Polycystic ovary syndrome (PCOS) is a typical medical condition that affects women of child-bearing age. It is caused by a hormonal imbalance in the secretion of reproductive hormones. As a result of hormonal imbalance, you face trouble with your ovarian function and ovulation.
Usually, the ovaries produce one egg per month, which gets released as part of the regular menstrual cycle. With PCOS, the egg may not develop properly or may not discharge during ovulation. It may appear impossible to become pregnant while suffering from PCOS. Fortunately, most women with PCOS can become pregnant after receiving proper treatment.
Read everything you must know about PCOS and how it impacts fertility.
Every woman experiences PCOS in distinct patterns since there are a lot of symptoms of PCOS. The symptoms a young woman experiences with it differ from the symptoms a juvenile girl experiences. This makes it more challenging to diagnose it and treat it. So, it is crucial to define the type of PCOS and obtain the best course of treatment.
Types of PCOS:
Before understanding the types of PCOS, you must comprehend the term “phenotypes” of it. In genetics, phenotypes refer to the characteristics or composition of organisms. This allows us to classify patients into different PCOS phenotypes based on the following combination of three diagnostic criteria:
- Polycystic Ovarian Morphology on imaging (PCOM)
- Hyperandrogenism (HA) can be either clinical or biochemical
- Ovulatory Dysfunction (OD)
Depending on the above-stated diagnostic characteristics, women with PCOS can be placed under one of the phenotypes, as discussed below:
Phenotype A:
This PCOS phenotype is a heavy form of it wherein the patient exhibits marked menstrual dysfunction, elevated and greater rates of insulin levels, metabolic syndrome, obesity, and other troubling forms of dyslipidemia. Women with this type of PCOS and insulin resistance have high Anti-mullerian hormone (AMH) levels, which results in an abundance of ovarian follicles. Despite having more follicles, women with Phenotype A are infertile because they do not ovulate inherently.
Phenotype B:
Phenotype B is a non-polycystic ovary type of PCOS with insulin resistance. Clinical hyperandrogenism or biochemical hyperandrogenism resulting in hirsutism and causing an ovulatory disturbance are symptoms of this type of PCOS. Like women with Polycystic Ovary Syndrome (Phenotype-A), women with this type of PCOS may notice irregular periods, higher insulin levels, insulin resistance, metabolic syndrome and obesity. Even though AMH levels range from normal to high, the patient suffers from infertility due to irregular menstrual cycles.
Phenotype C:
An ovulatory type of PCOS, women with Phenotype C have medium levels of androgens, so they do not suffer from intense metabolic syndrome or hirsutism. However, AMH levels are much lower, resulting in fewer ovarian follicles and infertility.
Phenotype D:
PCOS phenotype D is the non-hyperandrogenic form of the disease. Women with this phenotype have the least amount of endocrine and metabolic dysfunction and are less likely to have obesity, hyperandrogenism, metabolic syndrome, insulin resistance, or an abnormal lipid profile. However, they do have an increased number of follicles and ovulatory dysfunction, which leads to infertility.
Signs and Symptoms of PCOS:
Irregular Periods
If you get your periods 2-3 days late or early than your date, it does not indicate irregular periods. Generally, a normal periods cycle is between 22 and 35 days. So, if your menstrual cycle spans more than 35 days, you may have irregular periods. For women with PCOS, absent ovulation can be the reason behind irregular periods, thus progesterone deficiency. If you have it, you could be experiencing heavy periods or lighter ones.
Hirsutism
Hirsutism affects approximately 75-80% of PCOS women. Because women with PCOS can have high levels of androgens, they may experience excessive hair growth on the face and other parts of the body, where men typically have body hair. Hair can be found on the face, chest, back, arms, toes, abdomen, and thumbs of women with PCOS. This condition in which women develop unwanted hair on their bodies is known as hirsutism, and it is a typical symptom of it.
Migraines
No significant research has taken place around the linkage between migraine and PCOS. However, a study conducted in 2019 found that PCOS and migraine are highly connected. Needless to say, this does not mean that if you have PCOS and then you have a migraine. Some women have migraine but do not have PCOS. Your migraine could be a sign of it if
- When your other likely PCOS symptoms are particularly severe and you have headaches.
- Migraines occur at specific times during your menstruation.
- You didn’t start having headaches until you started having other PCOS-related symptoms.
Mood Swings
Female hormones can lead to mood swings, specifically during their periods – almost everyone is aware of the same. It may be hard to ascertain them from mood changes connected with PCOS. However, it frequently disrupts your menstrual cycle by preventing ovulation, so if you’re missing periods and facing mood swings, PCOS is to blame. Aside from mood swings, it is associated with a greater risk of anxiety, depression, bipolar disorder, and obsessive-compulsive disorder.
Tiredness
Though feeling exhausted when suffering from PCOS is uncommon, many women feel tired when having it. But, you shall keep in mind that tiredness can be a sign of your lifestyle factors or other illnesses. However, you do not have to diagnose PCOS or any other health problem solely based on the symptom of tiredness. Moreover, your doctor can diagnose your health condition based on other symptoms you have, your lifestyle and fatigue. Stress, lack of sleep, overworking, and not eating right are a few of the many lifestyle factors that contribute to fatigue.
Sugar Cravings
PCOS patients have high insulin levels in their blood. All of that insulin has the potential to interfere with the function of all other appetite-regulating hormones, leading to increased hunger. If you have a desire for sweets most of the time, it could be owing to insulin resistance, a classic symptom of PCOS. Sugar and processed carbs, in particular, can cause sugar rushes and crashes, resulting in even more hunger pangs. You should watch for some below-stated symptoms of low blood sugar if your cravings are insulin-related:
- Anger induced by being hungry
- Dizziness
- Headaches
- Irritatedness
Weight Gain or Trouble Losing Weight
Weight gain or difficulty losing weight is one of the tell-tale indications of PCOS. Many women with PCOS are overweight or obese and find reducing weight quite tough. Plus, putting on some extra kilos, especially around the stomach, is way more than expected – and once again – insulin could be the one causing a problem. Insulin stimulates fat build-up. Even if you eat healthily, exercise daily, and avoid binge eating, you may still gain weight if you have it.
Acne
A higher level of androgens associated with PCOS can increase the oil production glands on the skin, leading to acne. While acne is a common occurrence in adolescence, younger women tend to suffer from severe acne too. Some women with PCOS may also develop skin tags usually around the armpits. However, there are many other reasons why a woman gets acne. Some of the reasons are hormonal fluctuations, reactions, medication side effects, stress and more.
How Does it Affect Fertility?
Women with PCOS very often face trouble conceiving, making it one of the most prevalent reasons behind infertility. It causes irregular periods by interfering with ovulation, which leads to fertility concerns. Moreover, your fertility also gets affected if you are obese.
Ovulation may not occur to increase testosterone production or because follicles on the ovaries do not develop. Even if ovulation occurs, a hormonal imbalance may prevent the uterine lining from fully developing and allowing the mature egg to implant.
This is the most difficult aspect of PCOS for women who want to conceive now or in the future. However, this does not mean that it will intercept you from conceiving – even though difficult, it is treatable.
Your doctor can recommend ways to help you ovulate and increase the likelihood of developing pregnancy. If you’ve been detected with PCOS and really want it under control, consult Dr Banker right away. If you are having difficulty conceiving, he can also advise you on all of your other options. Know more about how PCOS affects fertility in women.
Fertility treatments for women with PCOS
Because there is no cure for it at the moment, treatment and care must be adapted to the patient’s specific needs. Here are a few options depending on the major problem you’re dealing with:
- You may find it challenging to lose weight because of higher testosterone levels. However, losing weight leaves a positive effect on balancing your hormones and ensuring a regular period cycle. So, exercising every day and bringing some changes in nutrition may play an integral role in your weight loss journey.
- To reduce the effects of insulin resistance and aid weight loss, you must consider taking insulin sensitizers.
- If no medicines work, you can choose IVF for carrying out a pregnancy. IVF is required in critical cases usually.
- You could take ovulation induction medicines for stimulating the ovaries after taking advice from your doctor.
- You should adopt a healthier lifestyle to conceive and have a healthy baby. Some of the examples of leading a healthy lifestyle are maintaining a healthy weight, reducing alcohol consumption, avoiding smoking, eating healthy, exercising and sleeping well.
