If you find your head hair thinning or you’re suddenly gaining weight when you’d never struggled before or discovered excess chin, back, or stomach hair or hair in other unwanted places, you may need to see your doctor. Many women may not realise that these types of bodily fluctuations are linked to hormones – and changes, fluctuations such as when a woman has PCOS, can sometimes have unpleasant and unwanted side effects. Yet, it’s estimated that around 50 per cent of women who have PCOS go undiagnosed. But it’s not all doom and gloom as there are solutions! Let’s explore what PCOS is and what you need to know.
What is PCOS?
PCOS is an abbreviation for “polycystic ovary syndrome”. PCOS is a hormonal disorder occurring in women of reproductive age. It’s estimated that 10-15 per cent of women globally have PCOS and that it affects as many as 1 in 10 women in the UK.
The etymology of the word itself “poly” and “cystic” means “many cysts”, although many women who have PCOS do not have polycystic ovaries.
PCOS is an endocrine system and metabolic disorder that impacts the body well beyond the ovaries. It’s one of the most common causes of female infertility, affecting as many as 6 to 12 per cent (around 5 million) of women in the US alone, worldwide those figures are shown at 3.4 per cent (or 116 million women). These statistics suggest that more diagnosis occurs in the US.
As you may know, hormones regulate the menstrual cycle (and, thus, reproduction and fertility). PCOS affects a woman’s ovaries where two hormones, estrogen and progesterone, are secreted. Most people know about those two, but the ovaries also produce a tiny amount of male hormones (or a hormone typically labelled as male) called androgens. Androgens are natural hormones that contribute to growth and reproduction in both women and men. But when there’s an overproduction of androgen hormones (and not enough production of the two female hormones), then it leads to PCOS where cysts may form on the ovaries (but not always).
PCOS is a serious condition and often runs in families. In other words, it’s genetic. It may also lead to obesity, type 2 diabetes, cardiovascular disease, and endometrial cancer.
What are the symptoms of PCOS?
The most common symptoms of PCOS are irregular or missed periods, excess androgen, and polycystic ovaries. Women may also notice difficulty getting pregnant due to irregular or no ovulation, excess hair growth (known as hirsutism) on the face, chest, back, or buttocks, weight gain, dark skin patches, thinning hair and hair loss on the head, and oily skin or acne.
- Irregular periods: Infrequent, irregular, or even prologued periods are the most common signs of PCOS. If you have fewer than 9 periods per year, more than 35 days between periods, or abnormally heavy periods and/or long-lasting, you may need to check with your doctor.
- Excess androgen production: As mentioned before, elevated levels of male hormones may result in physical “masculinising” effects such as excess facial and body hair (hirsutism), severe acne, and male-pattern baldness.
- Polycystic ovaries: With PCOS, the ovaries might become enlarged and contain follicles that surround the eggs. You may have heard the term “follicle” and follicles are small sacs of fluid found on the outside layer of the ovaries, containing immature eggs (oocytes). In a healthy ovary, when the follicle has grown to its proper size, it ruptures and releases a mature egg, ready for fertilisation (or to be discarded in menstruation). There’s only a single egg in a follicle; however, each cycle several follicles will develop, but only one of them will release an oocyte. Any follicle that doesn’t release an egg will disintegrate and is known as atresia, but this disintegration process can happen at any stage of follicular development. By contrast, in a woman with polycystic ovaries, her abnormal hormone levels prevent the follicles from growing and maturing and, therefore, oocytes are not released. Instead, immature follicles accumulate in the ovaries – a polycystic woman may have 12 or more in her ovaries (with each being approximately 8mm in size) – and it’s for this reason that the condition is called “many cysts.” This accumulation of defunct follicles may mean the ovaries fail to function regularly and may spell infertility in some women.
It’s also important to note that, according to the NHS, more than half of women with polycystic ovaries do not have symptoms at all. PCOS signs and symptoms are typically more severe if you’re obese.
What causes PCOS?
The exact cause of PCOS is not known. As noted before, PCOS often runs in families and is caused by abnormal hormone levels in the body, including high levels of insulin.
Some believe excess insulin increases androgen production, causing ovulation difficulty. Insulin is a hormone produced in the pancreas that allows your body’s cells to use sugar, the body’s primary energy source, which is often converted from carbohydrates and sometimes from protein. When blood sugar levels rise, the body might produce more insulin and excess insulin can lead to PCOS, weight gain, and/or conditions such as type 2 diabetes.
How do I find out if I have PCOS?
No single test can diagnose PCOS but you may have a blood test, pelvic exam, and/or sonogram to determine if you have PCOS.
What are the complications of PCOS?
Some complications of PCOS may include the following:
- Infertility
- Gestational diabetes (in pregnant women)
- Pregnancy-induced high blood pressure
- Miscarriage or premature birth
- Type 2 diabetes or prediabetes
- Sleep apnea
- Depression
- Anxiety
- Eating disorders
- Abnormal uterine bleeding
- Cancer of the uterine lining (endometrial cancer)
The more severe side effects are as follows:
- Low-grade inflammation: where the body’s white blood cells produce substances to fight infection (yet there’s no “real” infection). Women with PCOS generally exhibit signs of low-grade inflammation that may stimulate the ovaries to produce androgens and can sometimes lead to heart and blood vessel problems.
- Non-alcoholic steatohepatitis: severe liver inflammation caused by fat accumulating in the liver.
- Metabolic syndrome: which is a cluster of conditions that include high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels all of which increase your risk for cardiovascular disease.
PCOS is often associated with obesity and can worsen the disorder’s complications.
How does PCOS affect women?
Around 40 per cent of women diagnosed with PCOS suffer from depression and low self-esteem after diagnosis. With women often gaining weight, suffering from acne, growing unwanted body hair, and finding they have thinning head hair, they may feel underconfident and hopeless, especially mixed in with struggling infertility and a higher risk of longer-term complications.
The good news is PCOS can be treated and many of the symptoms can be lessened (or eliminated).
How to treat PCOS?
PCOS can be treated through lifestyle changes and medications.
Doctors often prescribe birth control pills, patches, and vaginal rings to help regulate periods and treat any physical symptoms, like acne and hair growth.
Diet changes such as reducing simple carbs and successful weight loss can often restore normal menstruation.
For mental health-related problems, women can also talk to their doctor about the right option for them whether it’s therapy and/or depression and anxiety medications.
Celebrities with PCOS
If you’re worried that you may not be able to have children and/or more children, there are many celebrity mums (and non-mothers) out there who have talked openly and candidly about having PCOS.
Here are fifteen, to name a few!
- Star Wars actor, Daisy Ridley
- Glee actress, Lea Michelle
- Former Spice Girl and fashion designer, Victoria Beckham, wife of former footballer David Beckham
- Jools Oliver, wife of celebrity chef, Jamie Oliver
- British treasure, actor, and screenwriter, Dame Emma Thompson
- Victoria’s Secret model, Romee Strijd
- Jillian Michaels, American fitness guru
- South African-born American actress, singer, and songwriter who is known for her role in Pretty Little Liars, Sasha Pieterse
- Alaia Baldwin, daughter of Baldwin brother Stephen Baldwin
- English actress, known for portraying Karen Maguire in Shameless, Rebecca Atkinson
- Teen Mom 2 American reality star, Kailyn Lowry
- 16 and Pregnant, Teen Mom OG, and Naked and Afraid American reality star, Maci Bookout
- American actor and model, Jamie King, known for roles in Sin City and films
- Harnaam Kaur, English social media personality, postpartum coach, life coach, and motivational speaker who is known for wearing a full beard due to the condition
- Filipina actor, Pauleen Luna-Sotto, host of the long-running Philippine variety show, Eat Bulaga!
All of these women are beautiful, feminine, talented, and strong, so a PCOS diagnosis may impact your body but doesn’t have to impact your confidence.
What is hirsutism and how can it be treated?
One of the symptoms that most embarrass women with PCOS is hirsutism. With 50 to 70 per cent of women with PCOS suffering from hirsutism, there are many solutions. From the usual plucking, waxing, shaving, and threading to more permanent solutions like laser hair removal (at a salon or at home), there are ways to manage and eliminate these symptoms.
Societally, the standard of “beauty” often shows someone who is slim, hairless, effortlessly chic, and always perfectly presented. Although, this “ideal” image can be constricting for some women, often, a hair-free physique is the easiest “beauty standard” to achieve. But, thankfully for many of us, the standards of beauty are widening to be more inclusive of all the beautiful women out there; hairy or hair-free, slender or pleasantly plump, and everything in between!
Be the fabulous you
If hair-free makes you feel more comfortable in your skin, but the salon price tag of laser hair removal puts you off, you can remove any unwanted hair permanently, reducing the hair by up to 70% in as few as three treatments, with Tria Beauty’s Hair Removal Laser 4X. You can jam out in your underwear to the radio whilst removing hair in the comfort of your own home.
Whether you want to rock or remove hair, that choice is yours and how you want to manage your PCOS symptoms is personal. But if you’re experiencing any of these symptoms, you may want to talk to your doctor so you can manage the condition.