I’ve had the idea of writing this post since my blog started. It’s taken some time to figure out how i wanted to present it. Poly Cystic Ovary Syndrome (PCOS) is something personal to me and also something i think not enough women are educated on.
After reading a good amount of papers and seeing what information is out there, I've decided to make this post slightly longer than my usual ones.
Firstly , what is PCOS ?
PCOS = polycystic ovary syndrome - In simple terms, PCOS can be described as a reproductive disorder found in women. It’s exact cause is something that is still being researched. It is said to be caused by a combination of environmental and genetic factors . There is no current cure for PCOS, this may be due to the complexity of the disease or lack of research done in the field. Maybe a little bit of both.
PCOS is not very easy to diagnose as it is based on a range of symptoms. From what i have read, diagnosis of PCOS is one of the difficult aspects of the syndrome and also the differences in how it manifests in women at different stages of their lives.
What are the symptoms?
Diagnosis of PCOS is usually determined when a woman shows ⅔ of the main symptoms. The main symptoms being:
Hyperandrogenism: production of androgen hormones
Poly cystic ovaries - the presence of poly cystic ovaries which can be detected using ultrasound. A positive test has more than 12 follicles per ovary with a diameter of 2-9mm
So now the science
PCOS is said to affect 5-10% of women of reproductive age.
PCOS is a heterogeneous disorder that leads to the production of androgens. This means PCOS is caused by a range of factors which makes it difficult to model the disease. Androgens are a group of hormones that are responsible for the developments of male characteristics. For the context of PCOS it leads to the increased production of testosterone.
The increased production of the androgens is what causes the symptoms of PCOS. There is still a lot of research to be done into understanding the exact mechanism of PCOS
Current research suggests that PCOS results due to an increase in Lutienisng hormone(LH). The role of LH in the normal menstrual cycle leads to the development of the ovarian follicle and ovulation( release of the egg ).Excess LH leads to the premature stopping of follicle development, leading to many underdeveloped follicles. Imbalance of LH can lead to the stimulation of the production of testosterone.Increase in LH increases the production of androgens from theca cells in the ovaries.
A lot of places link PCOS to an increased risk of developing type-2 diabetes. Type 2 diabetes occurs due to decreased insulin sesitivity in the body. Insulin is the hormone that regulates the level of blood glucose. Women with PCOS are said to be less sensitive to insulin in their muscle and adipose tissue, this causes the body to overcompensate and produce more insulin. Decreased sensitivity to insulin leads to higher blood glucose and hence type-2 diabetes.
The decreased insulin sensitivity means that insulin's post- receptor activity is decreased which leads to defects such as the stimulation/suspension of different metabolic pathways. Defects such as an increased production of LH due to more insulin being presnet can increase the level of androgens in the ovary; the cause of hyperandrogenism.
Many women are diagnosed with PCOS at around their late teens to early twenties .It is important to note everybody is different and a combination of different factors determine how the syndrome is expressed.
Let’s get a bit personal …
How did i find out i have PCOS ?...
I was already late to the period party when i was in secondary school, that may have been the first sign. Fast forward a few years into regular periods. Around 16/17 things began to change. Months went by and no mother nature scratching at my uterus. At first this was kind of a good thing. I didn’t have to worry about tummy pains. But once the months start rolling by you do get a bit worried. My periods were irregular to the point when they actually arrived it was like pay back. The worst i remember lasting for 2 and a half weeks with heavy bleeding. To put things into perspective most periods last 7 days max. Mine was double and then some. Finally my mum got fed up and we went to the GP. I explained everything, did an ultrasound and voila i now had PCOS.
I do not show any of the symptoms of hyperandrogenism( maybe oily skin counts) but i did have irregular periods and polycystic ovaries. As mentioned above you need to have 2/3 of the main symptoms to be diagnosed.
My GP explained that it’s what caused my irregular periods and not to worry. 1 in 10 women are usually affected by it. She offered birth control to regulate my periods but i really wasn’t ready for all the side effects. She did explain that it could lead to complications if i wanted kids. Is this something i have thought about? Yes; but i’m only 21 and i'll cross that bridge when i get there.
I hope I've been able to educate you a bit more on PCOS. Feel free to message me on any of my social media platforms to explain anything in more detail. I wan’t to encourage discussion around this topic. Do share with your friends and family.
Other sources that further explain PCOS and the hormones mentioned
Moore, A. M. & Campbell, R. E., 2017. Polycystic ovary syndrome: Understanding the role of the brain. Fronteirs in Neuroendocrinology , 46(1), pp. 1-14.
Patel, S., 2018. Polycystic Ovary syndrome ( PCOS), an inflammatory, systemic, lifestyle endocrinopathy. The Journal of Steroid Biochemistry and Molecular Biology , 182(1), pp. 27-36.
Pfeifer, S. M. & Kives, S., 2009. Polycystic Ovary Syndrome in the Adolescent. Obstetrics and Gynecology Clinics of North America, 36(1), pp. 129-152.