PCOS: Understanding the Most Common Cause of Irregular Periods 

About 15% of women of reproductive age have polycystic ovary syndrome (PCOS), and most are diagnosed in their 20s or 30s, when irregular menstrual periods and difficulty getting pregnant prompts them to seek expert evaluation and care for infertility. 

What they learn about their newly diagnosed condition is that reproductive issues are just part of the adverse effects connected to PCOS. 

In recognition of PCOS Awareness Month this September, our women’s wellness team at Panhandle Obstetrics and Gynecology in Amarillo, Texas, is here to discuss the ins and outs of this common female health problem — from warning signs and health effects to treatment options. 

Understanding PCOS 

PCOS is a complex health condition that causes reproductive hormonal imbalance during a woman’s childbearing years (ages 15-44). Specifically, it prompts your ovaries to produce high levels of androgens, or male sex hormones, frequently leading to irregular or missed periods, inconsistent ovulation, and fertility problems. 

PCOS takes its name from small, fluid-filled sacs (follicle cysts) that are often visible on the outside of the ovaries of women with this condition. Follicle cysts, which aren’t dangerous or painful, appear with the lack of ovulation (anovulation) that can occur with PCOS. However, not all women with PCOS have visible follicle cysts on their ovaries. 

The mechanisms of PCOS 

While experts are still studying the causes of PCOS, research suggests it’s a product of genetic and environmental factors, along with chronic, low-grade inflammation. This may be why PCOS is more common among overweight women; excess fat fosters increased and ongoing systemic inflammation. 

High androgens 

Women’s ovaries produce estrogen, the main female reproductive hormone, along with lesser amounts of androgens, or male sex hormones. But with PCOS, your ovaries produce abnormally high levels of androgens like testosterone, DHT, DHEA, and androstenedione.

Insulin resistance 

Besides causing ovarian dysfunction and high androgen levels, the persistent, low-grade inflammatory state behind PCOS often gives rise to insulin resistance, the precursor of prediabetes and type 2 diabetes. Insulin resistance affects about 70% of women with PCOS. 

A vicious cycle 

Insulin resistance intensifies the high androgen state by prompting your ovaries to release even more androgens. The complex interaction between excess testosterone and increased insulin levels sets the stage for a vicious cycle that perpetuates and worsens these imbalances. 

PCOS signs and effects 

Along with low-grade inflammation and excess androgens, insulin resistance is a prime root physiological imbalance behind most (if not all) PCOS cases. This imbalance is what promotes easy weight gain and exacerbates PCOS symptoms and effects. Let’s take a closer look:

Reproductive issues

Excess androgens are the primary cause of the reproductive issues associated with PCOS, including irregular periods and ovulation as well as trouble conceiving naturally. These effects vary among individuals; some women with PCOS have mostly regular periods, while others have little trouble getting pregnant. 

Appearance changes

High androgen levels can lead to oily skin, acne, thinning scalp hair, and excess hair growth in areas where men typically grow hair and women don’t, such as your face, chin, chest, and abdomen. About 70% of women with PCOS have excess male-like hair growth. 

Insulin resistance can cause the formation of skin tags on your neck or in your armpits; it can also cause darkened patches of thick, velvety skin in your neck creases, near your groin, or beneath your breasts. 

Increased health risks 

The combination of high androgen levels and insulin resistance acts as a sort of one-two punch, significantly increasing your risk of developing chronic health problems like high cholesterol, high blood pressure, heart disease, and type 2 diabetes. 

Insulin resistance also promotes easy weight gain and makes it harder to lose weight. Like high androgen levels, excess weight — particularly excess midsection fat — increases inflammation, worsens insulin resistance, and intensifies the PCOS imbalance cycle. 

Gain control over PCOS 

Luckily, PCOS is highly treatable, and most women can see significant symptom and health improvements with a combined approach that includes: 

Lifestyle changes

Three specific lifestyle changes can minimize the effects of PCOS. Our team helps you come up with a concrete plan to:

• Reach and maintain a healthy weight 
• Establish healthier eating patterns 
• Exercise more and improve your fitness

These changes alone — weight management, a nutritious diet, and daily exercise — are sometimes all it takes to improve insulin resistance, ease systemic inflammation, and minimize PCOS-related symptoms and concerns. 

Targeted treatments

Sometimes, the best treatment approach for PCOS involves lifestyle changes supported by medication. If you aren’t trying to get pregnant, we may recommend:

• Hormonal birth control medication
• Androgen-blocking medication
• Metformin to improve insulin sensitivity 

If you’d like to conceive in the near future, you may find success through lifestyle changes combined with ovulation-inducing medications. If ovulation medications don’t work, in vitro fertilization (IVF) is often a good next step. 

To learn more about PCOS management, call us at 806-359-5468 to schedule a visit at Panhandle Obstetrics and Gynecology today.