Polycystic Ovarian (or Ovary) Syndrome, also known as PCOS, is an endocrine disorder caused by an imbalance of hormones in people with ovaries. This hormonal imbalance means that people with PCOS produce more androgens (“male” hormones) than is normal or expected. This leads to symptoms such as (but not limited to) irregular menstruation, no ovulation (anovulation), excessive hair growth, excessive acne, and hair loss or thinning. PCOS is also predominantly connected to obesity, diabetes, and heart disease. It affects up to 20% of the world’s population of people with ovaries and is the leading cause of infertility. However, PCOS is severely under-researched, thus leading to a lot of misinformation, lack of diagnosis, and various subpar treatments.
So, for the sake of much-needed education, let’s bust some common PCOS myths:
- PCOS is self-inflicted (caused by the person with PCOS)
This is false. Whilst the cause of PCOS is yet to be identified due to lack of research, most existing literature argues that it is a mixture of genetics and environmental factors. This means that if someone in your family has PCOS, it is likely that you may also develop PCOS (given that you have ovaries, of course). Environmental factors considered to be linked to PCOS are diet and environmental toxins-some even suggest that microplastics contribute to it as they enter the bloodstream and disrupt hormone levels. Many people chalk PCOS up to being caused by high androgen and insulin levels, but the root of these problems is not always identifiable. The main takeaway here is that a person does not give themselves PCOS.
- Only overweight people have PCOS/being overweight causes PCOS
Again, this is not true. PCOS affects menstruating people of all shapes and sizes. PCOS is linked to obesity, but it isn’t the root cause of it. This myth exists because it is very common for someone with PCOS to rapidly gain weight and then struggle to lose it. This is because of the insulin resistance that comes along with PCOS. The insulin resistance causes the body to keep producing insulin but doesn’t allow it to use it effectively, thus causing excessive insulin production and storage, resulting in weight gain. This is also why PCOS is largely connected to obesity and diabetes. Ultimately, being of a larger size can make PCOS symptoms worse but it isn’t the cause of it and isn’t the only type of body that PCOS affects.
- Pregnancy is impossible if you have PCOS
Some more false information. PCOS is the leading cause of infertility in people with ovaries, but it doesn’t mean that pregnancy is impossible. If treated properly, meaning symptoms are all being managed, you should be able to fall pregnant. PCOS does make the process a little trickier but doesn’t inhibit it. Fair warning though, due to the lack of research and treatments available, a medical professional is most likely to advise you to lose weight in order to fall pregnant, as it is believed that symptoms are better when you are of a lower weight. This, accompanied by advanced fertility technology should make pregnancy a possibility even with PCOS.
- PCOS is curable
There is a common belief that if you lose weight, change your diet, and exercise regularly, then you can cure your PCOS. Unfortunately, the best you can do with PCOS is manage the symptoms through lifestyle changes. PCOS cannot be cured, but symptoms can be alleviated and hormones can be balanced to more of a normal scale.
- Excessive and hardcore workouts will help PCOS symptoms
Though exercise is widely encouraged as a way to relieve PCOS symptoms, excessive exercise can actually worsen PCOS symptoms. Too much exercise, or exercise that is too demanding on the body, can act as a stressor, which influences areas such as blood sugar levels, blood pressure, and metabolism. These are all areas already affected by PCOS, thus putting your body through more stress may worsen symptoms connected to these areas. On top of this, exercise is meant to be an enjoyable experience, so forcing yourself to do exercises that you aren’t a fan of and that cause severe strain, isn’t going to help you in any way. People with PCOS are encouraged to do exercises such as weight training, yoga, and Pilates, as these are gentler on the body, but still provide enough exercise to help PCOS symptoms. However, the choice is ultimately yours, as PCOS affects people differently, and their bodies respond to various forms of treatment (such as exercise) differently. The key is finding something that you like and that motivates you to keep exercising (this includes even something as simple as going on walks).
- The only way to treat PCOS is through hormonal birth control (HBC)
HBC is probably the most common “treatment” given to people with PCOS as it provides them with more “female” hormones and aids in the treatment of symptoms such as painful periods, acne, and excessive hair growth. HBC allows for an attempt at rebalancing the hormones through increased oestrogen and progesterone (to match the increased androgens). However, HBC comes with its own set of side effects, such as depression and weight gain, that can make the effect of hormone balancing feel somewhat useless. Therefore, HBC is not the only way to treat PCOS and is often referred to as a blanket that is pulled over the symptoms. Further, coming off HBC, whether for personal choice or pregnancy, can be a nightmare in and of itself (but this is a discussion for another day). PCOS can be managed just as well (maybe even better) through lifestyle changes.
PCOS is very clearly under-researched and misunderstood. Even the name of this disorder is misleading, as it signifies cysts on ovaries, which there aren’t necessarily in PCOS. The supposed “cysts” are ovary follicles that don’t contain fluid. Furthermore, someone can have PCOS without actually having any ovarian “cysts”, as long as they have menstruation problems that align with that of PCOS and display symptoms of increased androgens (excessive hair growth, acne, etc.). The main flaw in PCOS education is that it doesn’t always fully inform people as to how extensively PCOS affects someone, as they often only discuss it in relation to weight and reproduction.
Unfortunately, PCOS reaches a far broader scope than just reproduction and weight. It influences hormones that have influences on mental health, gut health, and other hormones. PCOS is linked to prolonged and severe inflammation and high cortisol (the stress hormone) levels. These cause a higher chance of depression and anxiety. Some doctors also argue that the symptoms alone (especially when one is only minorly aware of PCOS) can induce anxiety and depression- which is why going on HBC to treat PCOS can be so dangerous. On top of this, cortisol levels are higher in people with PCOS than in people without it. This means that people with PCOS are almost constantly under stress, thus influencing (worsening) their sleep patterns and their metabolism which results in worsened symptoms. People with PCOS also often suffer from severe fatigue, making it hard for them to get through simple daily activities.
This should make it quite clear that living with PCOS is not as simple as having a reproductive problem and not as quick of a fix as going on HBC. Instead, it involves numerous hours of research about what type of exercise is best for PCOS, as well as what type of diets work well and don’t cause inflammation and severe bloating. It’s a long process of trial and error to find what works best for your body. For those interested, you may want to research low carb diets, keto diets, or going gluten and dairy-free diets. These are all diets widely promoted by people with PCOS, but just like exercise, it depends on your body and how it reacts to certain foods. On top of this, PCOS is linked to increased heart disease, diabetes, sleep apnoea, infertility, and endometrial cancer, making life increasingly stressful because of fear of these connected conditions.
Ultimately, the severe lack of research on PCOS is worrisome because of how complex the disorder is and how widely it affects people with PCOS. On top of this, such a large portion of the population suffers from PCOS, meaning there is no excuse for the lack of research done on PCOS. PCOS can be a very difficult disorder to live with because of how hard it is to manage. It also goes undiagnosed in so many people, thus increasing the risk of more severe symptoms. If you experience any of the symptoms discussed above, you may want to go speak to your doctor about it so that you can learn how to manage the symptoms.