PCOS 101: Understanding Polycystic Ovarian Syndrome

Introduction

If you take a look at Allara’s blog, you’ll see we’ve gone in depth on popular topics that surround PCOS, like the connection between nutrition, PCOS, and fertility, how exercise can help manage PCOS, thyroid health, and much more. But if you’ve only recently begun to suspect that you have PCOS, or you just got a positive diagnosis, navigating all the information and research out there can feel a little overwhelming, to say the least.

That’s why we’ve created this article to cover the fundamentals of PCOS, so whether your next step is to book a video consultation with a physician at Allara, get blood work done, or find the care plan that’s right for you, you’ll have the information you need to help you make informed, confident decisions.

Here’s what you can expect to know by the end of this article:

• What Is PCOS  
• Most Common Symptoms of PCOS
• What To Do If You Suspect You Have PCOS
• Resources To Visit Next

Let’s dive in.

What Is PCOS?

PCOS stands for polycystic ovarian syndrome. It’s a reproductive health condition (sometimes referred to as an ‘endocrine disorder,’ but these terms essentially mean the same thing) that is characterized by an imbalance of hormones.

Understanding the root cause of PCOS, where it comes from, and what researchers believe is the evolutionary reason behind it is too expansive for this article, so we’ll give you the Cliff’s Notes version of what PCOS entails:

• Typically women with PCOS have higher levels of androgens (male sex hormones) than women without PCOS, and they often also display insulin resistance.

This idea can be confusing at first – how are hormones related to insulin? Well, scientists are beginning to think that this hormonal imbalance and glucose intolerance exacerbate one another. Specifically, high insulin levels prompt the ovaries to produce more testosterone, leading to symptoms such as facial hair and acne, while also driving lower sex hormone binding globulin (shortened to SHBG) levels, which can contribute to signs of excess estrogen.

This brings us to our next point:

• Women with PCOS also have elevated levels of estrogen than women without PCOS.

Wait, so PCOS drives excess male sex hormones (testosterone) and excess female hormones (estrogen)?

Unfortunately, yes. This is why women with PCOS can simultaneously experience signs of high testosterone (think acne, hair loss, excess hair growth), as well as high estrogen (painful periods, heavy menses, and sore breasts).

Most Common Symptoms of PCOS

PCOS symptoms vary from person to person, but the most popular signs of an underlying PCOS diagnosis often include:

• Hirsutism (excess hair growth)
• If you find dark, thick hair on your cheeks, chin, breasts, stomach, chest, and backs of your thighs, this could be a sign of androgen excess
• Hair loss
• We mentioned excess hair growth in the point above, so this sounds like the complete opposite – unfortunately, this hair loss relates to thinning on the head. This hormonal-driven hair loss is often referred to as ‘androgenic alopecia’ or female-pattern hair loss, and is characterized by thinning or balding on the crown of the head, in particular around the middle part. Unlike male-pattern hair loss, women usually don’t see entire balding, with the front hairline preserved.
• Acne
• Acne, particularly cystic acne, on your cheeks and chin can be a result of androgen excess, which often promotes increased oil production.
• Unexplained weight gain
• More than half of women with PCOS are overweight, and they often find it difficult to lose this unexplained weight gain, at least in part thanks to the accompanying insulin resistance.
• Irregular or absent periods
• If your periods occur closer than 21 days apart, or you go more than 35 days between periods, this is a sign of an irregular cycle. If you don’t have periods at all, this may be a sign you aren’t ovulating. One of PCOS’ main implications is that it disrupts your ability to ovulate regularly.
• Cysts on the ovaries
• Contrary to popular belief, not all women who have PCOS have cysts on their ovaries. Perhaps even more surprisingly, many women who don’t have PCOS have cysts on their ovaries, demonstrated by ultrasound scans. That being said, the presence of many cysts on ovarian follicles can lead to painful periods, and are often used as one of three criteria that are considered when doctors give a diagnosis. (These three criteria are popularly known as the Rotterdam criteria – learn more about them, and how they assist in diagnosing PCOS, here).

Given these symptoms, it appears that the underlying causes of this hormonal imbalance manifest themselves in physical symptoms. This can be extremely stressful and uncomfortable, but there is a positive side to this: your body is telling you something is out of balance, and once you receive a diagnosis, you can begin taking the right steps toward figuring out, and giving, your body what it needs.

What To Do If You Suspect You Have PCOS

• Get in touch with your primary care doctor
• If any of the above symptoms sound familiar to you, then we highly urge you to seek the advice of a medical physician. These symptoms could be PCOS, or they could be something else, and the only way to know with peace of mind is to collaborate with an experienced doctor who can run the appropriate tests and ask the right questions.
• Start keeping track of your symptoms, as well as your menstrual cycle
• One extremely common symptom of PCOS is an irregular period, or no period at all, thanks to the anovulatory effect PCOS has on your body. Track signs of ovulation, as well as your menstrual flow. Using apps such as Clue or P.D. can be convenient resources for this step!
• Keep in mind that if you are on hormonal birth control, you won’t be able to track your cycle, since the monthly bleed you experience each month is a ‘withdrawal’ bleed, not a period.
• Explore your options
• Platforms such as Allara Health allow you to have a free call with an experienced medical professional (specializing in reproductive health), who can collaborate with you to understand all different types of approaches to treating PCOS. Learn more about how we tailor a personalized care plan, customized to your lifestyle and needs, here.
• Educate yourself on PCOS
• Phrases like ‘endocrine disorder’ and ‘anovulation’ aren’t words you typically hear day to day (unless you work in a medical setting!). But understanding PCOS doesn’t have to be complicated – that’s why we’ve put together accessible, easy to read resources on important topics like building a PCOS plate, managing PCOS pain, and tackling fertility and PCOS.
• We recommend starting with the following:
• How PCOS is diagnosed
• Learn what blood tests you can expect a doctor to likely order, criteria for diagnosis, and how to navigate a positive diagnosis.
• How to advocate for yourself with PCOS
• This is super important! Unfortunately, it’s well known that women’s health concerns are brushed under the rug (one review refers to this gender bias as the ‘trivialization of women’s health complaints’), so it’s important to keep these skills in mind when navigating the traditional healthcare system. Just remember that you deserve to be heard, understood, and given high quality care, no matter what.
• Finding the best PCOS treatment plan for you
• There is no ‘right’ way to manage your PCOS. At the same time, you shouldn’t accept being given a leaflet about this complicated, potentially life-altering reproductive condition and being sent on your way. Finding the best PCOS treatment plan for you could take some time, but the right team will collaborate with you to create one that fits your needs and health goals.

Allara Health provides personalized treatment for hormonal, metabolic & gynecological conditions that utilizes a holistic plan that merges nutrition, lifestyle, medication and supplementation, and ongoing, expert support to heal your body.