Polycystic Ovarian Syndrome: What Is It? (P.S. it’s more common than you may think)
Perhaps one of the scariest experiences a girl can experience in her lifetime is missing her period. Most of the time, this is associated with being pregnant. However, it can also be a sign of more serious health problems. One such health condition is polycystic ovarian syndrome (PCOS).
During my senior year of high school, I missed my period for about six months. I knew I wasn’t pregnant, I didn’t have a boyfriend, I wasn’t even dating or seeing any guys. The first month I missed it, I didn’t think much of it, I just thought my period was going to be a little late, which had happened to me before. Around the third month mark, I finally brought it up to my mom. She got concerned and made an appointment for me to see a gynecologist as soon as possible.
From my research online, knowledge of my family history, and a recent acne breakout, I had suspected that PCOS may be the cause of my missing periods. I finally went to the gynecologist. After a blood test and an ultrasound, she confirmed I had PCOS.
According to the Office on Women’s Health, PCOS is caused by an imbalance of hormones, typically a spike of male hormones (testosterone and androgens), preventing the ovaries from releasing an egg (ovulating) and thus preventing menstruation. This typically causes irregular or completely absent periods, which can, in turn, be a cause of infertility in women, and promotes the development of cysts in one or both ovaries. PCOS is also known to be a genetic condition.
Despite the name of the condition, women diagnosed with it do not necessarily have many cysts. Two of the three following conditions must be met for a woman to be diagnosed with PCOS:
- Irregular/absent periods (typically less than eight periods in a year)
- High levels of male sex hormones (androgens and testosterone)
- At least 12 cysts on one or both ovaries
Commonly, women with PCOS also have acne, hair on areas of the face or body where men typically experience hair growth (called hirsutism), thinning hair like male-pattern baldness, weight gain, darkening of the skin, and skin tags. Other symptoms of the condition include anxiety and depression, due to the increased number of androgens. Many women with the condition find it difficult to lose weight, despite their earnest efforts, whether they are overweight or are of a healthy weight.
PCOS is caused mostly by high levels of androgens and testosterone but is also likely caused by high levels of insulin, caused by insulin resistance, which is genetically linked to diabetes. Because the body cannot absorb sugar correctly, it overproduces sugar, causing the body to produce more testosterone and androgens. Studies have shown that most women with PCOS have insulin resistance, and thus may have a risk of being prediabetic or diabetic before age 40. However, it is possible to have the condition without insulin resistance, as my blood tests showed that I do not have it.
The most common ways of dealing with PCOS are to maintain a healthy diet and exercise routine, go on a birth control pill, and/or go on a medication that controls insulin (if the woman has insulin resistance). My PCOS is regulated through a hormonal 28-day regimen birth control pill (Kariva). I can honestly say that being on the pill feels great to me in general, as it keeps my periods short and light, and it regulates my body to have a period every month on the same day every month. I will say that transitioning to the pill wasn’t easy, as I did feel a bit nauseous some days, but after being on it for over three months now, I have little to no symptoms. It is important for women to menstruate monthly because if they do not, the uterine lining will continue to grow and increases the chance of endometrial cancer. Birth control also helps women with PCOS to control their acne, but this cosmetic effect only starts to happen about six months after starting the birth control regimen.
Although PCOS is manageable, it is important to understand that there are future health risks, such as becoming diabetic or prediabetic, and having a higher risk of developing breast cancer, endometrial cancer, heart disease, and having difficulties getting pregnant (in fact, PCOS is the leading cause of infertility in women). However, my gynecologist did say that it is possible for me to outgrow the disease when I’m out of college because my onset of PCOS was likely induced by stress.
PCOS affects more women than you may think. About 1 in 10 women are affected by the disease, and about 50% of them are undiagnosed. Many women find it helpful to talk to other women with the disease. There are resources available such as PCOS Challenge to help women with the disease.
Unfortunately, there is not much information available about the disease. Not only do not many women know about it, but also some doctors do not know much about the disease, and thus women are not given enough information about the disease. People studying the disease are also struggling to find its root causes and other possible long-term consequences.
If you suspect you may have PCOS, contact a gynecologist. Also, understand that because this is your body, you have every right to ask your doctor any questions you may have and to ask for what you believe you should receive in terms of care and treatment.
Parker, Sydney. “When Missed Periods are a Metabolic Problem.” The Atlantic, 26 June 2015,
“Polycystic Ovary Syndrome.” Office on Women’s Health in the U.S. Department of Health and
Human Services, 22 October 2018, https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome