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The 411 on Polycystic Ovarian Syndrome (PCOS): The Disease Affecting More College Women Than You Might Think

As collegiettes, we know it’s important to stay on top of our health by getting enough sleep, eating right and washing out hands.  And we know to watch our for nasty illnesses, like pink eye and the flu.  But there’s a condition that affects roughly 5 to 10 percent of all reproductive-age women that many collegiettes™ don’t know about: Polycystic Ovarian Syndrome (PCOS). September is PCOS Month, so here at Her Campus, we’re taking a closer look at what PCOS is and how to recognize and manage it because we’re willing to guess that there’s a girl in your dorm, or your sorority, or on your sports team, who has it.
Ok, so what exactly is PCOS?
PCOS is an endocrine disorder that can manifest anytime during the time that menstruation occurs, according to Dr. Clare Flannery, an Associate Research Scientist in Endocrinology at the Yale School of Medicine. This means the condition typically affects those between the ages of 11 and 50 — meaning college-aged women are at risk.
Characterized primarily by small cysts in the ovaries, as the name suggests, PCOS can lead to early onset diabetes and cardiovascular disease. The condition occurs due to an imbalance in the female sex hormones, which can be prompted by behaviors many collegiettes take part in: taking the Pill, having a poor diet, experiencing high levels of stress and using petroleum-based cosmetic products, such as petroleum jelly, certain powders and others.
Though women who are obese are at greater risk for developing PCOS, any woman at the reproductive stage may be diagnosed with the condition. In addition, PCOS can be passed down genetically, and may affect multiple systems in the body, including the reproductive system — going as far as to cause infertility.

How do I know if I have PCOS?

PCOS can be hard to identify because there isn’t any one symptom or set of symptoms that suggests the presence of PCOS, explains Dr. Kai I. Cheang, Associate Professor of Pharmacotherapy & Outcomes Science at Virginia Commonwealth University, who notes that any of the following may result from the syndrome:

  • Absent or irregular periods
  • Excess hair growth on the face or body
  • Acne that’s difficult to control
  • Weight gain and/or difficulty losing weight

Sound familiar? Many collegiettes already experience irregular menstrual cycles and with the notoriety of the “Freshman 15” and stress-induced breakouts, these symptoms might not always seem like cause for concern, leaving PCOS undetected. So if you’re experiencing any of these symptoms, be sure to visit your student health center, just in case.
Taylor Kilbride, a junior at California Polytechnic State University in San Luis Obispo, began having irregular periods during her sophomore year of high school. It wasn’t until she saw her doctor that she found out she had PCOS.
“My period was never regular and would only happen once or twice a year,” she says. “My doctor said that it’s normal for girls to have that problem in their early teens, but mine was starting to be an issue.
If that time of month comes fewer than nine times a year, or if you don’t have a period for three or more months at a time, ask your doctor if PCOS could be the problem.
In addition to paying attention to changes in skin conditions and menstrual cycles, it’s important to know your family’s medical history. “The data suggests that PCOS may have a genetic component,” says Dr. Lubna Pal, Director of the Program for Polycystic Ovarian Syndrome at the Yale School of Medicine. Clinical studies show that women whose mothers have been diagnosed with PCOS and/or are obese are more likely to develop the condition.

Even without family histories of obesity, women who are overweight are at greater risk of being diagnosed. Approximately two-thirds of women with PCOS are obese and, says Dr. Pal, “We’re seeing more women diagnosed with PCOS as the country’s body mass index goes up.”
On the flip side, just because a girl doesn’t have difficulty losing weight doesn’t mean that she can’t be diagnosed PCOS if other symptoms are present. “[PCOS] is more common in women who are overweight, but lean or normal women can also have PCOS,” says Dr. Flannery. “Sometimes they are overlooked.”

What should I do if I’m experiencing symptoms?
For those with one or more of the symptoms of PCOS, Dr. Flannery advises that women ask their primary care physician or a nurse practitioner for an evaluation. Be sure to compile a record of when your last period occurred, the length of the period, any skin changes you have noticed, and other possible symptoms. Just like you would for a physical exam, take a list of your current medications with you.
A physician will perform an abdominal/intravaginal ultrasound to look for cysts on the ovaries (although not everyone who is diagnosed with PCOS has these cysts, and not everybody who has cysts has PCOS). Blood tests are taken to evaluate testosterone levels, since higher results, which could lead to symptoms like excess hair growth and male pattern baldness, suggest the presence of PCOS.
However, just as there isn’t one symptom that defines PCOS, there isn’t one test that will automatically identify it. “PCOS is a diagnosis of exclusion,” says Dr. Pal. Doctors diagnose a woman with PCOS after they have ruled out other medical conditions based on the results of blood tests and medical imaging.
Depending on your diagnosis, it may be important to work with a team of specialists, including an endocrinologist, who can treat hormonal imbalances, in addition to a nutritionist and dermatologist, who will work to cure the weight gain and skin changes that may occur with PCOS. Referral to an endocrinologist occurs in more advanced cases of PCOS, but they can be located using the American Association of Clinical Endocrinologists’ physician finder.

What does treatment involve?

“The first part of treatment is typically weight loss through improved diet and exercise”, says Dr. Flannery. This is important because PCOS is thought to be both a result and source of insulin resistance.
Depending on the results after changes are made to diet and exercise routines, medications may be prescribed to help control symptoms. “It can take multiple tries to find the right medication”, as Devon Williams, a student at Eckerd College, experienced when she was diagnosed with PCOS during her sophomore year of high school. “They started me on birth control to boost my estrogen and start my period again, but we had to go through several brands because the hormone balance needed to be very particular or I would get violently ill,” she says.

What happens when PCOS goes untreated?
 Girls diagnosed with PCOS can struggle with their weight and acne, especially as they are trying to find diet/exercise plans and medications that work for them.

Like Devon, Taylor experienced side effects from the medication that her doctors initially prescribed. “My body reacted very badly with the pill they put me on,” she says. “I am an athlete and eat very well and still gained 25 pounds. My breasts grew 3 sizes, my skin was retaining water, and my previously good skin was acne ridden. I was very emotional and would cry all the time, which was very weird for me.” After the short-term consequences of taking the birth control significantly affected her everyday life, Taylor chose to discontinue the medicine. “I’m lucky, and even though my case is severe, I don’t show many of the physical symptoms,” she says. “I often have pain in my back and lower stomach and still only get my period a few times a year, but the Pill wasn’t the right choice for my body so I’m currently seeking something else to try.”  
Put time into finding a treatment method that works for your body, whether this means switching medications or altering your diet, which your doctor will advise you on. If it isn’t treated early on, PCOS can result in gestational diabetes, early onset diabetes, cardiovascular disease, and, in some cases, difficulty getting pregnant. While PCOS cannot be definitively cured, finding effective exercise and diet plans and/or medications can help to control symptoms. “We don’t talk about cure, but we do talk about prevention of diabetes,” says Dr. Flannery. “PCOS is a chronic condition, so management is generally life-long.” 

How can I find support?

It can be tough to talk with friends about medical issues, especially if they’re not experiencing what you’re going through. Fortunately, there are many support programs in place for girls with PCOS, including “SoulCysters” and “PCOSupport.”
Devon initially felt angry and frustrated with her diagnosis, but she found great comfort after her doctor helped her find other women who also suffered from PCOS. “Some went on to have beautiful families, succeed as athletes, and to find the right prescriptions to help balance their hormones and work on their acne,” she says. “[Hearing their stories] completely strengthened my will power and made me more persistent at reaching my goals and breaking out of the confines of what PCOS had ‘set.’” 
Whether you’ve been diagnosed with PCOS, know someone with PCOS, or are learning about it for the first time, it’s a condition that deserves the attention of all collegiettes™. Taking care of your own health is more than just maintaining a balanced diet or exercising right — it’s knowing what symptoms to watch out for before facing the risk of letting an illness go undetected. During PCOS month this September, pass this information along — and help collegiettes™ everywhere stay healthy and happy!
Dr. Clare Flannery, Associate Research Scientist in Endocrinology at the Yale School of Medicine
Dr. Lubna Pal, Director of the Program for Polycystic Ovarian Syndrome at the Yale School of Medicine
Dr. Kai I. Cheang, an Associate Professor of Pharmacotherapy & Outcomes Science at
Virginia Commonwealth University
Taylor Kilbride; California Polytechnic State University, San Luis Obispo
Devon Williams, Campus Correspondent, Eckerd College
“Polycystic Ovary Syndrome” http://www.mayoclinic.com/health/polycystic-ovary-syndrome/DS00423
“PubMed Health: Metformin” http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000974/
“Clinical manifestations of polycystic ovary syndrome in adults,” Dr. Robert L. Barbieri and Dr. David A. Ehrmann
https://www.uptodate.com/store “American Association of Clinical Endocrinologists: Find an Endocrinologist”
https://www.aace.com/resources/find-an-endocrinologist “SoulCysters”
http://www.soulcysters.com/ “What is Polycystic Ovarian Syndrome?”
“Women’s Health: WebMD” http://women.webmd.com/tc/polycystic-ovary-syndrome-pcos-topic-overview
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Madeline Buxton is a rising junior at Yale University, where she is majoring in English and writes for the Yale Daily News Magazine. She spent two summers as an intern at the Rhode Island International Film Festival and is spending summer 2011 as a marketing intern at the Isabella Stewart Gardner Museum, where her responsibilities include drafting press releases and writing for the museum's newsletter. While not working, she enjoys relaxing by watching romantic comedies, writing/reading in independent coffee shops, and trying out new smoothie concoctions (hint: adding coconut to anything instantly makes it better).