Things You May Not Know About PCOS

PCOS, or polycystic ovary syndrome affects approximately 10 million women of reproductive age across the world. It is known by those who have the disorder to cause everything from unwanted facial hair, to excruciating pain, to infertility, yet little is known by the average Joe due to the fact PCOS mainly affects women, and it affects the reproductive organs, which are a taboo subject in the Western world. However, I have PCOS and it is my goal to break down that stigma and teach others about the disorder.

Not everyone with Polycystic Ovary Syndrome has polycystic ovaries.

The name "polycystic ovary syndrome" is the definition of a misnomer. If a person's gynecologist believes they may have polycystic ovary syndrome, the doctor will use a system known as the Rotterdam criteria to investigate. According to the Rotterdam criteria, a person must have two out of the three symptom groups in order to be diagnosed with polycystic ovary syndrome. These symptom groups are:

1. High levels of male sex hormones, usually testosterone
2. Irregular periods, sometimes absence of a period for extended periods (pun intended) of time.
3. Polycystic ovaries (Polycystic ovaries are ovaries with multiple fluid-filled sacs, known as cysts)

Thus, a person can have high levels of testosterone shown on blood tests or physically through facial hair and irregular periods, but not polycystic ovaries and still have polycystic ovary syndrome. In fact, a person who has the first two symptoms may not even get an ultrasound to determine if their ovaries have cysts simply because it's already been proven they have polycystic ovary syndrome, and an ultrasound is not needed.

Polycystic Ovary Syndrome doesn't just affect the ovaries.

As with the previous bullet, it may already seem obvious that polycystic ovary syndrome does not just affect the ovaries. But did you know Polycystic Ovary Syndrome can also affect a person's brain in the form of negatively impacting mental health? According to a longitudinal study published in the journal Fertility and Sterility, women with polycystic ovary syndrome are at a much higher risk for depression than their healthy counterparts. Whether or not this is due to high levels of testosterone, body image, or infertility is unclear; however, another study, published in the journal Steroids states that mental health is unrelated to BMI or excess weight in people with polycystic ovarian syndrome. At least that is good, because...

Polycystic Ovary Syndrome can cause insulin resistance, weight gain, and type 2 diabetes.

Obviously, it's important to treat a syndrome that can affect hormone levels and cause people pain. But did you know that, if left untreated, polycystic ovarian syndrome can cause type 2 diabetes? According to an Australian study, women without polycystic ovary syndrome had a 0.3 percent chance of developing type 2 diabetes, whereas women with polycystic ovary syndrome had a 5.1% chance of developing it. That may not seem like a large increase risk, however, that is almost six times the normal rate! That is why it is so important for people with polycystic ovary syndrome to see their primary doctor, endocrinologist, and gynecologist regularly and develop healthy lifestyle habits.

Polycystic Ovary Syndrome is the most common cause of female infertility.

This probably is not shocking, since polycystic ovary syndrome affects so many people, but polycystic ovary syndrome is the most common cause of infertility in women. This is because polycystic ovary syndrome can cause ovulation to be irregular, or hinder ovulation entirely. Ovulation testing, in vitro fertilization, or other types of fertility treatments can be possible options and solutions for those struggling with infertility caused by polycystic ovary syndrome, and there are support groups for those struggling with PCOS-related infertility. For some, adoption or fostering children may be the best solution due to the expenses acquired from IVF or other medical interventions.

Polycystic Ovary Syndrome wasn't the original name.

Polycystic Ovary Syndrome used to be called Stein-Leventhal syndrome, named for Irving F. Stein, M.D. and Michael L. Leventhal, M.D., who discovered and first researched the disorder, beginning in the 1930s. However, it was not given a name until the 1950s, when Irving Stein published "The Stein-Leventhal Syndrome: A Curable Form of Sterility". Nowadays, it is known simply as Polycystic Ovary Syndrome, however, some advocates wish to return to the original name, as not everyone with polycystic ovary syndrome has polycystic ovaries. A rose by any other name would smell as sweet. This rose, however, is not the sweetest, no matter the name.

Polycystic Ovary Syndrome was recorded very early on.

Despite its relatively new discovery, Polycystic Ovary Syndrome has been written about and recorded since ancient times, just not under this name. Hippocrates said once, “But those women whose menstruation is less than three days or is meager, are robust, with a healthy complexion and a masculine appearance; yet they are not concerned about bearing children nor do they become pregnant,” in Diseases of Women 1. Soranus of Ephesus also once said “[s]ometimes it is also natural not to menstruate at all... It is natural too in persons whose bodies are of a masculine type... we observe that the majority of those not menstruating are rather robust, like mannish and sterile women”. Polycystic ovary syndrome is not a hot new trend, it has been recorded for many millennia.

Polycystic Ovary Syndrome can lead to obstructive sleep apnea

Obstructive sleep apnea is a disorder that causes the muscles in the throat to relax and prevent breathing. Obstructive sleep apnea can cause a person to wake up in the middle of the night due to their throat getting too relaxed and stopping breathing, leading to falling asleep randomly during the day, attention issues, and irritability or mood instability. Sleep apnea can also be potentially fatal if a person does not wake up in time when they stop breathing. Women with polycystic ovary syndrome are 5-10 times more likely than people without Polycystic Ovary Syndrome to develop obstructive sleep apnea. Sleep apnea can be treated, but only if it is discovered and understood by the person who has it, and this link is not often discussed.

Polycystic Ovary Syndrome is also linked to nonalcoholic fatty liver disease

There has been shown to be a link between nonalcoholic fatty liver disease and polycystic ovarian syndrome. This is due most likely to obesity, fatty weight being carried around the midsection, and insulin resistance, which are all factors in nonalcoholic fatty liver disease for people with polycystic ovary syndrome. Lifestyle changes are key for fighting this disease; however, there is no standard of care for patients with nonalcoholic fatty liver disease and polycystic ovary syndrome. People with polycystic ovary syndrome really have a lot on their plates when it comes to other chronic illnesses and risks!

Polycystic Ovary Syndrome can only currently be treated, not cured.

A simple Google search of “PCOS cure” reveals hundreds of articles from women claiming they have cured or healed their polycystic ovary syndrome through diet, exercise, medication and vitamin routines, yoga, or crystals. But none of this is simply true. There is currently no permanent cure for polycystic ovary syndrome. However, treatments such as diet, exercise, and medication can help treat symptoms. When a person finds the right regimen for them, they may feel like they’re cured, but the polycystic ovary syndrome is still there, and just a few slip-ups can cause a person with polycystic ovary syndrome to feel like they are back at square one.

A regimen for Polycystic Ovary Syndrome may look like simply eating the right foods and staying fit with a regular exercise routine. Some women diet using the ketogenic diet, eating organic, or using programs such as Weight Watchers or Whole30. While this is great for anyone, healthy or not, for some people with polycystic ovary syndrome, a diet change and exercise plan may not help every symptom. For some people, medications such as metformin, an insulin medication; birth control or other hormone replacement therapy; or spironolactone, an anti-androgen medication may assist with insulin resistance, chronic pain, weight loss, or other issues caused by polycystic ovary syndrome. It is important for every person to talk to their doctors and specialists and come up with a solution best for them, as polycystic ovary syndrome and its various issues can vary so vastly from person to person.

A cure for Polycystic Ovary Syndrome may be in the near future.

Despite the outlook currently feeling rather bleak for those of us with Polycystic Ovary Syndrome, a recent study done by Dr. Paolo Giacobini shows there may be hope. Dr Giacobini and his team triggered Polycystic Ovary Syndrome in prenatal mice by exposing them to too much anti-Müllerian hormone in-utero. Then, Dr. Giacobini’s team were able to reverse the polycystic ovary syndrome by injecting the drug cetrorelix, a medication usually used for IVF. By the end of 2018, they are hoping to have a trial of cetrorelix specifically tailored for people with polycystic ovary syndrome. Over 80 years after polycystic was given its first name, and millennium after Polycystic Ovary Syndrome was first written about and recorded, and a cure may just soon be in the grasps of those who need it.