Irregular Periods, Weight Gain and Facial Hair? It Could Be PCOS

PCOS is diagnosed when women have irregular menstrual cycles, often excess hair growth or acne, and sometimes polycystic ovarian morphology.
Illustration of the female reproductive system, showing the uterus, fallopian tubes, and ovaries.
Androgens – hormones like testosterone that are typically considered male – can cause some of the trademark signs of PCOS, including acne, facial hair growth and female pattern hair loss.Wikimedia Commons
Published on

When Dr. Sushrutha Sridhar, an endocrinology, diabetes and metabolism fellow at Penn State College of Medicine, began noticing irregular menstrual cycles, annoying facial hair and weight gain while in medical school in 2018, she knew something was off.

She was 27 and hoped to start a family once her medical training was complete. An ultrasound revealed that she had polycystic ovarian syndrome (PCOS).

Sridhar is one of the more than 5 million women in the United States with PCOS, the most common hormone disorder among women, according to the Endocrine Society.

While many people associate PCOS with ovarian cysts, Dr. Richard Legro, chair of the Department of Obstetrics and Gynecology at Penn State Health Milton S. Hershey Medical Center, says the term is misleading.

Illustration of Polycystic Ovary Syndrome shows ovaries, fallopian tubes, and uterus, highlighting cysts on ovaries.
Since the hormones are out of balance, women with PCOS don’t ovulate regularly, which makes it harder to get pregnant.Wikimedia Commons
There aren’t necessarily cysts on the ovaries. Women with PCOS aren’t ovulating regularly, so the tiny follicles never become cysts. It involves the ovaries, but it’s not exclusively about the ovaries.
Dr. Richard Legro, chair of the Department of Obstetrics and Gynecology at Penn State Health Milton S. Hershey Medical Center

A complex diagnosis with common symptoms

Dr. Stephanie Estes, a reproductive and infertility endocrinologist at Penn State Health Obstetrics and Gynecology, says PCOS can come with a variety of different symptoms.

PCOS is diagnosed when women have irregular menstrual cycles, often excess hair growth or acne, and sometimes polycystic ovarian morphology, meaning the way the ovaries look on ultrasound. It’s also a cause of androgen excess in women.
Dr. Stephanie Estes, reproductive and infertility endocrinologist at Penn State Health Obstetrics and Gynecology

Androgens – hormones like testosterone that are typically considered male – can cause some of the trademark signs of PCOS, including acne, facial hair growth and female pattern hair loss.

Since the hormones are out of balance, women with PCOS don’t ovulate regularly, which makes it harder to get pregnant.

Young woman in a white T-shirt lies on a bare mattress with her eyes closed.
Since hormone imbalance is the root cause of PCOS, the first step in treatment often involves combined birth control pills.Unsplash
PCOS commonly runs in families, but there’s not yet enough research to confirm the condition is hereditary, Estes said. Women can be diagnosed as early as two years after their first period, but it’s more common to be diagnosed in their 20s and 30s when they try to start a family.
A lot of women go to their family doctors with irregular periods, and they’re told, ‘Oh, you’re just young. Go on these birth control pills. But often, they don’t receive a full hormonal workup. The benefit of Milton S. Hershey Medical Center and our affiliated practices is our focus on diagnosing PCOS early, rather than delaying care.
Dr. Stephanie Estes, reproductive and infertility endocrinologist at Penn State Health Obstetrics and Gynecology
A hand holds a bright pink menstrual cup against a plain black background.
After her diagnosis, Sridhar was prescribed Metformin, a diabetes drug often used to treat PCOS, but the side effects were too intense, and she had to stop taking it. Unsplash

Hormone management, weight loss ease PCOS

Since hormone imbalance is the root cause of PCOS, the first step in treatment often involves combined birth control pills. Estes explained that estrogen in birth control pills increases a protein that binds to androgens and helps reduce symptoms like acne and unwanted hair. Progesterone also lowers the risk of uterine cancer by regulating menstrual cycles.

Beyond hormonal management, Estes says an exercise regimen and weight loss are often effective.

After her diagnosis, Sridhar was prescribed Metformin, a diabetes drug often used to treat PCOS, but the side effects were too intense, and she had to stop taking it. Her condition continued to worsen as she completed medical school and moved into residency, where she was encouraged to lose weight. Despite her best efforts, the weight refused to budge.

As she started her fellowship at Penn State College of Medicine, she turned to Legro and Estes for help and found that, in addition to PCOS, she had precancerous lesions in her uterus.

To fast-track her treatment, she asked to try GLP-1 agonists, a medication used to treat type 2 diabetes and obesity, and finally found the results she needed.

While weight loss can help diminish symptoms of PCOS, Legro is careful to point out that the disorder is not directly caused by higher body weight.

Weight loss is going to improve your overall reproductive and metabolic health, and you’re more likely to respond to medications we use both for fertility and PCOS treatment.
Dr. Richard Legro, chair of the Department of Obstetrics and Gynecology at Penn State Health Milton S. Hershey Medical Center

After losing more than 60 pounds, Sridhar found that both her PCOS symptoms and her precancerous lesions were greatly improved.

New research offers hope

Estes and Legro are both currently investigating new treatments for PCOS. Estes is the principal investigator for the REBALANCE Study at Penn State College of Medicine, which is testing a less invasive procedure for ovarian ablations. Ovarian ablations are often used to jump-start ovulation as a part of fertility treatments. Estes hopes that, rather than using incisions to reach the ovaries for treatment, physicians can access the ovaries through the vagina, reducing risks and recovery time.

Legro is investigating the use of inositol, a low-cost and commonly available supplement that might mimic the effects of other PCOS treatments like Metformin by decreasing insulin resistance. While some brands of inositol supplements claim they can help with weight loss and infertility, Legro notes there is little research to back up those claims. The study is currently underway.

(Newswise/PPP)

Illustration of the female reproductive system, showing the uterus, fallopian tubes, and ovaries.
PCOS and Depression: The Mental Health Struggle No One Talks About

Related Stories

No stories found.
logo
Medbound
www.medboundtimes.com