Polycystic ovary syndrome, or PCOS, is a common problem in women. In fact, it’s the most common hormonal issue facing women between about 12 and 51 years old.
Annevay Conlee, MD, a family medicine obstetrics physician at OSF HealthCare, treats women with PCOS. Dr. Conlee aims to get to the root of the problem and address the issue at the source.
PCOS symptoms
PCOS is a wide term that describes many different things. It sometimes causes cysts on your ovaries. It sometimes causes an overgrowth of the adrenal hormone, which should occur in women in small amounts.
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When a woman has small cysts on her ovaries, her body produces more androgens – the hormone that regulates male traits. When her body produces more androgens, ovulation doesn’t occur as it should. When ovulation doesn’t occur as it should, her menstrual cycles are irregular.
Symptoms of PCOS can greatly interfere with quality of life. Some of those most common symptoms include:
- Irregular periods
- Acne
- Excessive hair growth
- Diabetes or insulin resistance
- Weight gain or struggling losing weight
- Struggling to get pregnant
Periods can be irregular in many ways.
Sometimes women have periods that last a long time – even weeks at a time. Sometimes they have short periods. Sometimes their period shows up only a week after ending their last period. And some women don’t have periods at all.
Types of PCOS
PCOS has a wide range of causes and symptoms, so it’s hard to capture it all in easy categories. There aren’t really “types” of PCOS. But it affects women in these ways.
Insulin resistance PCOS
Insulin resistance occurs in at least 70% of women with PCOS. Elevated insulin levels cause hormone levels to rise. This is because higher insulin levels cause the body to produce more hormones to make up for it. Many women with PCOS struggle to maintain blood sugar or have diabetes.
Adrenal PCOS
This type of PCOS occurs when stress levels on the body are high. Sometimes stress can cause androgen to increase.
Inflammatory PCOS
PCOS often goes hand in hand with inflammation. It may cause your body to have elevated hormone levels that affect your immune and inflammation response. Studies show that women with PCOS have higher CRP levels, which is a protein made in the live that responds to inflammation. This can cause things like chronic inflammation, which can lead to muscle and joint pain.
Post-pill PCOS
Post-pill PCOS can happen when you stop taking birth control pills. For some women, their providers prescribe birth control for PCOS to help regulate periods. However, this doesn’t treat the underlying issue causing irregular periods.
So, if you’re experiencing post-pill PCOS, you likely had the condition before going on an oral contraceptive. When you go off the pill, symptoms return because the pill doesn’t treat PCOS.
Knowing what type of PCOS you have may help to identify what treatment will work best for you.
PCOS diagnosis
When diagnosing you, your provider will look for four signs. If you have at least two of them, you’ll be diagnosed with PCOS. These signs include:
- Enlarged ovaries
- High androgen levels
- Irregular periods
- Ovaries that aren’t working properly
There are several PCOS tests that can help your provider narrow down what’s happening with you.
- Internal pelvic exam: Your provider will check for enlarged ovaries, cysts, tumors or any other abnormalities in your pelvic area.
- Hormone test: This is usually a series of blood draws at different times of your cycle to determine what hormones are too low or high.
- Ultrasound: Your provider will use an ultrasound to check for any growths or abnormalities.
PCOS treatment
PCOS can affect many functions of the body. So, PCOS treatment often includes addressing a few different things in your body.
“It’s best to find a provider who works in cooperation with your body and your cycle,” Dr. Conlee said.
Many problems associated with PCOS cause enlarged ovaries. Testing to find the root cause can help.
“Once we know the root cause, we can try to decrease the size of that ovary by addressing that problem. Because when your ovary gets larger, it just doesn’t function well,” Dr. Conlee said.
That may include losing weight, changing your diet or surgery.
Decreasing ovary size can even help regulate periods and achieve pregnancy.
Another common PCOS treatment includes taking hormones at certain times throughout your cycle.
PCOS can make hormone levels wonky, such as progesterone, estrogen, testosterone and androstenedione. However, your body naturally has times throughout your cycle when certain hormone levels are higher and lower. So, it’s important to get the hormones balanced at the right time during the cycle.
That’s where the Creighton model of fertility awareness can help. Women can work with Creighton-trained fertility providers to track their cycles (not just their periods). By observing the signs of your body, you can learn lots of information about what’s going on inside.
Diet for PCOS
An unhealthy diet and lifestyle often worsen symptoms of PCOS. It can also lead to higher risk of complications later in life, such as heart disease.
“The PCOS diet I recommend is a healthy one, full of fruits, vegetables and lean protein,” Dr. Conlee said.
Avoid inflammatory foods and instead include anti-inflammatory foods in your diet, like turmeric.
“Losing weight also helps to get healthier and manage PCOS,” Dr. Conlee said.
However, with PCOS, weight loss can be difficult. It’s helpful to find a provider who will work with you to establish a good weight loss plan.
Losing weight will help you to manage your blood sugars better and lower your risk of developing type 2 diabetes.
PCOS and pregnancy
Getting pregnant with PCOS can be a little bit tricky. When hormone levels are off, it can affect how fertile you may be.
Because of the symptoms of PCOS, fertility is often obstructed. Things like elevated androgen and testosterone levels or enlarged ovaries interfere with your body’s ability to ovulate as normal. If you don’t ovulate like normal, your chances of achieving pregnancy are lower.
If you’re trying to achieve pregnancy while living with PCOS, find a provider who can help you address the root cause of those issues. Natural Procreative Technology (NaPro) can offer an effective and natural fertility treatment that addresses the root cause of PCOS. It can also increase your chances of getting your healthy fertility back.
“We want you to have the healthiest pregnancy possible. Women who achieve pregnancy and have a history of PCOS are often put in a high-risk category. We often monitor them for other things. One of those would be blood sugars,” Dr. Conlee said.
What is the difference between PCOS and endometriosis?
PCOS and endometriosis are both reproductive issues in women and seem to be more common now than ever.
Like PCOS, endometriosis can cause symptoms like imbalanced hormones and irregular periods.
Endometriosis is a condition that causes endometrial tissue to grow in areas where it shouldn’t – for example, on the ovaries or fallopian tubes. It often causes severe pain.
Dr. Conlee encourages her patients to get to know their cycles. Every woman’s cycle is different. So, it’s best to know what’s normal and not for your own health. Knowing your cycle can also play a role in diagnosing what condition you might have.
Last Updated: February 22, 2024