnant, you have to ovulate, and PCOS can cause ovulation to happen less often.”
How is it treated?
While you can’t prevent it if you are genetically predisposed, you can manage it. The birth control pill is often prescribed to those with PCOS, notes Alisa Vitti, a hormone expert and functional nutritionist who is the founder of FLO Living. And “there are androgen-blocking pills that help reduce the levels of circulating testosterone in the body, [which] helps minimize acne flares, excess face and body hair growth, and can reduce the scalp hair loss,” notes dermatologist Tsippora Shainhouse, MD.
However, lifestyle changes with exercise and diet are an extremely important element in managing PCOS since they address the root of the hormone issues, Vitti says.
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