September marks an important month for many women across the globe: Polycystic Ovary Syndrome (PCOS) Awareness Month! As one of the most common female endocrine disorders, PCOS impacts 1 in 10 women of childbearing age.
Despite its prevalence, there are many myths and areas of confusion about PCOS. And unfortunately, many women that have the disorder go undiagnosed. To set the facts straight, we’ve answered six of the most common PCOS-related questions that patients ask us.
- How is PCOS diagnosed? The Rotterdam Criteria are the most widely accepted criteria used to diagnose PCOS. Two out the three features must be present: irregular or absent ovulation, symptoms or lab work to show high androgen levels, and polycystic-appearing ovaries. Occasionally, women receive a PCOS diagnosis because they’ve had an ovarian cyst, or an elevated AMH or LH/FSH ratio, but these are not part of the criteria! Sometimes confirming a diagnosis in a teen is tricky, but we can identify at-risk adolescents and help them get started on a healthier lifestyle that can preempt a lot of the unwanted symptoms of PCOS.
- Can PCOS be cured? Unfortunately, there’s not a sure-fire cure for PCOS. The goals for management are tracking and treating whichever symptoms are impacting you most at any given time (whether it’s irregular bleeding, infertility, hair growth, anxiety or depression, acne, weight or metabolic concerns, etc.). For many women, trying to restore their ovulatory cycle is a big goal. We can achieve that in many cases, but it can require a strict adherence to dietary and exercise goals, and often a multidisciplinary approach. Working with a team that can help you confirm ovulation is important.
- Can I get pregnant if I have PCOS? Absolutely, but some women may require help from a fertility specialist in order to have a baby. The good news is that even if ovulation is not restored spontaneously, there are simple treatments to help induce ovulation – namely an oral medication called letrozole that will stimulate follicular growth. Of course, when it comes to your fertility, age is a critical factor so success rates remain highest before you reach your mid-to-late 30s. In vitro fertilization (IVF) and other treatments are also options for many women with PCOS, depending on their personal circumstances. It’s best to discuss your case with a fertility specialist.
- Do I have to go on the Pill if I have PCOS?Although combined oral contraceptive pills (OCPs) are the most common method of managing hormonal dysregulation in PCOS, some women prefer a medication-free approach, as discussed above. However, OCPs help many of the most bothersome PCOS symptoms – irregular or heavy cycles, acne, hair growth – and so it is definitely worth exploring which approach will best protect you from uncontrolled symptoms. Most importantly, it is essential to have regular uterine bleeding to allow the uterine lining to shed and protect your uterus from pre-cancerous or cancerous changes. If you’re not on OCPs, pregnant or breastfeeding, you should have some sort of bleed every 3 months at least. Aside from OCPs, contraceptive rings, progesterone IUDs or implants can also help – discuss with your doctor which option makes most sense for you.
- What do I need to do to stay healthy with PCOS? Because PCOS can cause a variety of health issues, especially as relates to weight gain and risks of gestational diabetes, type 2 diabetes and more, it is critical to not ignore your general health. Make sure you are seeing your doctor regularly and have good guidance as to a reasonable diet and exercise goals, and that you are up-to-date on your health screenings. Catching any health changes early is best, so make sure you have a management plan in place that you feel comfortable with and confident about.
- Will I pass PCOS on to my children? There are definitely hereditary components to PCOS, and in general, we will see higher risks of PCOS or metabolic disease in daughters *and* sons (who will show the metabolic risks factors primarily) of women with PCOS. However, our best understanding currently is that at least part of this genetic transmission has to do with the intrauterine environment during pregnancy. This means that making sure you’re healthy before you conceive and staying healthy during pregnancy, have the potential to decrease the impact on your children. It is also true that if you keep your health in check, your health after menopause is likely unaffected by the diagnosis. So, there are a lot of great reasons to take good care of yourself!
PCOS is a multi-faceted, complicated syndrome, and impacts each women in a unique way. If you think you might have PCOS or if you’ve been diagnosed with PCOS and are trying to conceive, we recommend talking to a CCRM fertility specialist. CCRM is here to provide comprehensive, compassionate care that is tailored to you, and maximizes not only your fertility, but the health of you and your family along the way. Contact us today!
Dr. Rashmi Kudesia is a board certified reproductive endocrinologist at CCRM Houston.