PCOS affects over five million in the world today, according to only the data reported by the medical field (which means more women suffer but remain untreated). In part this is due to patient unawareness, but also due to a lack of effort or willingness to listen from medical staff.
I was “diagnosed” at age 12 with PCOS, but doctor’s refused to treat me because I was young enough they hoped by body would just “fix itself.” PCOS is a hormonal dysfunction experienced by women for a variety of reasons.
The key to seeking treatment- and avoiding the “evils” of self-diagnosis- is being upfront and adamant with your health care representative about what you believe is wrong…and that means you need to have a full awareness and understanding of PCOS.
Poly-cystic Ovarian Syndrome
The easiest definition of PCOS is to simply refer to it as an excess of androgen hormones found in women, which leads to a multitude of symptoms such as:
- Infrequent or absent menses is experienced by some; other experience chronic or heavy bleeding in addition to menstrual irregularities.
- Hyperandrogenism: big word that basically means a higher level of androgen hormones which can cause clinical signs (male pattern hair loss, hirsutism, deepening of vocal cords) and/or biochemical signs (proof in blood work)
- Poly-cystic ovaries: exactly what it sounds like. Cysts. In. Your. Ovaries. Can be few or can be many; some rupture (agony) and some don’t.
- Metabolic issues/ cardiovascular risks: 40-85% of women with PCOS exhibit obesity compared to women of the same age in a control group; Insulin resistance is present in 30-70% lean and obese women with PCOS compared to those in a control group.
- Nonalcoholic steatohepatitis: inflammation of the liver due to fat buildup (also called “silent liver disease”).
- Mood: Studies show links to disorders (depression, anxiety), impaired quality of life, and eating disorders.
- Gonadotropins: break down your word roots for this one. Literally means follicle stimulating (androgen linked) hormone).
The crappy part?
Many doctors don’t want to slap a label on this because (don’t hate) it’s easier to tell women to lose weight than it is to diagnose someone with a disorder people know little about. Even now PCOS is relatively unheard of, though it is gaining its’ awareness.
Recently the medical field (whoever names disorders and such) questioned changing the name to match the diagnostic criteria, which does not have to include poly-cystic ovaries.
In fact, diagnosis can include (in order of year method emerged):
Revised diagnostic criteria of PCOS
1999 criteria (both 1 and 2)
- Chronic anovulation
- Clinical and/or biochemical signs of hyperandrogenism, and exclusion of other aetiologies
Revised 2003 criteria (2 out of 3)
- Oligo- and/or anovulation
- Clinical and/or biochemical signs of hyperandrogenism
- Polycystic ovaries and exclusion of other aetiologies (congenital adrenal hyperplasias, androgen-secreting tumours, Cushing’s syndrome)
Other Proposed Diagnostic Criteria in Polycystic Ovary Syndrome
- Inappropriate gonadotropin secretion
b) Abnormal response to GnRH agonist testing
a) Hirsutism, androgenic alopecia, acne
I. Total testosterone
II. Free testosterone (free androgen index, etc.)
3. Ovarian appearance
a) Polycystic-appearing ovaries
b) Increased (stromal) size
4. Insulin resistance
a) Acanthosis nigricans
b) Fasting measures of insulin/glucose
c) Oral glucose tolerance test
d) Dynamic tests of insulin sensitivity
I. Euglycemic clamp
II. Frequently sampled intravenous glucose tolerance test
5. Chronic anovulation
a) Self-reported history
b) Tests of ovulatory function
I. Basal body temperature charting
II. Urinary LH testing
III. Serum progesterone measurement
IV. Endometrial biopsy
FSH, follicle-stimulating hormone; GnRH, gonadotropin-releasing hormone; LH, luteinizing hormone.
Lots of medical talk, but basically it means this:
If you honestly think you have PCOS and exhibit the symptoms, see your doctor! If they don’t want to listen, “self diagnose.” Keep a log of your menstruation, document (photos!) any signs of genuine hirsutism and acne, keep weight logs and if you’re actively trying to lose weight (with or without success) track that, too. If your doctor won’t listen, request a specialist or see a different doctor.
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- lookingforliz said: I have PCOS, it’s a daily struggle but all we can do is keep fighting!
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