Understanding PCOS

Since my first consultation with my fertility specialist, I have wanted to blog in order to better explain Polycystic Ovarian Syndrome. I was diagnosed with the disorder roughly 2 years ago, but the way it was recently explained to me completely opened my eyes to just why PCOS has made pregnancy such a hard thing for me.

Many of you know about PCOS (and indeed some of you have it yourselves), but I encourage all of you to read this in hopes that it may be just as enlightening to you as it was to me. And, PCOS is the leading cause of infertility in women - you never know who it may affect - so you may be doing yourself, your daughter, your friend - a huge favor to know what it is and what the symptoms are.

First of all, I'm going to explain what PCOS is and why it makes pregnancy difficult. Then I'll explain the signs/symptoms of PCOS. I made some drawings to try to better illustrate my points. I'm by no means an artist, but I think they get the point across :).

To be vague, PCOS is a hormonal disorder involving a woman's reproductive hormones. For a woman NOT experiencing PCOS, at the start of each menstrual cycle, a woman's estrogen levels are low, and that is when the brain sends a signal to the reproductive organs to begin sending out FSH (follicle-stimulating hormone). FSH causes a woman's follicles to develop into a mature egg that can eventually be fertilized. Although several follicles generally begin to develop, one is usually dominant - receiving more of the FSH - and is the egg that eventually is released from the ovary - it is, per say, the strongest of the bunch - while the remaining follicles disintegrate.

When a woman has PCOS, her cycle begins the same way. When FSH begins to be sent out, in essence, a competition begins for the many follicles to become the "most mature." However, no dominant follicle presents itself, and in general, no one egg becomes the most mature. An egg may not be released at all, or if it is, it generally is not a very good quality egg and thus if it is by chance fertilized, can result in miscarriage, birth defects, etc. In the meantime, the other follicles that were trying to mature do NOT disintegrate as they should, and thus cause what look like cysts on the ovaries (my doctor pointed out that they are actually NOT cysts as the name of the disorder implies, but are, essentially, eggs).

Here's a diagram of what the ovaries look like at the beginning of a woman's cycle:

Notice that the PCOS ovary has MANY more follicles present than the normal ovary.

Now here is what the ovaries look like right before the egg is released:

Again, notice that there is a dominant egg in the normal ovary, whereas the PCOS ovary has no dominant egg about to breakthrough.

Do those diagrams help PCOS make more sense to you? Maybe it doesn't clarify it for you like it did for me, but honestly, this was a major breakthrough in understanding for me. No one had ever explained PCOS to me like this before, and once I understood it I really began to understand why PCOS patients have a horribly hard time getting pregnant and keeping their babies if they do conceive.

Ok, so here's what you really need to know about PCOS. I know that some of these things can be embarrassing for people to admit, but know that you (or your daughter, friend, etc.) are NOT alone. I'll admit that I suffer from almost every single one of these symptoms.

Symptoms (in no particular order or importance or dominance):

1. Irregular/abnormally long periods - a normal cycle is generally no more than 35 days long. This one symptom by itself should be enough to prompt a visit to your doctor.

2. Hair growth on the face, back, chest, toes, stomach, thumbs - PCOS patients have excess testosterone in their system, the cause for this embarrassing "manly" attribute.

3. Difficulty losing weight/gaining weight - a majority of women with PCOS have a hard time losing weight and keeping it off.

4. Difficulty getting pregnant - there are a lot of things that can contribute to an inability to conceive, but it's worth asking about PCOS if you've been trying unsuccessfully for more than a year (I wouldn't even wait that long).

5. Blood sugar issues - women with PCOS can have problems with insulin resistance, and are at risk for developing diabetes

6. Skin problems like acne, dandruff, oily skin and skin discolorations

Keep in mind that not every one of these symptoms have to be present in order to have a PCOS diagnosis. Likewise, my doctor also emphasized that PCOS is a very loosely used diagnosis and may very well be given to women who do not have the disease. The only way to know for sure is to talk to your doctor about your symptoms and have the necessary tests done that can determine if PCOS is the cause.

I realize I've given a lot of information in this post, and for anyone wondering if they or someone they know has PCOS, I would be happy to answer any questions you have. Feel free to ask me in the comments here, on Facebook, or you can send me a private message on FB if you feel more comfortable. PCOS has forever changed my life, and I'm here to help. I'm also here to be a support to others suffering from this. Please feel free to share this post with anyone you feel may benefit from it.