Here at PLRG, we constantly receive emails about new products, restaurants and services targeted at women just like us. It’s not often, however, that something really makes us stop and want to learn more and in this case - scares us. A few weeks ago, we read an article about how thousands of women across the country are mistaking their acne and/or excessive hair growth for mere beauty “fixer-uppers” when they are actually external symptoms of PCOS - Polycystic Ovary Syndrome. By turning to beauty treatments, these women are actually hiding the warning signs and covering up what could be a serious health condition that if left untreated could lead to infertility and even cancer. We needed to know more so we reached out to fellow PLRG (and kick-ass OB-GYN), Dr. Jessica Groden. Dr. “G” as we like to call her filled us in on PCOS and what we all should know about it. We are thrilled to have Dr. G as a new regular contributor to PLRG.com, bringing us information and advice every month on various women’s health issues and information. Here’s to your health!

"Why are the young, hot doctors standing behind me!?"

Polycystic Whaat?!

Polycystic Ovarian Syndrome, also known as Stein-Leventhal syndrome, or more commonly, PCOS, is a disorder that affects the reproductive (ie: babymaker) and metabolic systems of the body. It’s hard to estimate it’s prevalence given the debate among the criteria necessary for diagnosis of this disease; some estimate approximately 7% of reproductive aged women are affected by PCOS.  In recent years, different organizations like the National Institute of Health and the Androgen Excess Society have created varying diagnostic criteria, but they all share key features of the disease.

Editors Note: Ok, we’re about to throw some smart shit your way (like harvard smart) so if you’re still working off last night’s hangover, we suggest you consider bookmarking this one.

Hyperandrogenism, or elevated levels of androgens in the blood, is the first of these features.  Androgens are hormones naturally found in both men and women, but in significantly higher concentrations in our male counterparts- and possibly some female body builders, but don’t quote us on that.  Testosterone is the most well known of the androgens, and is the hormone to which we owe Brad Pitt’s deep manly voice, Tom Selleck’s  thick chest hair, and the big muscles that we wish our boyfriends had.  However, abnormal hormone regulation in PCOS causes elevated androgen levels, which in turn has some unpleasant consequences such as acne, oily skin, and abnormal hair growth in places like the chin or chest.  Some may even have an enlarged clitoris or a deep voice. Is that good enough of a visual for you?

A second key feature of this disorder is abnormal periods.  Women with PCOS may have a total absence of periods, or very irregular cycles.  We can also blame this on the abnormal hormone regulation, which is due to anovulatory cycles, or menstrual cycles where no egg is released from the ovary.  As you may have guessed, when there is no egg released each month, getting pregnant can be difficult.  In fact, many women are first diagnosed with this condition when they try to become pregnant and are unsuccessful.

Despite its name, the presence of polycystic ovaries is not required for diagnosis of PCOS.  Polycystic ovaries are ovaries that have multiple cysts on them. Yes, we know how scary that sounds, but cysts are actually an extremely common and often incidental finding on pelvic ultrasound or other imaging study.  In combination with the above mentioned symptoms, polycystic ovaries may aid in the diagnosis, but not all women who have ovarian cysts have PCOS, and not all women with PCOS have ovarian cysts.  Other features are often found in women with PCOS, obesity being one of the most common.  PCOS patients may also have elevated blood pressure and early signs of diabetes mellitus like insulin resistance.  Women who are diagnosed with PCOS will always be screened for these conditions.

So what’s the big deal? A little chin hair never hurt anyone.

PCOS is a risk factor for some more serious diseases than acne and unsightly hair.  PCOS carries with it an increased risk for cardiovascular disease and diabetes, as well as other worrisome complications such as endometrial hyperplasia (sometimes a precursor for cancer) and endometrial cancer.  We can blame this on the chronic exposure of the endometrial lining of the uterus to estrogen, which is normally suppressed during half of our menstrual cycle after ovulation.  Luckily, simply losing weight can reduce the risk of these complications substantially!  Weight loss in PCOS patients is associated with resumption of normal menses, increase in spontaneous pregnancy rates, and improvements in insulin resistance and cholesterol, not to mention your jeans will thank you. These benefits of weight loss aren’t limited to PCOS patients.  If you’re overweight, go for a walk, join a gym, get a workout buddy…whatever it takes to be as healthy as you can!

I have acne…Do I have PCOS?

An occasional zit is normal. Stubborn, bad acne that won't go away no matter what you do? That's something to talk to your doc about.

Just like not everyone who carries a Prada bag has a big bank account, not everyone who has irregular periods or acne has PCOS.  Sometimes acne is just acne and irregular periods are just irregular periods.  There is a broad differential diagnosis for the various combinations of symptoms of PCOS, from thyroid disease to primary ovarian failure.  If you are worried about any combination of symptoms, make an appointment to see your gynecologist or primary care doctor to get things checked out.  If you’re trying to get pregnant without any success, it’s important to keep in mind that true infertility is not diagnosed until it has been unsuccessful for a full year.  Trying for 2 months without success is NOT something to worry about.  That being said, it’s always a good idea to see your doctor before trying to become pregnant so you can get your prescriptions for prenatal vitamins and find out all the food (and drinks) to avoid.  No matter where you’re at in your reproductive life- trying to get pregnant, trying everything you can to not get pregnant, trying to lose weight or get rid of that stubborn acne- establishing yourself with a doctor you trust and respect while you’re young and healthy is important!  So talk to your friends, ask for referrals, do some research and think about a new year’s resolution to stay healthy.

Happy holidays!
Dr. G

Dr. G was born and raised in Boston. She graduated from Tufts University and went on to the Tufts University School of Medicine. After graduating from medical school, she began her training as a resident physician in Obstetrics and Gynecology at one of the largest medical centers in the midwest. She currently is living the life of a PoorLittleRichGirl on a resident physician’s salary, and is always happy to share some free medical advice in between delivering babies and going to the operating room!