Do You Have PCOS?

Polycystic Ovarian Syndrome (PCOS) affects millions of women in the United States and causes a variety of fertility, hormone, skin, and ovarian problems.  In January 2013, a panel based on the Evidence Based Methodology Workshop at the National Institutes of Health suggested renaming and redefining the diagnostic criteria as they reported that PCOS should be determine by having 2 out of 3 criteria: excess androgens, ovulatory issues and multiple cysts in the ovaries.  This eliminates the requirement for ovarian cysts in absolute diagnosis as many people currently believe.

Typical symptoms of PCOS include: acne, excessive hair growth in places women typically do not want it, missed periods or irregular periods, not ovulating, weight gain especially around the middle, blood sugar and insulin problems, fertility problems, and ovarian cysts.  Androgens are a group of hormones such as DHEA, testosterone, androstenedione, and dihydrotestosterone that cause the skin and hair complaints.  Testing for PCOS can be difficult and as it is very multi-factorial .  First, evaluating for symptoms is important. Next, testing for androgens and looking for elevated levels.  Evaluating the menstrual cycle history looking to see if it is regular (roughly every 26 to 32 days) and if she ovulations. Testing for fasting blood sugar and insulin levels may indicate further consequences.  An ultrasound will visualize cysts on the ovary and discussing fertility challenges are important.

One of the issues the panel discussed was the difficulty in diagnosis as women will see different doctors or specialists for different issues.  A woman having trouble conceiving may see a fertility specialist while the woman with no menstrual cycle visits her gynecologist.  Acne and hair growth around the upper lip, chin, neck, nipples and abdomen may be evaluated by a dermatologist or aesthetician. If all symptoms are not accounted for, PCOS may be missed.  Also, women and their doctors may rule PCOS out if the ultrasound does not show multiple cysts on the ovaries yet she still has all the other symptoms.

Treatment for PCOS is important as long term sequelae can include diabetes mellitus, high blood pressure, high cholesterol, obesity, and a higher risk for cancer.  Seeking a healthcare provider who can evaluate all the symptoms, blood work and imaging then come up with a short and long term plan addressing all aspects is critical for health.  If the symptoms of PCOS sounds like you, do not hesitate to seek help as your health is important.

References:

1.       PCOS Diagnostic Criteria Clarified; Name Must Change.  Web.  27 January, 2013.
http://www.medscape.com/viewarticle/778066
2.       Increased Risk of Type 2 Diabetes with Polycystic Ovary Syndrome.  Web.  27 January, 2013.
http://www.medscape.com/viewarticle/767811