Polycystic Ovary Syndrome, frequently referred to as PCOS, is a common endocrine problem which globally affects 6-10% of reproductive-age people with ovaries. Common features of PCOS include irregular menstrual cycles and hyperandrogenism (e.g., acne, coarse hair growth, scalp hair loss). Treatment is focused on menstrual cycle control, treatment for acne, hair growth, and scalp hair loss as well as lowering cardio-metabolic risk through healthy eating and regular exercise.
Diagnosis
Patients must have 2 of the 3 criteria in order to be diagnosed with PCOS.
Irregular Menstrual Cycle: cycles >35 days apart or <8 menstrual cycles per year
Excess Androgens: abnormal laboratory results or clinical symptoms
Elevated testosterone or DHEA
Hirsutism
Polycystic Ovaries: ≥20 follicles per ovary or a volume of 10mL plus per ovary
Causes
The causes of PCOS are complex and not well understood. They can include genetics, environmental factors, and transgenerational exposure (i.e., prenatal exposure to maternal androgens).
Management
PCOS is a variation in physiology. Learning about these differences and the reasons for the physical changes can be empowering. It can help with acceptance and finding ways to feel healthy and good in the body.
Protecting the Uterus – When months pass with no menses, it is necessary to prevent the endometrial cells from building up and becoming abnormal. If this happens, it can cause a condition called endometrial hyperplasia which, in rare cases, can lead to uterine cancer. Strategies used for this are: oral birth control pills, hormonal intrauterine contraceptive device (IUD) or Nexplanon, or inducement of menses with oral progesterone for 10 days every 1-3 months.
Treatment
Treatment for PCOS largely focuses on treating insulin resistance which is multifactorial and includes: learning about food choices and combinations of foods for a steady supply of glucose and energy; finding activities that bring joy to build muscle; and if appropriate, medication.
There are also options for treating acne, hair loss, and hirsutism symptoms which include: oral birth control pills and other medications such as spironolactone and topical minoxidil.
Support
SHS has medical providers, registered dieticians, and behavioral health providers available for students.
SHS medical providers will obtain a medical history, order testing, and collaborate with the individual to find the best pathway towards health depending on their needs and goals. This will involve an examination, check-ins for support, and monitoring with laboratory testing. For some the addition of medication will also be appropriate.
SHS registered dieticians can work with individuals to learn about food choices that can avoid spikes and drops in blood sugar. They also have valuable perspectives and strategies for building a positive relationship with food. The registered dieticians consider the reality of each individual’s living situation and food access in order to make realistic and achievable goals.
SHS behavioral health team can help manage mental health challenges like depression, anxiety, and disordered eating that can be associated with PCOS. Individuals struggling with their mental health can find ways to cope using tools like talk therapy and cognitive behavioral therapy.
