You may think polycystic ovarian syndrome is a primary disease of the ovary but that is not the case. “It is a complex metabolic disease that has side effects that cause the ovary to be dysfunctional and produce more androgens than normal,” said Dr. Bryan Rone, obstetrician/gynecologist at UK. The condition is unique in the sense that there is no distinct test. “There are criteria patients have to meet, as the National Institute of Health said they have to have (1) evidence of what we call anovulation or oligomenorrhea, which means abnormal menstrual cycles and (2) hyperandrogenism, or an increase in male sex characteristics like oily skin, abnormal hair growth on the face, chest or back,” said Rone. This criterion has to be met in the absence of another cause for increased androgens. “We do blood tests to rule things out like thyroid disorders, prolactinoma, androgensecreting tumors of the ovaries or adrenal glands,” said Rone.

Sometimes physicians add an ultrasound to the list. “The third criteria is a little, small cyst on the ovary,” said Rone. The tough part about polycystic ovarian syndrome is there are associated problems. “Women who have polycystic ovarian syndrome tend to have issues with pregnancies and estrogen levels starting to be high in the postpartum, which is an inhibiting factor for breast milk production,” said Doraine Bailey, breastfeeding support services coordinator and international board-certified lactation consultant with the Lexington-Fayette County Health Department. This means women with polycystic ovarian syndrome may have suppressed or low milk supply, as well as issues with maintaining it.

Nobody knows the cause of polycystic ovarian syndrome but it is possible that there are genetic factors. Nontheless, it remains common. “Between one in ten and one in 20 women are expected to have it but it is hard to diagnose since there is no specific test, just a list of factors,” said Bailey. The list of symptoms may seem endless. “There is infertility, inability to get pregnant, excessive hair growth on the face and body, excessive acne, weight gain, low blood sugar, baldness or thinning of hair, dark, rough patches of skin on the body, skin tags, pelvic pain, anxiety, depression, irregular menstrual periods or sleep apnea,” said Bailey.

By having too much insulin in the body, weight gain occurs mostly in the mid-section. “Too much insulin in the body stimulates the ovaries to produce more androgens like testosterone,” said Bailey. This means there is a hormonal imbalance. “It causes the eggs not to mature so ovulation does not happen,” said Bailey. Cysts are the result of hormonal imbalances and overproduction of insulin, which is the underlying problem. “You can get diagnosed as young as 11,” said Bailey. Sometimes people take medications to control the symptoms and others use birth control pills, diabetes medications or fertility medications if they want to get pregnant. Lifestyle modifications can help. “It is important to reduce or eliminate refined carbohydrates and things with white flour or simple sugars because they trigger the overproduction of insulin,” said Bailey. Avoid sweetened drinks and try to eat more fiber, lean protein and foods rich in omega-3s.

Exercise can be beneficial because it helps your body be less resistant to insulin. “It is recommended to get at least 150 minutes per week or 30 minutes per day of moderate intensity exercise,” said Bailey. It does not cure polycystic ovarian syndrome though, as once you have it, you have it. “The only thing you can do is control the symptoms with diet, exercise and possibly medication,” said Bailey. If you are going to try supplements, talk it over with your healthcare provider and make sure to read the label carefully and consult a doctor about any side effects. “A USP verified symbol is not a bad idea because it means that the product has been checked on the amount of everything it says it does but that does not mean it will work for whatever problem you are encountering,” said Bailey. Natural does not always mean safe because the supplement may contain dozens of compounds.

Do not trust everything you see on the internet and talk about polycystic ovarian syndrome with your doctor, particularly before starting a new exercise program. “A lot of people think they just need cardio activity but strength training cannot be overlooked and helps you lose weight, which helps with insulin resistance,” said Bailey. The more muscle you build, the more calories you burn. Since you are at higher risk for anxiety and depression, talk about treatment for mental health conditions if appropriate with your doctor. While it is not easy to cope with polycystic ovarian syndrome, it is manageable.

By Jamie Lober, Staff Writer