Polycystic ovary syndrome
(PCOS)
Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders and affects around 20% of all people with a uterus of childbearing age, i.e. between puberty and menopause
Time for Reflection
What you know about PCOS
Approximately 20% of all people with a uterus have PCOS. So it is very common. But what do you know about it?
Do you know what PCOS is?
What does PCOS look like?
Do you know anyone with PCOS?
What does PCOS mean?
| Poly | = many, several |
|---|---|
| Cystic | = relating to cysts |
| Ovarian | = relating to the ovaries |
| Syndrome | = pattern of multiple symptoms with a common cause |
PCOS therefore refers to various symptoms associated with the ovaries and often also with cyst formation.
How does PCOS develop?
The exact causes are not yet fully understood. It is likely that several hormonal disorders cause the ovaries to produce more male sex hormones. Incidentally, all humans have male hormones, not just men. You can find more information on this topic in the section on hormones. This prevents the egg cells from maturing properly and causes small sacs (cysts) to form. This leads to a hormonal imbalance.
Patients also often develop insulin resistance: the body becomes less sensitive to insulin, making it harder to regulate blood sugar levels. This metabolic status, in turn, stimulates the production of male hormones, a mechanism that can worsen the symptoms of PCOS.
Symptoms
The first signs often appear during puberty. The severity varies greatly from person to person, and there are numerous manifestations
Abnormal menstrual cycles::
delayed or absent menstruation
Hormones:
Excess male sex hormones (testosterone)
Cysts:
Polycystic ovaries (cysts in the ovaries)
Signs of so-called androgenization (i.e., apparent “masculinization” due to excess testosterone):
Acne
Increased body hair
Hair loss
Skin discoloration
Ovarian dysfunction can also lead to fertility problems.
However, not all symptoms need to be present for a diagnosis. Even if only a few of the symptoms are present, it can still be PCOS and be diagnosed.
Important: Some people affected are overweight, others are slim, some have cycle problems, others do not. PCOS is individual and subject to change over time.
PCOS and weight
Many people with PCOS have difficulty losing weight due to insulin imbalance. Between 40 and 80% of those affected develop obesity
Hormonal processes, especially insulin resistance, promote weight gain. Fat is particularly likely to accumulate in the abdominal cavity (visceral fat)
Metformin, a drug developed for diabetes patients, can help with weight loss in PCOS
Diagnosis
The diagnosis is confirmed in a gynecological practice by:
Taking a medical history of the menstrual cycle, period, weight, and physical changes
Performing an ultrasound examination of the ovaries
Performing blood tests for hormones and blood sugar levels
Treatment
Treatment depends on individual symptoms and needs.
Lifestyle changes
Exercise and dietary changes can alleviate symptoms. Studies show that weight loss can lead to an improvement in PCOS symptoms and quality of life.
Hormonal contraception
Birth control pills or other hormonal preparations can stabilize the menstrual cycle and at the same time balance out an excess of male hormones. In the section “Hormones”, you can find out more about the topic of hormones.
Fertility treatment
Medications that support egg maturation increase the chances of pregnancy. Many pregnancies are successful despite PCOS. When pregnancy occurs, it usually proceeds as normal. The risk of a multiple pregnancy (twins or multiples) is often increased.
Mental health and sexuality
An open dialogue about insecurities can help find solutions for enjoying a fulfilling sex life.
PCOS affects not only the body, but also mental health. Studies show an increased risk of depression and anxiety disorders.
In addition, PCOS also plays a role in terms of sexuality and self-image. Loss of libido, insecurities about one's own body image, or experiences of stigmatization are not uncommon. However, sexuality is much more than fertility or a certain appearance. Closeness, desire, and intimacy are possible for people with all body types, including those with PCOS. In the section "Sexuality & Language,“ you can learn more about how to talk about sexuality.
Stigma and social pressure
Many people affected report social pressure, for example, through comments about their weight, body hair, or desire to have children