Struggling with acne, excess hair growth, weight gain and irregular periods? Your body might be trying to tell you something.
Wendy Martinez, MD, FACOG, NCMP Advocare The Women’s Group for OB/GYN
Polycystic ovary syndrome (PCOS) is one of the most misunderstood hormonal syndromes out there.
Diagnosing PCOS requires a deeper look – at symptoms, hormone levels and individual history – because no two cases are exactly the same, says Wendy Martinez, MD, founder of Advocare The Womens Group for OB/GYN.
What is PCOS?
PCOS (Polycystic Ovarian Syndrome) affects 5-6 million women.
To actually make the diagnosis, doctors use the Rotterdam criteria, which diagnose PCOS if two of the following three are present: irregular periods, signs of high androgens (like acne or excessive hair growth) and either an ultrasound showing a high amount of follicles on each ovary or high levels of the AMH hormone, which gives doctors a clue about how many eggs you have. For teens, only two criteria are used: irregular periods and signs of high androgens.
Here are a few symptoms to look for:
Irregular periods:
Irregular periods are typically defined as having cycles longer than 35 days or fewer than eight periods per year.
“Most women have cycles every 21 to 34 days, so anything outside that range is considered irregular,” says Dr. Martinez. “Birth control pills are often used to help regulate the cycle.”
Excessive Hair Growth and Acne
Excess hair growth and acne are common signs of PCOS.
“They can both be caused by elevated levels of androgens, like testosterone,” says Dr. Martinez. “To treat the acne and hair growth, birth control pills or a drug called spironolactone are commonly prescribed.”
Obesity
“Obesity is commonly seen in people with PCOS, and one of the first steps in managing it is encouraging a healthier lifestyle focused on weight loss or weight gain prevention,” says Dr. Martinez.
Some supplements and medications have also shown promise for managing PCOS-related weight gain.
Metabolic and cardiovascular issues
Women with PCOS face increased risks for high blood pressure, high cholesterol and high blood sugar and are three times more likely to develop type 2 diabetes, says Dr. Martinez.
Infertility
Since birth control can mask symptoms, many women don’t realize they have PCOS until they try to conceive.
Trouble getting pregnant often comes down to not ovulating regularly – or sometimes, not at all. There are medications used to help jumpstart ovulation if your body isn’t doing it on its own, and if that doesn’t work doctors turn to fertility treatments like IUI or IVF.
“The good news? People with PCOS often have plenty of eggs – they just need help ovulating,” says Dr. Martinez.
Depression, anxiety and eating disorders
“Many women with PCOS struggle with weight gain, acne and excess hair growth, which can take a toll on self-esteem and mental health,” says Dr. Martinez.
Bulimia, in particular, is a common eating disorder seen in women with PCOS to try to control their weight loss.
No symptoms at all
What many people don’t realize is that you can have PCOS and show none of the classic symptoms.
“There’s a lesser-known subset of PCOS often seen in women over 35. These women are lean, have regular cycles and don’t show signs,” says Dr. Martinez. “Because of this, they’re often overlooked or misdiagnosed, especially if they’ve been on birth control for years, which can mask the symptoms.”
