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Do I Have PCOS?

Adam Bataineh

Chief Medical Officer

The quick read :

  • PCOS is a complex metabolic-endocrine syndrome, which presents with multiple signs and symptoms.
  • Excess body hair, weight gain, irregular periods, infertility, mood swings, carb cravings, cystic ovaries are common symptoms of PCOS
  • 75% of woman are undiagnosed and those diagnosed are neglected until they want to have children.
  • PCOS symptoms can be managed immediately after diagnosis with through a low-carb diet

PCOS is the main cause of infertility and affects an astonishing 1 in 5 women. Despite the widespread prevalence of PCOS, many women remain undiagnosed. To be exact, recent estimates have suggested that 75% of woman are undiagnosed or misdiagnosed. These women are left in the dark and never fully understand why they experience unexplained weight gain, facial hair, fertility issues, or feel mentally and physically drained on a daily basis.

PCOS is an under appreciated illness. Those who are diagnosed are only treated when they want to become pregnant. Indeed, PCOS is a fertility issue, but this attitude overlooks the debilitating complications of PCOS, which have a profound effect on health and wellbeing.

The name PCOS is misleading and assumes that diagnosis is based on having cystic ovaries. This is not the case. A woman can have PCOS, without having cystic ovaries (or rather, fluid filled sacs).

Let's not forget that PCOS is a syndrome, meaning it is a collection symptoms that are far-reaching. Some symptoms are more obvious than others, and not everyone will present with the same set of conditions.

If you're reading this article, you may have long suspected PCOS, but never had it confirmed. I'm going to describe in more detail how to identify if you have PCOS, and what tests will help you verify diagnosis.

Visible Signs of PCOS

A physical exam and self assessment will identify if you have visible signs of PCOS. You can do a self assessment yourself and ask your doctor to do a physical exam. If you feel more comfortable, you can do a physical exam yourself and ask a good friend to take pictures of hard to see places! Look out for the following key features of PCOS :

Physical exam :

  • excess body hair on the chin, upper lip, chest, arms, stomach and back
  • hair loss and male patterned baldness
  • skin tags
  • dark, velvety patches of skin, called acanthosis nigricans
  • acne

Self assessment :

  • unexplained weight gain, especially around the abdomen
  • pelvic pain
  • infrequent, irregular periods
  • heavy periods
  • anovulatory cycles (ovulation doesn't occur)
  • trouble getting pregnant
  • fatigue
  • low mood
  • anxiety
  • mood swings
  • carb cravings
  • sleep apnea (irregular breathing during sleep)
  • insomnia or disturbed sleep

Concealed signs of PCOS

PCOS is not always visible to the naked eye. Elevated hormones, insulin resistance and fluid filled sacs on the ovaries are hidden signs of PCOS. Your doctor will be able to preform blood tests and an ovarian ultrasound scan to see if you present with internal PCOS symptoms. Below are a list of helpful blood tests that you can request.

Pituitary and Ovarian Hormone serum levels:

  • Luteinizing Hormone (LH)
  • Follicle Stimulating Hormone (FSH)
  • Estradiol
  • Progesterone
  • Prolactin

Circulating Androgens:

  • Free testosterone
  • Free androgen index (FAI): 17-hydroxyprogesterone
  • Sex hormone binding globulin (SHBG): 24 hr. urinary free cortisol
  • Dehydroepiandrosterone sulfate (DHEA-S)
  • Insulin-like Growth Factor (IGF)-1

Insulin Resistance :

  • Fasting insulin
  • Fasting blood glucose
  • HOMA-IR

And while you're at it, you may as well test HbA1c, blood lipid profile and thyroid panel. This will determine possible co-morbidities and illustrate a clearer picture of what's going on.

PCOS & Co-morbidities

I'm afraid the story doesn't end there. PCOS can also increases the risk of developing other health conditions like type 2 diabetes, obesity, non-alcoholic liver disease, cardiovascular disease, infertility, depression and sleep apnea (irregular breathing during sleep). If you suffer from any of these conditions, then consider that they could be related to PCOS.

Diagnosis

Once you've collected as much data as possible, then you can start joining the dots, have a discussion with your doctor, and establish whether or not you have PCOS.

A person is diagnosed with PCOS if they present with two or more characteristic, including :

1. Hyperandrogenism — elevated levels of male hormones, namely testosterone

2. Irregular periods — heavy or missed periods

3. Polyctystic ovaries —despite the name, these are not cysts, rather small fluid filled sacs in the ovaries.

If you've been diagnosed

If you are officially diagnosed with PCOS by your physician, then it's possible they will say "come back to me when you want to have children".  The news of having PCOS is devastating, but a diagnosis can also provide relief and understanding as to why you've been feeling so shoddy — finally you can make sense of the symptoms. However, it is brutal that women burdened with the uncertainty of whether or not they can have children, and their illness is neglected until they want to conceive. Let's not forget that some woman are voluntarily childless, so where does that leave them? Hairy, overweight, depressed and ignored.

As illustrated in this article, the sheer volume of cruel symptoms gives a clear insight into the emotional and physical strain of PCOS. Treatment shouldn't wait till an individual wants to get pregnant. PCOS should be addressed with immediate effect through a low carb diet, which will prevent further complications down the line. For more information on this, check out "You can reverse PCOS, naturally"

But what if you don't meet the criteria for diagnosis?

If you don't meet the criteria for diagnosis, but you present with some of the symptoms outlined, then don't rule out treatment. Your health is vital, and you should never normalise symptoms or brush off a niggle here or there. Diet and lifestyle changes have a profound effect on health. A low-carb diet is a non-invasive, no risk intervention that has endlessly shown remarkable health improvements. Give it a try, test, and see if it helps! Everyone can, and should try it. You might be surprised by how amazing you can feel, and your body's capabilities.


Like what you’re hearing?

Stay tuned for more guides, to help you with your health journey.

If you’re interested in joining Span, download our mobile app on www.span.healthor contact us at team@span.health to learn more.‍

Take care 👋
Adam

I’m sure you’re curious about the science behind all this 🔬 Here are some recent medical publications about this topic:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1334192/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372867/
https://www.ncbi.nlm.nih.gov/pubmed/23315061
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334071/#B4
https://www.ncbi.nlm.nih.gov/pubmed/9408743
https://www.mdpi.com/1660-4601/15/11/2589/htm
https://insulinresistance.org/index.php/jir/article/view/50/184#CIT0001_50
https://www.ncbi.nlm.nih.gov/pubmed/12827388
https://www.ncbi.nlm.nih.gov/pubmed/9618791

https://academic.oup.com/humrep/article/33/9/1602/5056069

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