Core Symptoms of PCOS Include:

PCOS has many different signs and symptoms. Some women may not be aware that seemingly unrelated symptoms are those of PCOS. Common PCOS signs and symptoms include the following:

Irregular menstrual periods
Infertility
Obesity
Excess hair growth
Severe acne
Oily skin
Patches of thickened, velvety, darkened skin called acanthosis nigricans
Multiple fluid-filled sacs in the ovaries

Not all women with PCOS have all of these symptoms. Often women find out they have PCOS when they see a health care professional because of irregular menstrual periods or difficulty becoming pregnant.

What causes PCOS

Although the cause of PCOS is not known, it appears that PCOS may be related to many different factors working together. These factors include insulin resistance, increased androgen levels, and an irregular menstrual cycle.

There is fivefold higher risk of inheriting the genes for PCOS from mothers with PCOS. Genetic studies suggest a causal relationship between PCOS with BMI, insulin resistance, onset of menopause, depression and male-pattern balding. New results suggest that altering the gut microprobe via prebiotics or probiotics, fish oil, and fiber may be a potential treatment option.

For women with PCOS with an elevated BMI, lifestyle modification is the first line of management. Weight loss alone is very helpful in restoring ovulatory function (regular periods), correcting insulin resistance and reducing the risk of diabetes. New weight reduction medications such as Contrave Saxende and Wegovy are the latest to be used with excellent results. Coupled with a meal guide (Mediterranean meal guide, Weight Watchers or equivalent, exercise (150 minutes/week) and/or a consultation with a dietitian are sure ways to get started!

Diagnosing PCOS

The diagnosis of PCOS relies on the history of irregular menstrual periods and elevated androgens, such as testosterone and DHEAs. Often hirsutism, acne, obesity and diabetes are present, but not always. An ultrasound of the ovaries often shows multiple small cysts in one or both ovaries. What is really interesting and important is that often the above symptoms are sometimes present but not always. The spectrum of presentation is really wide with a normal weight woman with relatively few complaints and somewhat irregular periods on the other end.

Up to 40% of hirsute women with regular monthly cycles may not ovulate regularly. Ovulations dysfunction is regarded as periods 735 days apart or less than 8 cycles per year. The most important blood tests to establish a diagnosis are FSH, LH, Testosterone, DHEAs, and AMH. The transvaginal ultrasound should show 20 or more 2 -9 mm follicles on at least one ovary. There is no one accepted definition of PCOS. PCOS is diagnosed when a woman has two of the three key features of PCOS:

1. Increased levels of androgens, either by measuring the levels of androgens in the blood or by noting the presence of unwanted hair growth.

2. Lack of menstrual periods or irregular menstruation

3. Ovaries with many fluid-filled sacs