PCOS stats: 25% of perfectly normal women display polycystic ovaries at one time or other (1). Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. PCOS affects us in a variety of ways. First, it’s important to understand how diagnosing PCOS is not enough by ultrasound alone. At Susannah Makram Clinics we use a functional approach, integrated care pathways, functional nutrition.
Diagnosis of PCOS
In some cases, PCOS develops later during the reproductive years. For instance, in response to substantial weight gain so we need to look closely at both PCOS and weight gain in context.
PCOS and weight gain – all of the signs and symptoms of PCOS can worsen with obesity.
When do we notice signs of PCOS typically? After a woman first begins having periods is typically the time that signs and symptoms of PCOS begin.
Diagnosis of PCOS is too often misunderstood. So, it’s best to get the right information. We outline these in your consultation.
Irregular periods. This is the most common characteristic. Examples include menstrual intervals longer than 35 days; fewer than eight menstrual cycles a year; failure to menstruate for four months or longer; and prolonged periods that may be scant or heavy. Ask us how you can obtain a more conclusive diagnosis of PCOS – how is it made and can we help you?
Excess androgen. Elevated levels of male hormones (androgens) may result in physical signs, such as excess facial and body hair (hirsutism), adult acne or severe adolescent acne, and male-pattern baldness (androgenic alopecia).
Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam.
Concerned with way your body is responding to weight gain? PCOS and weight gain are not the only things to look out for. Because we manage the cause or causes of hormone imbalance we’ve experience in advising with care. We have knowledge that is not known to the medical community as to how we can improve quality of life. Weight gain and PCOS and not the end of the story. They can be the start of your health journey.
Irregular ovulation is usually detectable by a long history, usually dating back to when your periods first began, of irregular cycle length or unpredictable menstrual bleeding. Some women with PCOS however, will begin their reproductive lives with regular cycles and then have the cycles become irregular during their early 20’s.
PCOS and weight
A big clue to possible PCOS is a history of abnormal male hormone production in a woman. Male type hormones are known medically as androgens. All women normally make a small amount of these androgens. The most common androgen that is found elevated beyond the normal low female levels in women with PCOS is Testosterone. Testosterone is a very potent male hormone. And this elevation of male Testosterone hormone in women with PCOS helps explain many of the “clinical findings” (what we see) found with PCOS shown below and separate to or in conjunction with PCOS and weight gain:
- ‘Androgen driven hair loss’ which is responsible for the majority of inherited hair loss in men (androgenetic) and for the hair loss in women who have PCOS.
- Facial or body hair growth – hair growth on the upper lip, on the chin, in the “sideburn” areas, in the middle of the abdomen, in the area around the nipples and in on the fingers or toes
- Pigmentation of the skin, especially on the neck – excess brownish pigmentation on the neck or behind the ears “acanthosis nigricans”
- Acne resistant to the usual treatment methods or persisting beyond age 15. Acne is the skin’s reaction to sebum or oil production where the excess oil blocks the normal drainage channels of the skin causing inflammation and pimples. At puberty, many boys develop acne from their sudden rise in testosterone production. Boys make far more testosterone than the girls, so the boys tend to get far more acne than the girls. Acne in an adolescent female is also the result of a (normally) small amount of testosterone arising from the awakening ovary. Girls normally make very little testosterone, so their skin conditions and associated acne are usually far less severe than that seen in the boys. A sign of underlying excess male hormone production in a female may be excess or severe acne.
- Weight gain and the inability to lose weight with normal weight loss measures
To summarise, irregular menstrual cycles can be monitored personally and self-screening for possible excess male hormone production means looking for any or all of the following as possible evidence of PCOS related excess hormone production
Noticing signs at an early stage to help identify PCOS and get the right care and treatment.
Facial hair growth – Hair growth on the upper lip – Hair growth on the chest – Hair growth on the arms and legs – Hair growth on the back – Excess skin oiliness – Resistant Acne – Weight gain that “won’t come off” – Pigmentation of the skin on the neck or behind the ears – Social aggression or seclusion – Increased libido