The 2023 Women’s Guide to PCOS, according to an ObGyn Specialist

Polycystic Ovarian Syndrome (PCOS) is a complex, chronic condition that can cause a variety of physical and emotional symptoms in women. For this reason, it’s important to stay up-to-date with the latest developments and best practices for managing the disorder – which is why we’ve put together The 2023 Women’s Guide to PCOD & PCOS according to an ObGyn specialist.

 

Here, you’ll find advice from Dr. Eric Pulsfus, MD FACOG, on how to manage your PCOS including diet changes, hormone treatments, lifestyle modifications and more. We hope this guide helps empower you to take control of your health and live a healthier life despite having PCOS.

What is PCOS?

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age. PCOS is characterized by an imbalance of female sex hormones, including androgens. PCOS can cause many different symptoms, such as irregular menstrual cycles, acne, unwanted hair growth, and pelvic pain. PCOS is also associated with an increased risk of certain long-term health complications like diabetes, heart disease, and depression.

 

 

What are the signs and symptoms of PCOS?

PCOS occurs when the ovaries produce higher than-normal levels of certain hormones, often including testosterone. This hormone imbalance interferes with the production of eggs during ovulation. As a result, multiple cysts can form on the ovaries. PCOS symptoms vary from woman to woman but may include:

 

– Irregular or missed menstrual periods

– Excessive hair growth on the face, chest, stomach or thighs

– Acne or oily skin

– Weight gain or difficulty losing weight

– Thinning hair on the scalp

– Skin tags in armpits and neck area

– Dark patches of skin on neck creases or underarms

– Fertility problems due to lack of ovulation

– Anxiety and depression due to hormonal imbalances 

 

PCOS isn’t just about physical signs and symptoms – it also has psychological effects such as anxiety, depression, low self-esteem and body image issues related to excess hair growth or weight gain associated with PCOS.

 

Why Does PCOS Cause Infertility?

Polycystic ovary syndrome (PCOS) is a hormone disorder that can cause a wide range of symptoms, including infertility. While the reason behind this is still largely unknown, it’s believed that it may be due to a variety of different factors.

 

The increased levels of male hormones (androgens) associated with PCOS can interfere with ovulation and lead to irregular periods. When ovulation does not occur, eggs cannot be released for fertilization. Furthermore, PCOS has also been linked to an increase in luteinizing hormone (LH), which can also disrupt the ovulation process and result in infertility.

 

Additionally, women with PCOS tend to have higher levels of insulin in their blood, which can affect fertility by inhibiting normal ovarian function or increasing ovarian cyst formation. Finally, the inflammation associated with PCOS can also damage egg quality or lead to poor egg survival rates.

 

In short, while the exact cause of infertility in women with PCOS is still not fully understood, it is likely related to multiple different factors that are associated with the condition.

 

Can Some Women with PCOS Get Pregnant?

While it is true that many women with polycystic ovary syndrome (PCOS) struggle to conceive, there are still many cases where women with the condition have successfully gotten pregnant.

 

In fact, due to recent advances in fertility treatments such as IVF and medication regimens, more than half of women with PCOS end up having successful pregnancies. However, women should consult their doctor for advice on the best course of action for their particular situation, as every case of PCOS is different.

 

For example, some women may need to adjust their current lifestyle and diet habits before attempting to get pregnant. Others may require medical intervention or a combination of lifestyle changes and medications in order to improve their chances of conception.

 

Overall, there is hope for those struggling with PCOS and infertility. By consulting a qualified medical professional and following the recommended treatments, many women have been able to increase their chances of conception and give birth to healthy babies.

 

Can PCOS Cause a Miscarriage?

Yes, polycystic ovary syndrome (PCOS) can increase the risk of miscarriage. This is because women with PCOS are more likely to have higher levels of male hormones (androgens) which can interfere with ovulation, as well as other hormonal imbalances that can cause problems in early pregnancy.

 

In addition, elevated levels of insulin associated with PCOS may lead to poor egg quality and a higher risk of miscarriage. Finally, inflammation and obesity, both common issues for women with PCOS, can also raise the likelihood of having a miscarriage.

 

It’s important to talk to your doctor if you’re pregnant and have been diagnosed with PCOS. They may recommend lifestyle changes such as exercising regularly and eating healthy foods in order to reduce the risk of miscarriage. Additionally, they may prescribe medications or suggest fertility treatments in order to improve your chances of having a successful pregnancy.

 

Why is PCOS so painful?

There are several different factors that can contribute to pain in women with PCOS:

• Inflammation is caused by high levels of male hormones in the bloodstream.
• Development of cysts or follicles on the ovaries which can cause pain when they twist or rupture.
• Cysts and endometriosis can lead to chronic pelvic pain due to inflammation and pressure on nearby organs.
• Unwanted side effects from certain medications used to treat PCOS.
• Stress can exacerbate symptoms and make existing pain worse.

 

Why Is There Excessive Hair Growth in PCOS?

Polycystic ovary syndrome (PCOS) is a condition that can affect many aspects of reproductive health, including the growth of excess body and facial hair. Excess or unwanted hair growth is called hirsutism, and it affects up to 70% of women with PCOS. So why does this happen?

 

Hirsutism is primarily caused by elevated levels of male hormones (androgens) in the bloodstream. The most common androgen associated with PCOS symptoms is testosterone, but other hormones such as DHEA and DHEAS can also contribute to excessive hair growth.

 

This increase in hormones leads to stimulation of the sebaceous glands, which produce oil that can make hair thicker and darker. Additionally, higher levels of testosterone can cause increased sensitivity to the hormone dihydrotestosterone (DHT), which further contributes to hair growth on the face and body areas that are typically reserved for men.

 

Can PCOS cause hair loss?

The answer is yes. It has been suggested that the same hormones that are responsible for the excess hair growth associated with PCOS can also contribute to thinning or shedding of the scalp hair. In particular, high levels of testosterone can inhibit the healthy growth of new hairs on the head, causing them to weaken and fall out prematurely.

 

Additionally, many women with PCOS have issues with insulin resistance or obesity which may further contribute to hair loss. Hair loss associated with PCOS is usually mild and reversible, so women should speak to their physician about their treatment options if they notice any changes in their hair health.

 

Diagnostic criteria for PCOS

To be diagnosed with the polycystic ovarian syndrome (PCOS), a woman must have two of these symptoms:

 

• Irregular or absent menstrual periods
• High androgen levels, as indicated by physical signs (such as excess body hair) or lab tests
• Twelve or more follicles on each ovary
• High levels of the hormone LH (Luteinizing Hormone)
• In some cases, a diagnosis may also require an ultrasound of the ovaries.

Blood Tests for Diagnosing PCOS

To diagnose polycystic ovarian syndrome (PCOS), a doctor may order the following blood tests:

• Follicle Stimulating Hormone (FSH)
• Luteinizing Hormone (LH)
• Testosterone
• Prolactin
• 17-Hydroxyprogesterone
• Thyroid Function Tests

 

What other diagnostic tests do you need to diagnose PCOS?

In addition to blood tests, doctors may also order an ultrasound of the ovaries or a magnetic resonance imaging (MRI) scan to evaluate the presence and size of ovarian follicles.

 

Ultrasound technology is commonly used to diagnose polycystic ovary syndrome (PCOS), as it can detect certain signs of the condition. These include enlarged ovaries with multiple small cysts clustered around the edges, a thicker-than-normal endometrium (the lining of the uterus) and an increased number of follicles.

 

The ultrasound findings associated with PCOS typically involve changes in the ovaries and uterus, so it’s important to have a full pelvic ultrasound done in order to get an accurate diagnosis.

 

Are the cysts in PCOS cancerous?

The short answer is no. While PCOS cysts can be concerning due to their size and number, they are usually benign (non-cancerous). In some cases, however, it may be necessary to have them removed if they become large or cause pain or discomfort.

 

Are PCOS and PCOD the Same Thing? What are the Differences?

Polycystic ovary syndrome (PCOS) and polycystic ovarian disease (PCOD) are two separate conditions, though there may be some overlap in their symptoms.

 

PCOS is a hormonal disorder characterized by irregular menstrual cycles, infertility, acne, and excess hair growth. It can also cause weight gain and metabolic disorders such as diabetes.

 

PCOD, on the other hand, is an ultrasound-diagnosed condition where small follicles or cysts form on the ovaries. This can affect the production of hormones such as estrogen and progesterone, leading to menstrual irregularities and fertility problems.

 

Both PCOS and PCOD are hormone-related conditions with potential impacts on reproductive health. If you think you may have either condition, it’s important to speak to your doctor so they can make an assessment based on your symptoms and test results.

 

Are PCOS and Endometriosis Related?

Polycystic ovary syndrome (PCOS) and endometriosis can be related in some cases, though the two conditions are distinct. Endometriosis is a condition where the tissue that lines the uterus grows outside of the uterus, causing pain and inflammation in the pelvic region. It can also lead to infertility.

 

PCOS is associated with hormonal imbalances which can affect reproductive health, particularly fertility. It can also cause irregular periods, acne, excess hair growth, and weight gain.

 

Although PCOS and endometriosis are separate conditions, they may both contribute to fertility problems or other reproductive issues. If you think you may have either condition then it’s important to see your doctor so they can make an accurate assessment based on your symptoms.

Does PCOS run in the family?

Yes, PCOS is thought to be a heritable condition and is known to have a genetic component. Studies have found that girls whose mother has PCOS are more likely to develop the disorder themselves. Research has also indicated that identical twins are more likely than fraternal twins to both have PCOS.

 

Can you get PCOS later in life?

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects women during their reproductive years. It is typically diagnosed between ages 18 and 21, but it is possible to develop the condition at any age.

 

Can PCOS affect other organs?

Yes, polycystic ovary syndrome (PCOS) can affect organs other than the ovaries. The condition is associated with an increased risk for a variety of medical complications, including type 2 diabetes, heart disease, and infertility.

 

Other organs which may be impacted by PCOS include the thyroid gland (which can lead to hypothyroidism), the liver (which can lead to fatty liver disease or cirrhosis), and the pancreas (which can result in impaired glucose tolerance). PCOS can also cause weight gain due to hormonal imbalance, leading to an increased risk of obesity-related conditions such as sleep apnea and hypertension.

 

Causes of Weight Gain in PCOS

There are several different factors that can contribute to weight gain in women with PCOS. These include:

 

• Insulin resistance reduces the body’s ability to use energy efficiently and can lead to cravings for high-calorie foods.
• Hormonal imbalances such as high testosterone levels can lead to an increase in appetite and cravings for sweet or fatty foods.
• Inflammation is caused by high levels of male hormones, which can slow down metabolism and make it harder for the body to burn fat.
• Metabolic syndrome, where multiple health issues—including obesity—combine to create a higher risk of diabetes and heart disease.

 

What is the Relationship Between PCOS and Diabetes?

Studies have found that women with PCOS are more likely than other women to develop insulin resistance or prediabetes. This can lead to higher levels of glucose in the bloodstream, reducing the effectiveness of insulin and leading to type 2 diabetes. Other risk factors for developing diabetes alongside PCOS include obesity, poor diet choices, lack of physical activity, and having certain genetic mutations.

 

What is the Treatment for PCOS?

The primary treatment for polycystic ovary syndrome (PCOS) is a lifestyle change, including weight loss and regular physical activity. Eating a healthy, low-carbohydrate diet can also help to improve symptoms of PCOS.

 

In addition, some women may also be prescribed medications such as metformin, clomiphene or gonadotropins in order to regulate ovulation and improve fertility rates. Birth control pills are also commonly used to reduce male hormone levels and to treat menstrual irregularity caused by PCOS.

 

Finally, fertility treatments such as in vitro fertilization (IVF) may be recommended for those wishing to get pregnant. In IVF, eggs are harvested from a woman’s ovaries and combined with sperm in a laboratory setting in order to create an embryo which can then be implanted into the uterus.

 

Other assisted reproduction techniques such as intracytoplasmic sperm injection (ICSI) may also be used to help improve fertility rates. Additionally, lifestyle changes such as weight loss, regular physical activity and eating a healthy diet can also be beneficial for those with PCOS.

What Medications are Used to Treat PCOS?

The primary medications used to treat polycystic ovary syndrome (PCOS) are:

Metformin

This is an oral medication that helps to regulate insulin levels and improve fertility rates.

Clomiphene

This is a pill that helps to induce ovulation by stimulating the production of follicle-stimulating hormone (FSH).

Gonadotropins

These hormones can be given intramuscularly or via an injection in order to induce ovulation.

Birth control pills

These are used to reduce male hormone levels and treat menstrual irregularity caused by PCOS.

 

In addition, lifestyle changes such as weight loss, regular physical activity, and eating a healthy diet can also be beneficial for those with PCOS. Talk to your doctor about the best treatment plan for you and the medications that may work best depending on your individual circumstances.

 

Can a Woman with PCOS be Prescribed Semaglutide?

Semaglutide is currently approved for the treatment of type 2 diabetes, and while it has been studied in clinical trials as a potential treatment for PCOS, it is not yet FDA-approved. Some studies have suggested that semaglutide may reduce insulin resistance in women with PCOS which can help to manage symptoms such as infertility and hirsutism.

 

However, any woman considering taking semaglutide should speak to their doctor about whether this medication could be an appropriate option for them. It’s important to consider potential side effects and risks associated with taking any medication before starting a treatment plan.

 

Can a Woman with PCOS be Prescribed Ozempic?

Ozempic is an injectable medication used to treat type 2 diabetes, and it belongs to the same class of drugs as semaglutide. While studies are currently underway to explore its potential benefits in people with PCOS, it is not yet FDA-approved for this use.

 

As with any medication, women considering taking Ozempic should speak to their doctor about whether this could be an appropriate option for them. Every person’s health needs are unique and various factors should be taken into consideration before starting a treatment plan.

 

Surgery for PCOS

Surgery is a possible treatment option for people with PCOS. The main type of surgery is laparoscopy or “keyhole” surgery, which involves the insertion of small instruments through small incisions to look inside the abdomen and remove any endometrial tissue buildup on the outside of the uterus. This can help regulate menstrual cycles and improve fertility in some women.

 

Other surgical options may be available depending on a person’s individual health needs and history, so it’s important to speak to your doctor about whether this could be an appropriate option for you. As with any procedure, potential risks and side effects should also be discussed before beginning any treatment plan.

 

What are some natural ways to manage PCOS?

PCOS can be managed through lifestyle changes and natural therapies. Exercise, stress management techniques such as yoga, acupuncture, and dietary changes can all help to improve symptoms related to PCOS.

 

Making sure to get enough sleep and eating nutrient-dense foods high in fiber and low in simple carbohydrates can also help keep blood sugar levels under control and reduce inflammation associated with PCOS. Taking the time to practice self-care is important for those living with PCOS, so it’s a good idea to find activities that you enjoy that will help you manage your symptoms.

 

Is Ashwagandha Safe for Use in PCOS?

Ashwagandha is a popular herbal supplement that has been used for centuries in Ayurvedic medicine. Studies have suggested that it may help reduce inflammation and improve metabolic issues associated with PCOS, however more research is needed to determine the full extent of its therapeutic benefits.

 

Is There a Cure For PCOS?

Currently, there is no cure for PCOS. However, this doesn’t mean that it can’t be managed. Making lifestyle changes such as eating healthily and getting regular exercise can help to reduce symptoms associated with PCOS, making day-to-day living easier. Other treatments such as the use of medications and natural supplements can also help to improve symptoms.

 

How Can Women with PCOS Decide Which Treatment Plan is Right for Them?

When it comes to deciding which treatment plan is best for women with polycystic ovary syndrome (PCOS), it’s important to consult a healthcare professional about your individual needs and preferences. Some factors that may be taken into consideration include:

Medical history

Your doctor should consider any medical conditions or medications you’re taking when recommending a treatment plan.

Symptom severity

The severity of your symptoms will help determine whether a medication or lifestyle change is needed.

Fertility goals

If getting pregnant is a goal, your doctor can recommend a course of action or fertility treatments that may increase the chances of conception.

 

Your doctor can also provide guidance on the pros and cons of different treatments, including potential side effects and risks associated with medications. Ultimately, the decision about which treatment plan is right for you will depend on your individual circumstances and needs.

 

Which Doctor Treats PCOS?

A range of medical professionals can treat PCOS, including primary care providers or gynecologists. Depending on the severity of your symptoms and other factors, you may need to consult a specialist such as an endocrinologist or reproductive endocrinologist. It is important to speak to your doctor about the best course of treatment for you.

Can I Discuss My PCOS Treatment Options Online?

Yes, it is possible to discuss your PCOS treatment options online with an experienced medical professional. You can do this through a virtual consultation with a doctor or specialist who can assess your needs and provide guidance on the best course of treatment for you. It is important to remember that this type of consultation should not replace regular visits to your doctor or specialist.

 

Conclusion

PCOS is a complex, chronic condition that can cause a variety of physical and emotional symptoms in women. It’s important to stay up-to-date with the latest developments and best practices for managing the disorder. The 2023 Women’s Guide to PCOD & PCOS is a valuable resource for staying informed about the latest treatments and management strategies for this condition. If you have any questions or concerns about your own health, we encourage you to book a telemedicine appointment with Dr. Eric Pulsfus, MD FACOG today.