Overcoming PCOS, the disease 5 million women have but don’t know it

Stock image | Photo by Rawpixel/iStock/Getty Images Plus, St. George News

ST. GEORGE — September is polycystic ovarian syndrome awareness month, and organizations like the PCOS Awareness Association are working to inform women about the disease that affects approximately 10 million women worldwide, over half of whom are unaware they have it.

PCOS is a hormonal disease that causes a woman’s ovaries to have difficulty releasing eggs each month. A woman can develop it at any time in her life, but it commonly appears during adolescence.

The Intermountain Women’s Health Specialists office, St. George, Utah, Aug. 14, 2018 | Photo by Mikayla Shoup, St. George News

Major symptoms of PCOS are irregular or missed periods and difficulty conceiving. Other symptoms include acne, weight gain, trouble sleeping, mood swings and abnormal hair growth in places where men typically grow hair, like the chest or upper lip, according to the PCOS Awareness Association.

Most women do not realize they have PCOS since it usually isn’t painful, and thus they only discover it when they see a doctor for irregular periods or trouble getting pregnant.

This was the case for Amber Spencer, who first saw a doctor after having an irregular menstrual cycle for eight months but having negative pregnancy test results. She was prescribed medication and told to wait a year to see if it improved her fertility. 

“A year? I didn’t have a year. I wanted a baby like, yesterday,” Spencer said. 

Frustrated by having to wait so long and tired of feeling sick from the Metformin she was prescribed, Spencer decided to see a different doctor, which is when she met Robert Chalmers, Dixie Regional Medical Center OB/GYN.

“Instantly, he became my favorite doctor,” Spencer said. “He heard my concerns and immediately started me on a new regimen. He talked to me about several treatment plans and things I could try right away.”

With Chalmers’ help, and the use of steroids, Femara and two human chorionic gonadotropin shots, Spencer was able to conceive her first child and has had two since.

Causes of PCOS

The exact reason why certain women develop PCOS is unknown, but there are a number of factors that predispose a woman to it. Usually, it’s a combination of family history, genetic predisposition and lifestyle choices, Chalmers said. 

Women with PCOS produce a larger than normal amount of androgens, which are male hormones like testosterone that women naturally make in small quantities, according to the U.S. Department of Health and Human Services’ Office on Women’s Health. High insulin levels also contribute to a woman developing PCOS.

The disease is becoming more common in the U.S., which may be because of an overall less healthy population. As a person’s weight increases, so does their risk of PCOS. This may be related to higher insulin levels, as many women with PCOS have insulin resistance, which also puts them at high risk of developing diabetes, Chalmers said.  

While medical treatment is still necessary for PCOS, Spencer started a paleo diet and exercise, which helped control the disease.

Treatment

Treatment options depend on whether a woman wants to become pregnant. If she does, she is given medicine to help her ovulate. The medicine makes the pituitary gland in her brain release the hormones that prompt the ovaries to release an egg every month.

“We take the signal that the brain sends to the ovary to tell it to do its job, and we just make it louder, we make it stronger,” Chalmers said.

If a woman is not interested in becoming pregnant, she is generally prescribed birth control pills that help regulate her menstrual cycle and balance her hormones, which in turn reduces other symptoms like acne and abnormal hair growth.

The birth control pill also raises the level of a protein called the sex hormone binding globulin, which acts as a sponge to absorb excess androgens. Regulating a woman’s menstrual cycle with the pill will help her to be more fertile in later years and protects her from developing uterine cancer later in life, Chalmers said.

It’s important for women who are having irregular periods to see a doctor sooner rather than later. Symptoms become more difficult to treat as time goes on and the sooner treatment can begin the better the chances of fertility. Missing a period occasionally is OK, Chalmers said, but chronically missing or having irregular periods is cause for concern. A normal menstrual cycle is between 21 and 35 days.

Not having a menstrual cycle for long periods of time, for several months or even years, like many women with PCOS experience, does not allow the uterine lining to change each month and can cause uterine cancer.

At the least, a woman who has missed a year’s worth of menstrual cycles will have a severe case when she finally does get her period, sometimes resulting in hospitalization or blood transfusions. Fortunately, Spencer was able to address the issue before it reached this point.

If you notice you aren’t having regular cycles, see your doctor immediately before your symptoms get worse,” she said.

A woman who does not want to become pregnant but also doesn’t want to take birth control pills has to treat the PCOS symptoms individually. There are other treatments and medications for acne, hair growth and even hormonal balance.

Treating diabetes and controlling the insulin levels in the body will often help a patient lose weight, as does regulating a woman’s hormones through medication. However, sometimes it can be hard to determine whether PCOS caused a person to become overweight or if being overweight caused PCOS.

“Some women have no idea that their hormones are the cause of weight gain,” Spencer said. “They try diet after diet and just get discouraged. By addressing the root of the problem, you can find a solution, rather than a band-aid.”

Since early treatment is so important, the PCOS Awareness Association is working to spread awareness of the disease. On Sept. 15, the group has organized nine 2018 PCOS Strides 5K Walks in cities across the U.S. The walk costs $30 and all proceeds go towards PCOS research. There is also a virtual walk for those who live outside of these cities, and participants can commit to walking around their towns and neighborhoods with PCOS signs or T-shirts.

Email: [email protected]

Twitter:  @STGnews | @MikaylaShoup

Copyright St. George News, SaintGeorgeUtah.com LLC, 2018, all rights reserved.

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