Understanding PCOS

PCOS (polycystic ovarian syndrome) is a bit of a misnomer as not everyone with PCOS gets polycystic ovaries.

Cysts are a symptom of a deeper problem but not the real issue. In PCOS, the real issue is an excess of androgens (male hormones).

The ovaries produce trace amounts of androgens and most of those androgens are converted into estrogen. In PCOS, the ovaries produce extra androgens and the adrenal glands do the same thing so you end up with too much of the male hormones.

This excess of androgens causes irregular and/or heavy menstrual cycles, acne, hirsutism (unwanted hair on the face, chin, breasts, stomach, thumbs, toes), hair loss (specifically following the male pattern of hair loss), polycystic ovaries, thickening and darkening of the skin (especially under your arms and breasts, your neck and groin), weight gain or difficulty losing weight, anxiety/depression, difficulty sleeping and/or feeling exhausted all the time, and trouble getting pregnant.

For some women, PCOS symptoms barely register a blip on their radar. For others, symptoms are much more pronounced.

The exact cause of PCOS is unknown, but common contributors include:

Family History

Family history and genetics appear to play a role. Women with PCOS are 50% more likely to have an immediate female relative (mother, aunt, sister, daughter) with PCOS. It is also common to find type 2 diabetes run in families with PCOS.

Hormone Levels

An imbalance in insulin and androgens causes the common signs and symptoms of PCOS.

Insulin Resistance

Approximately 85% of all women with PCOS have insulin resistance. Exercising regularly and eating healthy are very important in managing and reducing insulin resistance and can greatly improve the symptoms of PCOS.

Androgens

Androgens, or male hormones, are present in both men and women but at much lower levels in women. All women produce small amounts of androgens in the ovaries and the adrenal glands. 

Weight + lifestyle

PCOS occurs in both thin and overweight women. However, women with PCOS are at greater risk of being overweight or obese. Insulin resistance is caused in part by lifestyle factors (being overweight, diet, physical inactivity).