Polycystic Ovarian Syndrome (PCOS)
What is Polycystic Ovarian Syndrome (PCOS)?
Polycystic Ovarian Syndrome, or PCOS, is a constellation of symptoms that include irregular periods and symptoms of high male hormone levels such as scalp hair loss, acne, and increased body hair growth. Women with Polycystic Ovarian Syndrome may also have difficulty with weight loss and show signs and symptoms of high insulin levels.
PCOS affects as many as eight percents of women. We do not have a good understanding of what causes PCOS and scientists continue to work to improve our understanding of this common syndrome.
Researchers have discovered a link between PCOS and obesity. Such patients frequently have severe insulin resistance, with diabetes occurring in up to fifty percent of PCOS patients. They develop upper body obesity and accelerated heart disease risk.
Dr. Gage describes the ill effects of insulin in his book, The Thinderella Syndrome: A Practical Guide to Individualized Permanent Weight Loss. “The higher the insulin, the more illness we see.” Insulin resistance in women with PCOS seems to resemble what which occurs in the obese type 2 diabetic. Per Dr. Gage, the difference is that the insulin resistance of PCOS occurs first, with the obesity and carbohydrate cravings becoming a secondary phenomenon.
How is PCOS diagnosed?
There is no single test to determine if a woman has PCOS.
Our doctors make the diagnosis when women have two or more of the following symptoms:
• Irregular or infrequent periods
• Symptoms of high male hormones (acne, increased body hair, and scalp hair loss) or high levels of male hormones on blood testing
• Cysts on the ovaries seen on a sonogram
Two other hormonal abnormalities can have very similar symptoms— Cushing’s syndrome and congenital adrenal hyperplasia. It is important to rule out these diseases with blood testing and sometimes saliva testing.
Polycystic Ovarian Syndrome Testing
We offer a full range of diagnostic testing at our office including:
Our treatment approach is tailored to the concerns of each patient. Because we do not understand the cause of PCOS, treatments are focused on managing each woman’s symptoms.
• Birth control pills and other medications decrease acne and body hair growth and improve scalp hair loss. They also regulate a woman’s menstrual cycle.
• Diet and weight loss improve insulin resistance and decrease the risk of developing Type 2 Diabetes.
• There are many medications that can improve insulin resistance and may increase a woman’s chances of becoming pregnant when desired.
Dr. Gage cautions, “Beware because, without a strict lifestyle change, the medical effect seems to wear off.” Just like many obesity medications, patients can develop resistance to the medication or overeat despite taking the medicine. Dr. Gage explains, “These patients must protect themselves from the carbohydrate environment. Low carbohydrate diets don’t just happen; it takes behavioral planning and preparation. From shopping to dining out, patients need to keep their guard up.”
How does PCOS affect fertility?
Polycystic Ovarian Syndrome is associated with infertility. However, not all women with PCOS experience difficulty when trying to conceive. There is no testing that can predict which women with PCOS will have difficulty conceiving. We work with women to optimize the chances of conceiving with treatments such as weight loss programs and medications. We also discuss with women whether a consultation with a reproductive specialist is appropriate.
Can PCOS lead to other complications?
Women withPolycystic Ovarian Syndrome is at risk of developing Gestational Diabetes during pregnancy and Type 2 Diabetes later in life.
Does PCOS run in families?
Women with a first-degree relative (mother, sister, or daughter) with PCOS are more likely to develop PCOS themselves.
Schedule a consultation
At Park Avenue Endocrinology and Nutrition, our practitioners are well-versed in the diagnosis and management of PCOS. Schedule a consultation by calling our office at 212-772- 7628.