SKIP AHEAD. . .
The human body is beautifully complex, and the endocrine system even more complex––not only because every body is different, but also because hormones are such a sensitive component of the human body. Not enough or too many hormones can result in some major imbalances in the body (enter: PCOS). Even the slightest hormonal imbalance can result in health effects! On top of dealing with a sensitive endocrine system, PCOS is a disorder that researchers are still trying to figure out, which makes PCOS all the more confusing to navigate. It’s reported that 1 in 10 people with ovaries have PCOS (3), so if you do have it, know that you’re not alone! And when you’re not alone, that means you have others to lean on for knowledge and advice. After all, we’re in this together! Here at allbodies, we helped you out by asking some of the biggest questions surrounding PCOS including: do I have PCOS? Keep in mind, we aren’t diagnosing here – simply giving you the Qs to ask yourself and your providers so you can get proper care!
What is PCOS?
There are several different types of PCOS:
- Insulin-resistant PCOS
- Inflammatory PCOS
- Adrenal PCOS
- Post-Pill PCOS (many people will have PCOS after they’ve come off the Pill, even if they didn’t have it before)
However, at its basic level, Polycystic Ovary Syndrome is an imbalance of reproductive hormones (3). This hormonal imbalance causes problems in the ovaries. More specifically, the egg that is released each month when one menstruates either doesn’t develop or isn’t released (i.e. you don’t get your period) (2). The cause for this is pretty much unknown, but researchers do know that this hormone imbalance is most likely linked to an excess of androgens (a group of hormones typically found in higher amounts in those assigned male at birth- testosterone is one of them), insulin resistance or elevated insulin levels, and/or an abnormality between how the pituitary gland in your brain communicates with the ovaries (5).
Lots of ovary-havers who have PCOS tend to have insulin resistance (6), which essentially means your body has a difficult time regulating the release of insulin and results in increased insulin production. This is important to know because insulin is directly correlated to the production of androgen in the body. Basically, insulin works with the luteinizing hormone to increase androgen production in the body (6). So if you have insulin resistance and are producing an excess of insulin, ultimately more androgens will be produced (6). More androgens = excess hormone, which results in symptoms like Hirsutism (excess body hair), missed periods, acne, or baldness.
The major symptom of PCOS is exactly what its name denotes: polycystic ovaries. If your eggs are either not developing or not releasing each month as they normally should, the ovaries can then become enlarged from holding follicles that surround the eggs (4). These follicles appear as cysts and cause the ovaries to function irregularly (4). They can also be quite painful!
Interesting fact: polycystic ovaries and/or irregular cycles are normal and healthy in teenagers, while their reproductive system matures.
So how do you know if you have it? What can you look out for? As you can probably already tell, there’s a lot going on with PCOS. Causes are wide-ranging, which in turn means that symptoms are wide-ranging. PCOS can result in any of the following symptoms (3):
- Irregular periods (having fewer than 8 periods a year)
- Infertility, or frequent unexplained miscarriages
- Hirsutism, or an excess of hair on the face, chin or other parts
- Thinning hair or hair loss on the scalp
- Weight gain or difficulty losing weight
- Darkening of skin, which can be found most prominently along neck creases, the groin, or underneath breasts
- Skin tags, or small excess flaps of skin
PCOS can also result in:
- Heart disease
- Sleep apnea
- Gestational diabetes
It’s important to note that you may experience some of these but not others. Some people have acne, difficulty with weight, or skin tags, and others don’t ever experience those symptoms. We recommend talking with your health practitioner to confirm if you have PCOS. This can be done through blood tests to check your hormone levels, or even ultrasounds to assess the ovaries and determine if there are any cysts (6).
Side note: you can have PCOS without any cysts on your ovaries (7)!
PCOS Hair Loss
Some of the more notable symptoms of PCOS are the changes that can happen to your hair. Fewer people with PCOS experience hair loss than hirsutism (excess hair), so it’s common for practitioners and PCOS 101 guides to leave this symptom out.
How can PCOS cause hair loss and excess hair? Well, it does and it doesn’t. PCOS on its own does not cause androgenetic alopecia or female* pattern hair loss (FPHL). The combination of polycystic ovaries plus a hereditary predisposition to hair thinning causes this hair loss thanks to those pesky androgen and testosterone hormones (8). These hormones’ higher than normal levels are the main cause of androgenetic alopecia or female* pattern hair loss (FPHL) according to Jane Martins, trichologist at Philip Kingsley Trichological Clinic (8). Martins says the hair follicle shrinks and begins producing finer hair at the top and centre frontal hairline, something patients usually begin noticing as a widening part line (8). It should also be noted that, though we live for drama, this hair loss is gradual.
We know that having more or less hair on your bod where you may not want it can be hard. There are specific treatments to help with this. Hormonal birth control could be one temporary fix, but there are also other medications like Spironolactone (works for hair loss and hirsutism), which blocks the effects of androgen on the skin. Eflornithine is a cream that can help slow facial hair growth. And another option could be Electrolysis––this is a cosmetic procedure that uses a tiny needle that’s inserted into the hair follicle, pulsing an electric current that damages and eventually eradicates the follicle (4).
If you’re looking for a more natural approach, you can talk to your health team about trying supplements like Magnesium, and implementing some lifestyle changes (like the ones we’ll talk about later). Topical solutions like anti-androgen solutions may also help.
While some may hate the excess hair, others may embrace it. While we mention all the methods here of hair removal, it’s very important to add, that you can also do nothing at all and just you do you!
The good news is that it is possible to treat PCOS. It’s complex, it’s messy, it’s frustrating, BUT it’s possible. A lot of it boils down to understanding your body and figuring out treatment approaches it responds to best. The most common method to treat PCOS is lifestyle changes. This can include (you can probably guess):
- Diet: eating for your body, limiting sugar, carbs, and cow’s dairy. This one is HUGE.
- Stress reduction
When thinking of medication, anti-androgen medicines or metformin, as recommended for fertility issues, may help regulate insulin production in the body (3). Another route can be using hormonal birth control, such as the pill, patch, shot, vaginal ring, or IUD. For ovary-havers, hormonal birth control can act as temporary symptom relief, which has the potential to result in improvements with acne or even reduce extra hair on the body caused by Hirsutism (3).
However, Allbodies resident nurse, Danielle LeBlanc, would like to note: while hormonal birth control is often thought of to be a one size fits all band-aid, it is not a cure. When you discontinue hormonal birth control (for example if you were trying to conceive), symptoms will return. Sometimes, with additional issues.
Dealing with any chronic condition, especially a hormone-related one, is difficult and at times, isolating. Be patient with your body and know that you are not alone! With more research on PCOS means there are many more resources and communities specifically dedicated to this tricky condition.
Here are some:
The PCOS Awareness Association | https://www.pcosaa.org/
Soul Cysters | https://soulcysters.com/
PCOS Meetups | https://www.meetup.com/topics/pcos/
PCOS and fertility
Lots of ovary-havers tend to find out that they have PCOS when they are trying to conceive because PCOS can have a direct effect on one’s fertility. Actually, PCOS is a leading cause of infertility in people with ovaries (7). As with anything surrounding the human body: EVERYONE’S BODY IS DIFFERENT. So, it’s best to consult a healthcare practitioner to determine a specific approach for how to address issues surrounding your fertility. Sometimes, simple lifestyle changes can help to restore ovulation and increase your chances of conception (7). Other routes could be using medications––some common ones are:
- Clomiphene, an ovulation-induction drug
- Metformin, an insulin-sensitizing drug
- A combination of both Clomiphene and Metformin, the combination can be helpful for those who may not respond to Clomiphene alone (7)
Written by: Kristina Samulewski
Medical Review: Danielle LeBlanc BScN, RN
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
(1) “PCOS (Polycystic Ovary Syndrome): Basics, Causes, and Role of Hormones.” WebMD. WedMD. https://www.webmd.com/women/what-is-pcos.
(2) “The Endocrine System and Glands of the Human Body: Functions and Disorders.” WedMD. WedMD. https://www.webmd.com/diabetes/endocrine-system-facts#1.
(3) “Polycystic Ovary Syndrome.” Womenshealth.gov, April 1, 2019. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome.
(4) Polycystic Ovary Syndrome (PCOS).” Mayo Clinic. Mayo Foundation for Medical Education and Research, August 29, 2017. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439.
(5) Burt Solorzano, Christine, Ricardo Azziz, and David Ehrmann. “Polycystic Ovary Syndrome PCOS.”Polycystic Ovary Syndrome PCOS | Hormone Health Network. https://www.hormone.org/diseases-and-conditions/polycystic-ovary-syndrome.
(6) Roush, Karen. What Nurses Know … PCOS. Demos Medical Publishing, 2010.
(7) “Beyond Infertility: Polycystic Ovary Syndrome (PCOS).” National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, April 2008. https://permanent.access.gpo.gov/LPS113791/LPS113791/www.nichd.nih.gov/publications/pubs/upload/PCOS_booklet.pdf.
(8) Kilikita, Jacqueline. “This Common Condition Could Explain Why Your Hair Might Be Thinning Out.” Hair Thinning Polycystic Ovary Syndrome (PCOS). REFINERY29 INC., August 12, 2018. https://www.refinery29.com/en-gb/hair-thinning-pcos.