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Polycystic Ovary Syndrome (PCOS): Impact & Diagnosis

Magnifying glass, pencil and clipboard with white paper written with Polycystic Ovary Syndrome on wooden background.

In part two, we discussed the potential causes and symptoms of PCOS. This week, we will discuss the impact and diagnosis process of PCOS.

How PCOS Impacts the Body

Elevated androgen levels can affect fertility and other aspects of a patient’s health.

Infertility

PCOS is one of the most common causes of infertility in women because ovulation is necessary to get pregnant. Patients who don’t regularly ovulate release fewer eggs to potentially be fertilized.

Metabolic syndrome

Up to 80% of patients with PCOS are overweight or obese. Both PCOS and obesity increase a patient’s risk for high blood sugar, high blood pressure, low levels of HDL (“good”) cholesterol, and high levels of LDL (“bad”) cholesterol.

Collectively these symptoms are called metabolic syndrome and this syndrome increases the patient’s risk for heart disease, diabetes, and stroke.

Sleep apnea

Sleep apnea is a potentially serious condition that causes breathing to stop and start during sleep.

This sleep disorder is more common in patients who are obese, particularly if this patient also has PCOS. The risk for sleep apnea is 5-10x higher in obese patients that have PCOS compared to those that don’t have PCOS.

Endometrial cancer

The endometrium sheds during ovulation. If a patient doesn’t ovulate monthly, the endometrium can build up.

A thickened endometrium can increase a patient’s risk for endometrial cancer.

Depression

The hormonal changes and symptoms can negatively affect a patient’s emotional wellbeing. Many patients with PCOS end up experiencing symptoms of depression and anxiety.

SUMMARY

Hormonal imbalances can impact a woman’s health in a number of ways. PCOS can increase the patient’s risk for many things including; infertility, metabolic syndrome, sleep apnea, endometrial cancer, and depression.

How PCOS is Diagnosed

PCOS is usually diagnosed in women who have at least two of these three symptoms:

● ovarian cysts

● elevated androgen levels

● irregular menstrual cycles

Health care practitioners should also ask the patient whether or not they’ve had other PCOS symptoms like acne, abnormal hair growth, and unexplained weight gain.

A pelvic exam can look for any reproductive problems. During this test, the doctor will look for any ovarian or uterine growths.

Blood tests check for elevated levels of androgen. The doctor may also choose to do blood tests to check the patient’s cholesterol, insulin, and triglyceride levels to evaluate their risk for related conditions (like heart disease or diabetes.)

An ultrasound uses sound waves to look for abnormalities in the ovaries and uterus.

SUMMARY

Doctors diagnose PCOS if women have at least two out of three main symptoms — elevated androgen levels, irregular menstrual cycles, and ovarian cysts. Examinations like pelvic exams, blood tests, and ultrasounds are used to confirm the diagnosis.

Pregnancy and PCOS

PCOS disrupts the menstrual cycle and this makes it harder for patients to conceive. Between 70-80% of women with PCOS experience fertility problems.

PCOS can also increase the risk for pregnancy complications.

Patients with PCOS are twice as likely to have a premature birth compared to women who don’t have the condition. Additionally, they also have a greater risk for developing high blood pressure, gestational diabetes or suffering a miscarriage.

However, patients with PCOS can get pregnant using fertility treatments that help increase their ovulation. Losing weight and lowering blood sugar levels can also improve a patient’s chances of having a healthy pregnancy.

SUMMARY

PCOS can make it more difficult for patients to get pregnant, and it can increase their risk for pregnancy complications like miscarriage. Things like weight loss and fertility treatments can improve their odds of having a healthy pregnancy.

Come back next week for part four where we will be discussing the treatment options for PCOS.

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