Most women can develop PCOS when they first get their period in their teens. But may not show symptoms until their 20s. Some women do not have cysts. Some do. The name occurs from the process that creates a build-up of hormones. When we do not ovulate, our body thinks it needs more hormones (androgens) to develop follicles.
PCOS patients most often have irregular periods. They have a period twice a month, more than seven days at a time, spotting between periods, irregular timing, or periods more than 35 days apart. The body isn't in equilibrium. Your brain uses your hormones to regulate. So the brain is sent messages that it is stressed. We release hormones (LH or insulin) to fix it. Our ovaries then create too much testosterone.
Other symptoms:
Excess body hair, including the chest, stomach, and back (hirsutism)
Acne or oily skin (ask about zinc and spironolactone)
Male-pattern baldness or thinning hair
Small pieces of excess skin on the neck or armpits (skin tags)
Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts
Insulin-resistant PCOS
Inflammatory PCOS,
Hidden-cause PCOS,
and Pill-induced PCOS.
Adrenal PCOS
The most common treatment for PCOS is the pill. But it’s just a quick fix. The pill doesn’t deal with the real issues. Over time there aren’t long-term benefits.
When we are younger, we go on the pill to regulate our period. There are still limitations in medicine around early diagnosis for PCOS. Some doctors and labs do not have the same criteria. You can't be diagnosed on symptoms or scans alone. There are debates if women "meet the criteria." Different doctors have different diagnosis recommendations. Suppose you disagree with your doctor's diagnosis. Get another opinion. ADVOCATE FOR YOUR HEALTH. SHOP AROUND.
Lab patterns for PCOS:
- Low plasma SHBG levels (Normal: 20-118) - indicator for insulin resistance in which ask about metformin
- High AMH
- Lipid panel: high LDL & high cholesterol
- High total/free testosterone (Low SHBG numbers can impact free T elevating it. But have normal total T values)
- DHEA (greater than 200 ug/dl)
- Even thin women have an LH (elevated) /FSH (normal low) ratio of around 2.75
(LH is 3X as much as FSH) There are cases where LH/FSH are normal but with low levels of other key hormones.
OC's are the first thing prescribed for PCOS, but some women experience negative results: Why does it work as a treatment for some women and not for others?
Oral contraceptives help if you are diagnosed with hyperandrogenemia with PCO. The primary purpose of decreasing total testosterone.
More often than not, women have an adverse reaction to the pill—especially those sensitive to metabolic disorders.
I've read countless stories where women are not sure if they should go back on the pill after being diagnosed with PCOS.
Please DO NOT GO BACK ON THE PILL: IT CAN MAKE PCOS WORSE. Ask what is in it. Be sensitive to how your body reacts to these synthetic materials.
Certain types of birth control can cause high androgen levels.
A temporary surge in androgens when coming off a drospirenone or cyproterone pills like Yasmin, Yaz, Diane, or Brenda.
There are standard reports that COCs over extended time has:
- adverse effects on metabolism
- impaired fasting glucose, increased insulin resistance, and increased risk of thromboembolism disease
- they affect lipids:
consistently increased high-density lipoprotein cholesterol, triglycerides, and total cholesterol concentration
-If you have non-alcoholic fatty liver disease (NAFLD), OC's make insulin resistance WORSE
- COCs have also been associated with a two-fold increased risk of fatal and nonfatal likelihood of VTE (blood clots) among women with PCOS. It is reported to be 1.5–3 times higher than in non-PCOS controls.
So I read many studies about COCs and PCOS patients. The problem is most studies ARE SHORT TERM. They only analyze the effects of COCS on PCOS patients for under six months. What about longer? Since most women stay on for years?
Few studies look into using different types of progestin for PCOS type.
Does the OC contains antiandrogenic/antimineralocorticoid progestin?
Forms including progestogens, gestodene, desogestrel, cyproterone acetate, and drospirenone are all associated with higher SHBG levels.
Levonorgestrel is also associated with a low impact on SHBG. YET, Levonorgestrel is quite testosterone-like and so can cause androgen side effects such as weight gain.
A ring or patch is associated with the highest increase of SHBG levels. With similar hormone alterations as oral contraceptives.
Women are only fertile six days in their cycle.
IUDs have the lowest impact on SHBG levels. They have lower hormone amounts and use of different forms of estrogen and progestin. COPPER IUD's DO NOT ALTER HORMONES.
Otherwise, there are condoms, Caya diaphragm, and cervical caps. But the point is doctors shouldn't prescribe birth control without any explanation. Without presenting alternatives to heal your body in time. (Check diet intake: Vitamin D, total fiber, vitamin B9, and excessive consumption of sodium)
Stay Heathy. Stay Happy.
Resources: Resources:
Raps, M., Helmerhorst, F., Fleischer, K., Thomassen, S., Rosendaal, F., Rosing, J., Ballieux, B. and Van Vliet, H., 2012. Sex hormone‐binding globulin as a marker for the thrombotic risk of hormonal contraceptives. Journal of Thrombosis and Haemostasis, 10(6), pp.992-997.
Hugon-Rodin, J., Alhenc-Gelas, M., Hemker, H.C., Brailly-Tabard, S., Guiochon-Mantel, A., Plu-Bureau, G. and Scarabin, P.Y., 2017. Sex hormone-binding globulin and thrombin generation in women using hormonal contraception. Biomarkers, 22(1), pp.81-85.
de Medeiros, S.F. Risks, benefits size and clinical implications of combined oral contraceptive use in women with polycystic ovary syndrome. Reprod Biol Endocrinol15, 93 (2017). https://doi.org/10.1186/s12958-017-0313-y
Anjum, Sarwat et al. “Clinical Presentation and Frequency of Metabolic Syndrome in Women With Polycystic Ovary Syndrome: An Experience From a Tertiary Care Hospital in Pakistan.” Cureus vol. 12,12 e11860. 2 Dec. 2020, doi:10.7759/cureus.11860
https://pubmed.ncbi.nlm.nih.gov/31504532/
https://rbej.biomedcentral.com/articles/10.1186/s12958-017-0313-y
https://rbej.biomedcentral.com/articles/10.1186/s12958-017-0313-y#Sec1
https://blog.insidetracker.com/surprising-way-birth-control-affects-health-hormones