The truth behind Polycystic ovary syndrome (PCOS) diagnosis
Busting PCOS myths and understanding the realities of this condition.
By Fertility Specialist, Kath Whitton from IVFAustralia
Polycystic ovary syndrome (PCOS) is a common hormonal condition that often remains veiled in myth and misunderstandings.
Experienced by up to 15% of women, PCOS is frequently diagnosed when women have difficulty falling pregnant. It is a disorder that has both short term and long-term health implications.
Let’s explore how PCOS is diagnosed and debunk 5 common myths.
What is PCOS?
The exact cause of PCOS remains elusive, but it is characterised by hormonal imbalances, irregular menstrual cycles, and the presence of many small follicles (sometimes referred to as cysts) on the ovaries.
Many women have insulin resistance, with elevated blood insulin levels, and high levels of blood androgens, such as testosterone. There also appears to be a genetic component, with many women having other family members with the condition.
How is PCOS diagnosed?
Diagnosis is based on your history and a physical examination. Sometime a blood test and pelvic ultrasound will be arranged to help with or support the diagnosis.
More specifically, two out of the three diagnostic features need to be met, and other causes for your signs and symptoms much be excluded. The diagnostic criteria include:
1. Irregular or no periods – This is defined as menstrual cycle length of less than 21 or more than 35 days, or less than 8 cycles per year
2. Evidence of excess androgen levels – Either found on blood tests, or having acne or excess hair growth
3. Polycystic appearing ovaries – More than 20 follicles on one or both ovaries on a pelvic ultrasound
Is there a cure for Polycystic ovary syndrome?
Because we do not know the exact cause for PCOS, there is no known cure, however it does remain a condition that we can manage effectively. Management approaches include
1. Lifestyle modifications – Adopting a healthy lifestyle, including a balanced diet, regular exercise, and stress management, can help improve insulin sensitivity and reduce PCOS symptoms
2. Weight management – Achieving and maintaining a healthy weight can help improve PCOS symptoms and reduce longer term risks of conditions such as diabetes and cardiovascular disease
3. Medications – Sometimes medications are prescribed, such as the oral contraceptive pill and insulin-sensitizing drugs to regulate menstrual cycles, reduce androgen levels, and manage other PCOS-related issues
4. Fertility treatment – For women trying to conceive, fertility treatments like ovulation induction can be considered. IVF is also an option, but it is often not required
Because of the health implications of PCOS, it is important to have the condition recognised and managed early. Let’s separate fact from fiction when it comes to the elusive PCOS.
Myth-busting: The truth about PCOS
Myth 1 – PCOS only effects reproductive health
While PCOS commonly impacts menstrual cycles and fertility, it can have broader implications for your overall health. Individuals with PCOS are at an increased risk of developing metabolic conditions such as type 2 diabetes, cardiovascular disease, and obesity. It is also associated with an increased risk of sleep disorders, depression and anxiety.
Myth 2 – You can’t get pregnant with PCOS
PCOS can make it more challenging to conceive due to irregular ovulation, but this does not mean you can’t have children. Many women with PCOS successfully become pregnant with the right medical guidance and support. In fact, evidence reports that women with PCOS may take longer to conceive, but they tend to have the same number of children as women without PCOS.
Myth 3 – All women with PCOS are overweight
PCOS affects women of all body types. While weight gain can be a symptom, not all women with PCOS are overweight. Women with a low or normal body mass index can have PCOS too.
Myth 4 – Polycystic ovaries are dangerous
While the term polycystic may sound scary, ovaries in PCOS actually have many very small, fluid-filled sacs that measure between 2-9mm in size. They generally do not contain large cysts. The small sacs are called follicles, and most will contain an egg. So, most women with PCOS have many eggs on their ovaries.
Myth 5 – I had all of the PCOS symptoms as a teenager, I should have been diagnosed then
Diagnosis is not recommended within 8 years of a woman getting her first period. This is because irregular cycles, acne, excess hair growth, and polycystic appearing ovaries on ultrasound are common in adolescence, and overdiagnosis is likely. Instead, young women should be identified as being ‘at risk’ of PCOS and close follow-up should be arranged.
PCOS is a complex condition that can affect various aspects of health, and understanding the facts will empower you to take charge of your well-being. If you suspect that you may have PCOS or have already been diagnosed, seek support from healthcare professionals who can provide personalized guidance and help you navigate this journey with confidence and knowledge.
