The Silent Female Health Epidemic That Could Be Affecting You

November 13, 2017

Could your missed periods and weight gain be a signal of a larger problem?

If your period seems to be all over the place – popping up when you least expect it, then disappearing for weeks or months on end – you might think it’s just annoying, or that you need to download a better period-tracking app.

Gaining weight also might not set off any alarm bells. It might just be that you’ve been baking up a few too many batches of Nutella brownies, or indulging in some high-alcohol cocktails (which, incidentally, are also high-calorie). And who isn’t depressed these days? The state of the world is enough to make most of us want to stay in bed some mornings.

But all of these symptoms – depression, weight gain, unpredictable periods – could point to a more serious, increasingly common disorder that your doctor may not ever tell you about.

Polycystic Ovary Syndrome, or PCOS, affects as many as five million women in the United States alone, according to the Department of Health and Human Services. It’s a leading cause of infertility, and it increases the risk of diabetes, high blood pressure, high cholesterol, sleep apnea, and even cancer. Depression and anxiety are also common in PCOS sufferers.

So what exactly is this disorder, which only affects women? And why is nobody talking about it?

What is PCOS?

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Polycystic Ovary Syndrome (PCOS) is a metabolic disorder that wreaks havoc on a woman’s ovaries, often preventing them from forming and releasing a healthy egg each month, as they’re designed to do. PCOS sufferers produce elevated levels of male hormones (called androgens), which can prevent ovulation, cause acne and excess hair growth, and prevent proper absorption of glucose.

Doctors don’t know the exact cause of PCOS, but they believe it’s genetic; they’ve found a link between PCOS and insulin resistance, which is a genetic condition associated with diabetes. John Nestler, chair of the department of internal medicine at Virginia Commonwealth University, explains in The Atlantic that “the excess insulin that’s being produced stimulates the ovary to make testosterone, which can interfere with ovulation, rendering many women infertile.”

PCOS is the leading cause of infertility in industrialized countries. But it isn’t only a problem for women who want to get pregnant and can’t.

“Classically, we thought of PCOS primarily as an infertility disorder or a cosmetic annoyance, but we now know that it’s also a metabolic disorder and a serious long-term health concern,” says Nestler.

A study published in the March 2015 issue of Journal of Clinical Endocrinology & Metabolism found that women with PCOS are twice as likely to suffer from health issues like diabetes, mental illness, reproductive disorders, and endometrial cancer (cancer of the uterine lining) than women who don’t have the disorder.

How do you know if you have PCOS?

Does all this mean if your periods are irregular, you should get tested for PCOS? Maybe. The tricky thing about PCOS is, some women have lots of symptoms, while others don’t have any. These women may not suspect anything is wrong, until they try to get pregnant, and can’t.

Symptoms of PCOS include the aforementioned weight gain, depression, and period irregularity: you might have light, overly frequent periods, or infrequent, heavy ones, or some combination of the two.

PCOS sufferers might also experience hair loss in places they want hair – thinning scalp hair is a common symptom – and excess hair growth in places they don’t (hello, moustache and stray chin hairs). Anxiety is another symptom; so is fatigue. Acne and dark spots on your skin, particularly in creases, such as underneath your breasts, on your neck, and in the bikini area, are another annoying side-effect of PCOS.

But you don’t have to have all of these symptoms to be diagnosed with PCOS. If you have two or three symptoms – irregular or missed periods, elevated male hormones, or cysts on your ovaries – that’s often enough to diagnose a case of PCOS.

“If a woman has fewer than eight menstrual periods a year on a chronic basis, she probably has a 50 to 80 percent chance of having PCOS, based on that single observation,” says Nestler.

If she also has high levels of testosterone or other androgens in her blood, her chance of having PCOS jumps to more than 90 percent.

The best way to find out if you have PCOS is to see your doctor and ask for a complete blood workup, to find out if you have elevated androgens, as well as an exam to see whether you have cysts on your ovaries.

What can you do about it?

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If you think you might have PCOS, or you’ve recently been diagnosed with it, don’t panic. The good news is, it’s treatable. Most women are still able get pregnant once they treat their PCOS, so if that’s your goal, rest assured a healthy pregnancy may still be in your future. The bad news is, there’s no magic pill to treat PCOS. Treatment is a hit-and-miss process that involves work on your part, in the form of changes to your diet and exercise routine, of which your healthcare professional can advise you.

More than 75 percent of PCOS patients experience restoration of ovulation and fertility when they reduce their body weight between just five and seven percent over a period of six months, according to researchers. But, frustratingly, losing weight can be even more difficult for women afflicted with PCOS, especially if they’re already overweight. Angela Grassi, a registered dietitian who spoke to The Atlantic, says weight gain can be a vicious cycle for sufferers.

“The more weight you gain, the more corresponding insulin your body produces, and the more you continue to gain weight,” explains Grassi.

There is a definite link between body weight and PCOS; some doctors and researchers believe the increase in PCOS diagnoses is a direct result of an uptick in obesity among young women.

“We are seeing an explosion in PCOS in adolescent girls,” says Nestler, explaining there’s also been “an explosion” of obesity among adolescents.

“It’s quite possible that if those girls had remained a healthy weight, they would still carry the genes that predispose them, but they wouldn’t be expressing the disorder.”

But weight management is only one piece of the complex puzzle of PCOS. According to the non-profit PCOS Challenge, Inc., less than 0.1 percent of government, corporate, foundation, and community spending goes toward funding for PCOS awareness and support, and for that reason, says Nestler, healthcare professionals and sufferers alike are still largely in the dark about what causes it.

“The exact cellular and molecular mechanisms are still being explored, and are not completely understood.”

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