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What is PCOS and what causes it? #AskAugust

By Team August, verified by Dr. Staci Tanouye (she/her), MD FACOG, OB/GYN | 9.12.2022

September is PCOS Awareness Month!

Before we share personal PCOS stories from our community, we wanted to ensure that everyone had a baseline understanding about this hormonal disorder that affects 6-12% of Americans with a uterus who are of reproductive age.

All of the following medical information was verified by Dr. Staci Tanouye (she/her), MD FACOG, OB/GYN from the August Medical Board.

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is an endocrine (aka hormonal) disorder experienced by menstruators of reproductive age who have inconsistent and prolonged periods caused by high hormone levels.

The specific hormones are called androgens which are typically produced by those assigned male at birth.

The exact cause of PCOS is unknown but some factors that may be related are:

  • Excess insulin levels: insulin is the hormone produced in the pancreas that allows cells to utilize sugar (aka your body's primary energy supply). If your cells become resistant to insulin, then your blood sugar levels can rise. This, in turn, might increase androgen levels, causing difficulty with ovulation.

  • Low-grade inflammation: this is a term used to describe white blood cells' response to fight infection throughout the body. PCOS can cause a type of low-grade inflammation that prompts polycystic ovaries to produce androgens, which can lead to heart and blood vessel problems.

  • Genetic: Research suggests that certain genes might be linked to PCOS.

  • Excess androgen: Having too much androgen interferes with ovulation. If this is the case, the ovaries will produce abnormally high levels of androgen, resulting in hirsutism (aka excessive hair grown on your face) and acne.

What are the symptoms of PCOS?

The signs and symptoms of this hormone condition look different for everyone, so be sure to check in with your doctor if you have three or more of these signs & symptoms:

  • irregular periods (both infrequent OR prolonged) – the most common sign of PCOS
  • sudden weight gain
  • thinning hair
  • sudden adult acne
  • excessive hair grown on your face (hirsutism)
  • elevated androgen hormones (must be determined via a test by medical professionals)
  • polycystic ovaries: ovaries might be enlarged and contain follicles that surround the eggs, resulting in less or irregular functionality

When do PCOS symptoms show up?

Signs and symptoms of PCOS often develop around the time of your first menstrual period, during puberty.

That being said, sometimes PCOS develops later, for example, in response to significant weight gain.

How is PCOS diagnosed?

PCOS is a tricky disorder and quite hard to definitively diagnose, so there isn't a one size fit all path to diagnosis.

Usually, your doctor will start with a conversation about your symptoms, then run a blood test or pelvic exam. In some cases your doctor may also run an ultrasound to check out the appearance of your ovaries and the surrounding tissue to be 100% sure.

If you think you may have PCOS and are having trouble getting diagnosed, we’re here cheering you on and want you to feel empowered to advocate for yourself! Check out this piece about medically advocating for yourself as you navigate the healthcare system.

Protip: To be extra ready for your first appointment, prepare a detailed list of

  • your symptoms and the length of time you have had them
  • all the medications and supplements you take
  • a record of your menstrual cycle
  • and a list of all your questions

You got this!

What are the treatment options for PCOS?

Unfortunately, there is no cure for PCOS, but there are management options for ALL symptoms.

PCOS treatment focuses on managing the individual concerns and symptoms (i.e. hirsutism, acne, obesity, type 2 diabetes, and infertility) rather than a single method of treatment.

Your doctor may recommend different forms of birth control, progestin therapy, and medications to help stimulate ovulation like gonadotropins or letrozole to name a few.

If you are struggling with hirsutism, there are medications like spironolactone to block the effects of androgens on your skin.

For simple lifestyle changes, your doctor may recommend health and diet plans since PCOS can be aggravated by weight gain and high carbohydrate diets that cause fluctuations in your hormones.

In collaboration with your doctor, your treatment plan will be specialized to your needs.

How does PCOS affect a person’s menstrual cycle?

PCOS can cause irregular cycles including shortened flow duration, extended flow and heavier flow.

It can also affect the functionality of a person’s ovaries and ovulation.

Check out August’s sustainable period care options – including pads & tampons that biodegrade within 1 year!

Does PCOS cause infertility?

PCOS is the leading cause of infertility in menstruators. Although, not everyone with PCOS has trouble conceiving.

Can you develop PCOS after having a child?

PCOS can show up in one’s life at any time. Although, having a child does not “cause” or contribute to development of PCOS.

Notably, there can be early signs of PCOS that show up in pre-pubesence and many symptoms of PCOS persist past menopause.

Does PCOS cause diabetes?

Yes, it can cause insulin-safe diabetes.

For people with PCOS, the chance of having type 2 diabetes increases due to the connection of excess insulin and resistance to insulin caused by PCOS.

Have more questions about PCOS?

You can always #AskAugust

We’re here to empower you as you become more knowledgeable about your body and your period.

Stay tuned all September for PCOS Awareness Month, including personal stories from our #InnerCycle community!

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