There are a lot of things that can lead to an absent period or two; someone may be pregnant, trying out a new birth control method, or experiencing increased stress. But then you notice acne, hair on your chest, or perhaps a thinning of hair on your head. What could be happening?

You could be one of the 5 to 10% of people who have polycystic ovary syndrome, or PCOS. Her Wellness Health Center is here to explain PCOS, its symptoms and treatments for you to better understand what might be happening to your body.

Polycystic ovary syndrome (PCOS) is fundamentally a hormone imbalance. This often includes an increased level of testosterone-like hormones called androgens but also may involve imbalances of estrogen and progesterone as well. “Polycystic” describes the many small cysts, fluid-filled sacs, that form in the ovaries, preventing normal functioning.

Besides missed or irregular periods, excess body hair, and belly-focused weight gain, people with PCOS also may experience:

• Acne or oily skin
• Fertility difficulties – IMPORTANT! Simply having PCOS does NOT function as a contraceptive
• Skin tags – small pieces of excess skin on the neck or armpits
• Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts

Dr. Garritano or Christina will diagnose PCOS when you have at least two symptoms of these symptoms:

• Irregular menstrual periods especially fewer than nine periods each year
• Elevated levels of androgen hormones on bloodwork
• External symptoms of elevated androgens
• Ovaries with an abundance of cysts

Some people with PCOS may also have some resistance to insulin, and there can be a correlation between high levels of insulin in the body and increased levels of the sex hormones that cause PCOS symptoms. Being overweight may also can also increase insulin levels and worsen PCOS symptoms. Inversely, having PCOS can sometimes make it more difficult to lose weight. PCOS may also run in families, with sisters or a mother and daughter more likely to experience it.

PCOS typically occurs between the ages of 15 and 44, or childbearing years, but can develop at any age after puberty. Most people are diagnosed with PCOS in their 20s and 30s, sometimes when they are having difficulties getting pregnant and consult a doctor. Any person with ovaries is at risk of PCOS, but the risk is higher if you are overweight or if you have a close relative with PCOS.

Experts aren’t sure what causes PCOS to develop, but suspect that excess insulin production, low-grade inflammation, heredity and excess androgen production play a large role. There is no known method to prevent PCOS, but maintaining a healthy weight can be of some help.

Left untreated, PCOS can increase risk for:

• Fertility problems
• Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and high cholesterol or triglyceride levels that significantly increase the risk of multiple health issues including type 2 diabetes
• Abnormal uterine bleeding,
• Endometrial cancer

While many people with PCOS do not have difficulty becoming pregnant, some people do struggle with PCOS-related fertility difficulties.  Lifestyle changes and medications to help manage insulin resistance may help you ovulate more regularly, and Dr. Garritano and Christina can also refer you to a fertility specialist, who can provide a range of care, from hormonal medications to stimulate ovulation to invitro fertilization procedures.

If you are not planning on becoming pregnant, the most common treatment for PCOS is hormonal birth control, including the pill, patch, IUD, vaginal ring or injections.  These options can help regulate hormones, protect against abnormal uterine bleeding and irregular periods, and sometimes also reduce other symptoms like acne.  Not interested in hormonal birth control?  Dr. Garritano and Christina are always happy to talk about more holistic approaches to care, and can refer you to a naturopathic provider if interested.

While there is no cure for PCOS, with Dr. Garritano and Christina’s help, you can manage PCOS symptoms for a better quality of life, manage your family planning and lower your risk of diabetes and cardiovascular disease.

If you have questions about PCOS, or any facet of your reproductive and sexual health, call Her Wellness Health Center at 203-409-2539 or click here to schedule an appointment. We are always happy to help.