PCOS: Everything You Need to Know, Simply Explained

Polycystic ovary syndrome (PCOS) affects about 1 in 10 women of childbearing age. It’s not a serious illness, and with good management, you can live very well with it! Here’s a clear guide to understand what PCOS is, how to spot it, diagnose it, and treat it.

What signs should alert you?

PCOS shows up differently in different women. Here are the most common signs:
- Irregular periods: for example, you only get your period every 2 or 3 months, or not at all for a long time.
- Excess hair: a mustache that grows faster or hair on your chin or belly, called hirsutism.
- Acne or oily skin: imagine acne that sticks around on your face or back, even at 25.
- Weight gain: you gain weight, especially around the belly, and the pounds seem hard to shift.
- Trouble getting pregnant: you’ve been trying for months without success.

If several of these signs sound familiar, talk to your doctor. It doesn’t mean it’s definitely PCOS, but it’s worth checking!

How is PCOS diagnosed?

Diagnosis combines your symptoms and some tests. Doctors use 3 criteria (called the Rotterdam criteria):
1. Irregular cycles or no ovulation.
2. Signs of excess male hormones (hairiness, acne, or high levels in blood tests).
3. “Polycystic” ovaries on ultrasound: they see lots of small follicles, like pearls on a necklace.

You need at least 2 of these 3 things to confirm PCOS, after ruling out other causes (like a thyroid issue).

What tests should you do?

To be sure, your doctor might order:
- A pelvic ultrasound: a quick exam where they look at your ovaries with a probe (sometimes vaginally, but it doesn’t hurt!).
- A blood test: to check your hormones (testosterone, LH, FSH) and blood sugar, since PCOS can make your body less sensitive to insulin.
- A general check-up: a routine look at things like cholesterol and blood pressure to make sure everything’s okay.

These tests are simple and help clarify what’s going on.

How is PCOS treated?

Treatment depends on your needs, especially whether you want a baby or not. Here are the options, split into two real-life scenarios.

If you don’t want to get pregnant

The goal is to ease the symptoms bothering you:
- Weight loss if you’re overweight: for example, losing 3 to 5 kilos if you weigh 70 kg can already regulate your periods and reduce acne. Walking 30 minutes a day and cutting back on sweets makes a difference!
- Birth control pill: it gets your cycles in order (every 28 days), reduces hair and acne. For example, after 3 months, you might see your skin clear up a lot.
- Hair treatments: a cream like eflornithine or laser hair removal can help if the hair bothers you a lot.

If you want to get pregnant

Here, the focus is on ovulation and fertility:
- Weight loss if you’re overweight: even a small drop can kickstart ovulation. For example, a woman weighing 80 kg who loses 6 kg might ovulate on her own.
- Ovulation drugs: clomiphene citrate, taken a few days a month, stimulates the ovaries. Many women get pregnant within 6 months with this.
- Insulin management: if your body resists insulin, metformin can help regulate your cycles and boost ovulation. For example, after 2 months, your periods might come more often.

In both cases, your doctor will tailor it to you. Tell them what matters most to you!

Is it serious? How does it evolve?

No worries: PCOS isn’t a serious illness. It’s just a hormonal imbalance, not a dangerous ovary problem. With age, often after 40, symptoms usually lighten up because the ovaries make fewer hormones. For example, your periods might get more regular and hairiness might decrease naturally. But watch out: keeping a stable weight is key to avoid issues like diabetes or heart problems later.

The final word: you’re not alone!

PCOS is common, and there are ways to live well with it. Listen to your body, talk to your doctor, and adopt good habits (especially weight control). With the right follow-up, you can manage your symptoms, have kids if you want, and see things improve over time.