“So, as suspected, you have PCOS. You won’t be able to lose weight, but don’t gain more. You have a very low chance of falling pregnant. Also, you’re going to be on birth control for the rest of your life”.
At 17 years old, hearing this diagnosis from my gynaecologist – so bluntly, without any whys or hows – seemed like a death sentence. Being forced to research the condition myself led me down a dark path, and my depression got worse along with the other side effects of hormonal contraceptives. I became hyperaware of my body and its flaws, which were actually symptoms, and felt like a failure for not having a functioning reproductive system. Where did I go wrong?
As it turns out, I didn’t. In fact, PCOS (polycystic ovarian syndrome) is estimated to affect 1 in 12 people with female reproductive organs and a menstrual cycle. Of those who have it, most go undiagnosed as PCOS symptoms are often similar to other conditions. Five years after my diagnosis, I feel like I am finally figuring out my body. So, in light of September being PCOS Awareness Month, let’s talk about it!
What is PCOS?
PCOS is an endocrine and metabolic disorder, primarily affecting the ovaries and hormone functions. There is no known cause, but research points to genetic factors. The name is somewhat misleading as not all people with PCOS have ovarian cysts, but it is a common symptom and one of the obvious ways one can be diagnosed.
Symptoms
Aside from possible cysts, irregular and painful menstrual cycles, weight gain, excess facial hair, and dark patches of skin especially in the neck are common symptoms of PCOS. There are also long-term side effects such as irregular ovulation and low fertility, increased risk of high blood pressure, type 2 diabetes, heart disease, and depression. It is important to note that you don’t need all of these symptoms to be diagnosed with PCOS, but that they could also be indicative of other conditions.
Diagnosis and treatment
Diagnosis is done by a gynaecologist, usually after an ultrasound (to check for irregularities on the ovaries) and bloodwork (mainly to look at androgen levels – overproduction is a clear sign of PCOS). They also take your symptoms and menstrual history into account. The diagnosis process is not invasive, but your experience may vary depending on your gynaecologist. Some specialise in conditions like PCOS and endometriosis and may offer you more valuable information, while others (like mine) may lack the knowledge to guide you.
Treatment options vary, but there is no cure. Hormonal contraceptives are the most common prescription and are usually offered as a pill, but you may be able to use alternative methods. Myo-inositol supplements and alternative diets (specifically dairy-free, gluten-free, and keto) have been used to successfully treat PCOS symptoms and help with weight loss, but these should only be followed after discussion with a medical professional. Many dieticians also specialise in PCOS treatment, and most do not recommend changes other than lower sugar and increased fibre intake.
If you would like to have children, it is important to know that there is an increased risk of miscarriage and other complications. The good news is that many people with PCOS have successful pregnancies, with and without fertility treatments! It can be disappointing to hear that your reproductive health may be impacted, but modern medicine has helped many with PCOS have healthy pregnancies.
What to do if you think you have PCOS
If you have experienced any symptoms associated with PCOS, get in touch with a doctor who can refer you to a gynaecologist at a hospital of your choice. Remember that PCOS is misunderstood and poorly researched, so finding an effective treatment is likely to be trial and error. It took me 4 years to realise that birth control was worsening my symptoms, and another year to figure out alternative treatment options. Ultimately, PCOS is not a one-size-fits-all condition. Do what’s best for you and your physical and mental health.