WHAT IS PCOS? (and Why It Needs a New Name)
PCOS is Polycystic Ovarian Syndrome and affects around 1 in 10 women of reproductive age.
The hallmarks of PCOS are anovulation (lack of ovulation) and high levels of androgens (such as testosterone). The signs and symptoms of PCOS can vary woman to woman and include: anovulation (determined by tracking your cycle), amenorrhea (no period), irregular periods, hirsutism (excess facial hair), acne, hair loss, weight gain, and/or infertility.
To be diagnosed with PCOS you must meet a set of criteria. The two main ones are the: “Rotterdam Criteria” and “Androgen Excess Society Criteria.” I prefer the “Androgen Excess Society Criteria” because it emphasizes the importance of anovulation and androgen excess.
The Rotterdam criteria does not require androgen excess and instead puts equal emphasis on “polycystic ovaries”. You may be asking: Why is this an issue? The name is “polycystic ovarian” syndrome? Shouldn’t that be a key player in diagnosing PCOS? This is why PCOS needs a new name.
Polycystic ovaries are not specific to women with PCOS. Polycystic ovaries are a normal finding in 23% of women (reporting no menstrual irregularities, no infertility, and no abnormal hair growth). Whether or not you have polycystic ovaries, cannot rule in or out PCOS. Therefore a name such as ‘Anovulatory Androgen Excess’ would be much more appropriate.
If you think you have PCOS, it is important that a proper diagnosis is made. If you have been diagnosed with PCOS only based on the results of a ultrasound talk to your healthcare provider about being reassessed. This involves a thorough evaluation of your menstrual cycle, acne, weight, and hair growth, as well as comprehensive laboratory testing (including androgens).
Based on your individual presentation of PCOS a unique treatment plan can then be created. In general, this involves addressing one (or more) of the four main drivers of PCOS: insulin resistance, a hormonal imbalance from stopping the birth control pill, inflammation, or adrenal abnormalities.
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