September is PCOS Awareness month


by Leigh Ann Woodruff, September 11, 2012

In 1935, American gynecologists Irving F. Stein, Sr., and Michael L. Leventhal first described a syndrome in which they associated the presence of ovarian cysts with anovulation (absent ovulation) in women. The syndrome, originally named Stein-Leventhal syndrome, and is now a subset of a more encompassing disorder called polycystic ovarian syndrome (PCOS).

September is PCOS Awareness Month, and today the syndrome is understood to be a complex disorder that is characterized by an elevated level of male hormones (androgens) and anovulation. Not all women who are diagnosed witih PCOS have the polycystic ovaries — ovaries with small, immature egg-containing follicles that are called “cysts.”

“In the United States, polycystic ovarian syndrome is one of the most common endocrine disorders of women in the reproductive age group, with a prevalence of 4 to 12 percent,” says John Payne, M.D., a fertility doctor with Piedmont Reproductive Endocrinology Group (PREG) in South Carolina. “In various European studies, the prevalence of PCOS was 6.5 to 8 percent.”

Criteria for PCOS
Dr. Payne explains that in 2003, the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) recommended that at least two out of three criteria are required for PCOS to be diagnosed:

Oligo-ovulation (infrequent ovulation) or anovulation (absent ovulation) manifested as oligomenorrhea (infrequent menstrual periods) or amenorrhea (absence of menstrual periods).
Hyperandrogenism (clinical evidence of androgen excess) or hyperandrogenemia (biochemical evidence of androgen excess)
Polycystic ovaries, as defined with ultrasound
In women with PCOS, the ovaries are not making all of the hormones needed for an egg to fully mature; instead they are making male hormones. The woman’s egg follicles may start to grow and build up fluid, but ovulation does not occur, and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle becomes irregular or stops altogether.

Weight, Insulin Resistance Play a Role in PCOS
When discussing PCOS and weight, it’s kind of like the chicken and the egg: Does being overweight cause PCOS or does PCOS cause you to gain weight?

“Between 40 percent and 85 percent of women with PCOS are overweight or obese, and obesity is closely linked to the development of PCOS,” Dr. Payne says. “Although it is well established that obesity increases the severity of the clinical features of PCOS, data regarding the prevalence of PCOS in obese women and the change in body weight in women with PCOS over time are scarce.”

He cites one study that investigated whether obesity increases the risk of PCOS in the general population. “They demonstrated that the prevalence rate of PCOS in underweight, normal-weight, overweight and obese women were 8.2 percent, 9.8 percent, 9.9 percent, and 9.0 percent, respectively, similar to that observed in the general population,” he says “These results suggest that the risk of PCOS is only minimally increased with obesity.”

However, a Spanish study had different results. “In a Spanish prevalence study among overweight and obese subjects, they demonstrated a 28.3 percent prevalence of PCOS, which is markedly higher compared with the 5.5% prevalence of PCOS in lean women in Spain.”

PCOS also makes it more difficult for the body to use the hormone insulin, a condition called insulin resistance, which can cause insulin and glucose to build up in the bloodstream. These high insulin levels can also increase productive of male hormones, leading to symptoms such as body hair growth (hirsutism), acne and weigh gain. “Approximately 40 percent of patients with PCOS have insulin resistance that is independent of body weight,” Dr. Payne says. “These women are at increased risk for type 2 diabetes mellitus and consequent cardiovascular complications compared with healthy women.
The American Association of Clinical Endocrinologists and the American College of Endocrinology recommend screening for diabetes by age 30 years in all patients with PCOS, including obese and nonobese women.”

Be Aware
Symptoms of PCOS can show up at an early age, but may be confused with signs of puberty. “The age of onset is most often perimenarchal, before bone age reaches 16 years; however, clinical recognition of the syndrome may be delayed by failure of the patient to become concerned by irregular menses, hirsutism or other symptoms — or by the overlap of PCOS findings with normal physiologic maturation during the two years after menarche,” Dr. Payne says.

Often, women are not diagnosed until they start trying to conceive and experience infertility. So be aware of PCOS and get treatment early to get the condition under control. While signs and symptoms of PCOS vary from woman to woman, here are some of the most common :

Infrequent, absent or irregular menstrual periods
Hirsutism, which is increased hair growth on the face chest, stomach, back, thumbs or toes
Many immature follices/cysts on the ovaries
Acne, oily skin and dandruff
Weight gain or obesity, usually with extra weight around the waist
Thinning hair or male pattern baldness
Thick, dark brown or black patches of skin
Skin tags
Pelvic pain
Anxiety or depression
Sleep apnea

My thoughts on September being PCOS and this article …

1. I have never agreed with all of these causes or diseases with having a day, week or month but here I am posting something that is finally close to my heart to bring awareness to.

2. The criteria mentioned above is interesting because through various tests over the year I am pretty sure that I have been diagnosed with all of those items. I remember clearly when I had my ultrasound and you could see the white dots on the screen and the tech marked them all.

3. Chicken or egg…even in my skinner days I had the symptoms listed above that would describe PCOS, the stats are also interesting. How much of the issues is weight vs. PCOS and giving you the weight issue?

4. I look back now and I had severe and very irregular periods when I was a teen. The doctors and many others just chalked it up to being a teen and puberty. When I got to university I went four or five months without having my period, I know every girls dream right? That is until they induce it for you! I also have always known that my mom had immense difficulty in conceiving me and my parents also tried for a second child and were unable, so my family history has always been in the back of my mind, as well. Plus, after we got married and settled down we got family doctors and I said I think I have PCOS, a bunch of tests later the doctor confirms this and tells me that there is nothing to worry about until TTC. Once we made that decision he would immediately send us to a specialist. Well, last summer, we made the decision to try and the doctor then said well give it six to eight months to see if it will happen naturally…really? You know I have this condition and you tell me this. So, I went with him and decided it couldn’t hurt to just continue TTC and have fun. Six to eight months later I make another appointment, this time he tells me it would be good to track my temperature, ummm why did you not tell me that before? Would of helped a lot. So again, I decide to follow the good doctors orders and check every night. I see him two months later and he says that yes it does not look like I am ovulating. Shocker. Soon after we had our appointment book. Too bad it has taken so long.

5. symptoms listed above I can check almost everyone to a tee.

6. Babies are everywhere right now. I know they are cute but every time I see one I am reminded that I don’t have one and I am currently stuck not having one. Everyone seems to gently talk about it and so many people I know are preggers. Someone recently told me and it seemed like they were walking on eggshells, well thank you. If one more person tells me…good news; my DH has informed me he is not ovulating nor with child.

7. Still waiting, i feel like I am in a rut until I am able to get another test. Wait, wait and wait some more.

8. But until that, read the symptoms and be aware.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: