Polycystic Ovary Syndrome (PCOS) – what is it, and how do I figure out if I have it?

September is PCOS Awareness Month, so we are launching a short series on this important topic. PCOS is the most common “endocrine” (i.e., affecting the glands that secrete hormones or other products directly into the blood) disorder among women. PCOS affects between 4-20% of women, depending on the study and the exact diagnostic criteria used. If you’re thinking that we don’t talk enough about something that affects so many women, we couldn’t agree more. So let’s dive in:

PCOS symptoms may appear shortly after puberty or later on in early adulthood and frequently go unnoticed or undiagnosed. Typical symptoms include irregular or missed periods, ovarian cysts, weight gain, fatigue, excess hair growth (e.g., on face, back, chest, abdomen), acne, thinning hair, infertility, mood changes involving depression and anxiety, pelvic pain, headaches, and insomnia. Behind these symptoms is a hormonal imbalance with typically higher levels of male hormones and insulin. How exactly this imbalance comes about is still unclear, but there seems to be a genetic component.

When women are diagnosed with PCOS according to the now frequently used “Rotterdam criteria” if they have to meet 2/3 of the following: 1) Infrequent or missing periods, 2) Elevated levels of male hormones (based on symptoms such as excess hair growth or lab tests), and 3) Several cysts on their ovaries. When doctors check for PCOS, they typically run some blood tests checking different hormone levels, perform an ovarian ultrasound to detect cysts, discuss your and your family’s medical history, and complete a physical exam to look for other symptoms.

There remains significant controversy over whether women without high levels of male hormones have PCOS (the above Rotterdam criteria would say they do). In some cases, it can take a long time for women to get diagnosed; sometimes doctors are also cautious about diagnoses in teenagers, as irregular periods, ovarian cysts, and acne can be normal parts of puberty that go away. At the same time, diagnosing PCOS through a specialist is important, as it has been associated with type 2 diabetes, cardiovascular diseases, and endometrial cancer, and other serious health conditions. If you think you might have PCOS, speak with your doctor.

In upcoming posts, we’ll talk about how PCOS can affect fertility, and what women with PCOS can do to deal with its symptoms and risks.

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