I was recently diagnosed with PCOS, though I’ve had symptoms for 20 years, and I’m wondering why PCOS is looked at as a fertility issue and not an overall women’s health issue. PCOS predisposes me to all sorts of health problems. Why didn’t anyone care until I tried to get pregnant?
Polycystic ovarian syndrome, or PCOS, is the most common hormonal condition affecting women of reproductive age. While PCOS is a cause of infertility, it has much broader health implications and should be addressed as an overall medical issue independent of pregnancy plans.
In the United States, PCOS affects 6 to 12 percent of women of reproductive age. What exactly causes PCOS and its full impact on a woman’s body are unclear. We do know that women with PCOS have higher levels of androgens (male hormones) and ovulatory dysfunction, which means ovulation is irregular or infrequent. As a result, women do not haveregular menstrual cycles each month. Many women with PCOS also have insulin resistance, which means their bodies make insulin but they are unable to use it most effectively.
Women with PCOS are at increased risk for endometrial cancer, diabetes and heart disease. PCOS is also associated with infertility, and it increases the risk of some complications during pregnancy.
Medical professionals should not wait until there is a history of infertility to diagnose and treat PCOS. The diagnosis should be considered for any women who are experiencing symptoms of PCOS, including:
If a doctor suspects a woman may have PCOS after taking a medical history and doing a physical exam, he or she will order blood tests to check for specific hormone levels, and sometimes do an ultrasound of the ovaries. Once a diagnosis is confirmed, women with PCOS should be screened periodically for diabetes with a glucose tolerance test and for metabolic syndrome. Treatment for PCOS will depend on the variety of symptoms a women is coping with, the results of the testing, risk factors for diabetes and heart disease and pregnancy plans. One therapy that can almost always be recommended is exercise, which helps the body use insulin more effectively and can reduce the risk of diabetes.
On a Personal Note
I’m saddened to hear that PCOS was not considered as a possible diagnosis for you over the 20 years that you have had symptoms. Evaluation and management of PCOS should be routine care for every gynecologist.
Dr. Jen Gunter, often called Twitter’s resident gynecologist, is teaming up with our editors to answer your questions about all things women’s health. From what’s normal for your anatomy to healthy sex and clearing up the truth behind strange wellness claims, Dr. Gunter, who also writes a column called The Cycle, promises to handle your questions with respect, forthrightness and honesty.