Health & Wellness

Abundant acne, facial hair and belly fat: It could be polycystic ovary syndrome

When Olympic curler Helle Simonsen tested positive for a banned substance last week, she attributed the abnormal result to a hormonal remedy she was taking to treat polycystic ovary syndrome, or PCOS.

Dean Mouhtaropoulos / Getty Images
Helle Simonsen of Denmark.

Exactly which banned substance was found — or whether she will be allowed to compete — isn’t clear yet. What is known is that the condition is quite common and can disrupt a woman’s hormones, menstrual cycles and weight. It's a common cause of infertility. What's worse, women can go years before receiving a correct diagnosis.

Estimates of the number of women who suffer from PCOS aren’t exact, says Dr. Anuja Dokras, director of the Penn PCOS Center at the University of Pennsylvania and president of the Androgen Excess and PCOS Society. It may be anywhere from 1 in 10 to 2 in 10, she adds, explaining that the murkiness in the numbers may be because many women go undiagnosed.

Part of the problem is there isn’t a single test, like the fasting glucose test for diabetes, for PCOS.

DIAGNOSIS

PCOS is a sort of “umbrella term,” explains Dr. Meredith Snook an endocrine and fertility specialist the Magee-Womens Hospital at the University of Pittsburgh Medical Center. Women are said to have PCOS if they have two out of the following three symptoms:

  • Irregular periods or no menses at all.

  • Clinical evidence of high levels of male hormones, which can lead to increased acne and hair growth in places such as the chin, the upper lip and the sideburns. Blood tests can reveal high testosterone levels even when hair growth appears to be normal and acne isn’t present.

  • A large number of bumps on the ovaries seen on ultrasound. The little bumps are actually follicles that contain eggs, Snook says, adding that the name of the syndrome is a bit misleading since there aren’t any cysts involved. Women normally produce a large number of follicles at the beginning of their menstrual cycles As the cycle progresses, one or two keep growing, while the others die down. That doesn’t happen in women with PCOS. The follicles don’t sort themselves out. They all remain about half an inch tall.

ADDED COMPLICATIONS

These issues can lead to a host of other health problems.

  • Irregular menstrual cycles and follicles that don’t grow, mature and spew out an egg, can lead to infertility.

  • When periods are missed and the lining of the uterus doesn’t have a chance to shed, the lining can get thicker and thicker which can lead to an increased risk of abnormal cells in the uterus.

  • The syndrome also puts women at a greater risk for metabolic syndrome, which leads to increases in belly fat, cholesterol levels and blood pressure.

Currently no one knows exactly what is at the root of PCOS, but it’s suspected that some women inherit a predisposition to developing it, Dokras says. She suspects that there are multiple genes involved, including ones in the brain that send chemical messages to the ovaries to produce more testosterone than is normal and ones in the ovaries that make them more sensitive to the messages from the brain.

There’s also a suspicion that weight plays a role in exacerbating the syndrome, Dokras says, with the caveat that there are women with PCOS who are not overweight.

Therapies for PCOS focus on symptom control.

TREATMENTS

  • The most simple treatment is the birth control pills, which can fix many of the issues related to PCOS. Oral contraceptives can help regulate irregular periods and clear up acne by knocking back testosterone levels. While the pill may also help with hair growth in unwanted areas, sometimes electrolysis is recommended if the problem is severe.

Related: A third of teens go on pill for non-contraceptive reasons

  • Women who want to get pregnant may be prescribed a medication that helps follicles to mature. “Clomid helps one or two of the follicles to become dominant and once that happens, most will ovulate on their own,” Snook says. The good news: the abundance of follicles shows that the woman has a lot of eggs, Dokras explains.

  • If the woman is overweight or obese, weight loss can sometimes ease symptoms.

Related: 8 nonprescription ways to ease menstrual cramps and headaches

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