What is PCOS?
Polycystic ovarian syndrome, or PCOS, is a condition characterized by hormonal and metabolic imbalance resulting in abnormal periods (usually infrequent periods), excess body and facial hair growth or excessive acne or lab evidence of elevated testosterone, and/or ovaries that appear to have many small cysts on ultrasound (“polycystic”). One must meet at least two of the above three criteria to be considered to have PCOS. Other possible characteristics of people who have PCOS include central obesity (fat distribution around the waist rather than hips), insulin resistance (prediabetes or type 2 diabetes), high blood pressure, high cholesterol - these are altogether known as metabolic syndrome. Infertility is also common among people with PCOS, usually due to the lack of regular menstruation.
How is it treated?
The mainstay for treatment of PCOS is birth control pills to regulate hormones, and diet and exercise (and medication if needed) management of any metabolic syndrome component that might be present. Birth control pills not only normalize estrogen and progesterone to cause normal periods, it also decreases circulating testosterone to reduce acne and male pattern hair growth and protects the uterus from cancer in the future. As with all people who have irregular periods, people with PCOS are at risk for developing endometrial (uterine) cancer later in life due to prolonged lack of progesterone (the main hormone that helps to time periods to be regular). All birth control pills contain a progesterone to help replace what the body is missing and to reduce this risk. If birth control pills are not an option for whatever reason, other contraceptive methods that contain a progesterone can be considered. If someone with PCOS wants to get pregnant, they may of course stop their birth control pills temporarily in order to get pregnant. If spontaneous pregnancy is difficult (as often can be the case), they should discuss with their gynecologist medication options to help with ovulation.
A good website (and soon-to-be app) to help educate yourself further about PCOS and dietary changes to help manage PCOS is Lilli Health (lillihealth.com).
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