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March 11 2020

PCOS: Understanding This Female Hormonal Disorder

A vast percentage of women may be no stranger to irregular periods, abnormal weight gain, and perhaps the growth of unwanted hair in unusual parts of the body or even hair loss.
Dealing with these conditions can be tough, so it would be best to seek professional help as these are also signs that point to one condition: polycystic ovary syndrome or PCOS.

What Is PCOS?

PCOS is a female hormonal disorder affecting the function of a woman’s ovaries. It is a common condition that can affect up to 70% of women, usually between the ages of 15 and 44. These are the so-called reproductive or child-bearing years when the ovaries are producing hormones that prompt women’s monthly menstruation.

The Effects of PCOS on Women

The problem with PCOS is the imbalance in hormones because the body is producing excess levels of certain hormones, causing irregularities in a woman’s menstrual cycle.
PCOS may also lead to the ovaries developing problems, such as eggs not becoming mature enough to trigger ovulation. As such, PCOS can affect the ability of a woman to bear children.

Common Symptoms of PCOS

A PCOS diagnosis needs at least two of the following symptoms:
  • Irregular periods

The lack of ovulation prevents the uterine lining from shedding each month regularly. This leads to irregular or unpredictable periods. In fact, some women with PCOS have fewer than eight or nine periods annually, while others do not have periods within a year at all.
  • Heavy bleeding

PCOS can also cause heavy, fast-flowing periods, and sometimes, they come with large blood clots. As the uterus sheds its lining, the anticoagulants that the body releases to keep blood from clotting cannot keep up with the quick pace of bleeding, so blood clots are passed during menstruation.
  • Polycystic ovaries

In PCOS, the term “polycystic” means “many cysts,” although having PCOS does not necessarily mean you have cysts in your ovaries.

What polycystic ovaries indicate is that the ovaries have become enlarged and contain many small follicles that may be up to 8mm or 0.3inches in size. Because of these follicles, the ovaries are unable to ovulate or release eggs. Without eggs to be fertilized by a man’s sperm, it will be difficult for women to get pregnant.
  • Abnormal hair growth or hair loss

Excessive growth of hair on the face, chest, back, or buttocks is called hirsutism. This condition is the effect of high production of the male hormone androgen, which is what results in unwanted facial and body hair. On the flip side, excess androgens can also result in hair loss or acne.
  • Obesity

Up to 50% of PCOS patients deal with obesity problems. This is because people affected by PCOS tend to produce high insulin levels, which stimulate appetite and cravings.
  • Boils and lumps

This is another PCOS hormone-related problem wherein a woman develops pea-sized lumps or bigger on top of or beneath the skin. Usually, the lumps grow in body parts where the skin rubs together, such as neck, underarms, groin, thighs, under the breasts, or between the buttocks, causing the surface to be inflamed.

How is PCOS Diagnosed?

There is no single test to diagnose PCOS, so a patient needs to undergo a series of examinations and symptoms check to help an obstetrician-gynecologist (OB-GYN) narrow down the diagnosis. These tests include the following:

1. Physical exam

The doctor will measure your blood pressure, body mass index (BMI), and waist size. The skin will also be checked for extra hair, particularly on the face, chest, and back, as well as acne and skin discoloration.

2. Pelvic exam

The doctor will be looking for any growth or abnormalities in the ovaries and uterus by inserting gloved fingers into the vagina.

3. Pelvic ultrasound

An ultrasound can show if a woman has a high number of follicles that are affecting her ability to ovulate or release eggs. The doctor may also use this test to look for tumors and measure the lining of the uterus.

4. Blood test

The doctor may order a blood test to check hormone levels and screen for health problems associated with PCOS, including diabetes and high blood pressure.

5. Hysteroscopy and Biopsy

Hysteroscopy is an examination procedure done on the cervix and uterus if a woman is experiencing constant or heavy bleeding. The doctor will also do a biopsy by taking a tissue sample to make sure there is no pre-cancerous or cancerous development on the uterus lining.

Factors That Play a Role in PCOS

Since the cause of PCOS is not entirely known, it may help to look at the factors that can lead to PCOS instead.
  • Insulin

Insulin is the hormone produced by the pancreas that regulates sugar to produce energy. If cells become resistant to the function of this hormone, blood sugar levels can rise, causing the pancreas to produce more insulin. Elevated insulin levels may increase androgen production, which causes ovulation difficulties.
  • Androgen

Androgens are commonly known as male hormones, but the ovaries also produce this in small amounts. Large amounts of androgen can lead to PCOS symptoms like acne and hirsutism or unwanted body hair.
  • Progesterone

The absence or small amount of progesterone in the ovaries can cause the lining of the uterus to become thicker, resulting in substantial and frequent bleeding episodes.


There is no known cure for PCOS, and the best way to deal with it is knowing how to regulate the menstrual cycle, as well as managing other symptoms. These things can help:
  1. Weight loss. Even if the patient only loses about 5% to 10% of her weight, this is enough to bring about improvements in the way her ovaries work. Include regular exercise and eating a healthy, balanced diet with lots of lean meat, fruits, vegetables, and whole foods to help lose those pounds.
  2. Birth control. If the patient is not planning to get pregnant just yet, taking medications for birth control can help in regulating hormone levels and, consequently, the monthly period.
  3. Fertility medications. If a patient does wish to get pregnant, it will be best to discuss this with her doctor first so that she will be given medications that stimulate ovulation.
  4. Diabetes drugs. These drugs work to regulate insulin levels and help reach an ideal weight, which can improve ovulation.

Being PCOS-Free is Good for the Future

Disorders like PCOS need immediate attention, particularly because it has the potential to affect a woman’s future if she wishes to have a family. At the first sign of any PCOS symptom, take the necessary precaution by going for a medical checkup, so a doctor can help figure out if it’s PCOS and not any other condition with similar symptoms.
For a more accurate assessment, seek professional help from the specialists at Makati Medical Center’s Department of Obstetrics and Gynecology.