Women's health care has become a hot topic recently, and it is something that needs to be addressed and talked about. Mothers and grandmothers cannot be ashamed to talk to their daughters about women's health and tips on how to keep healthy. Reproductive women's health is a subcategory that has become slightly taboo recently. Reproductive health is not just limited to making sure expecting mothers are okay or to women trying to start a family. Reproductive women's health also applies to young girls just hitting puberty and teenagers dealing with very painful period cramps and other menstrual complications. There are a bunch of reproductive health issues that women deal with every day from endometriosis, pelvic inflammatory disease, adenomyosis, fibroids, endometrial polyps, ovarian cysts, and polycystic ovarian syndrome to name a few.
Polycystic ovarian syndrome (PCOS) is a fairly common endocrine system disorder in which a woman's ovaries become enlarged due to cysts collecting in the ovary. It's pretty common for a woman to not realize she has PCOS until the symptoms become glaringly obvious. PCOS is different from ovarian cysts (think of PCOS as the plural form). PCOS can lead to a bunch of complications, but the most worrisome is a cyst rupture. When a cyst ruptures, it can be super painful or go unnoticed. Most women don't even realize a cyst ruptured. They may think it was a minor cramp or a gas bubble, but other women need to be hospitalized for a ruptured cyst if they're too large.
About two years ago, my freshmen year of college, I was diagnosed with PCOS. I had started to miss my period in the months before the diagnosis, which I had chalked up to stress due to moving into college for the first time. However, by the third missed month I had decided that this wasn't normal and there was no possible way it could've been pregnancy.
Diagnosing PCOS is pretty straight forward. There are a couple of ways to determine if you have it. For me, my doctor ordered a blood sample to start, where she found that my testosterone levels were four times higher than they should've been. Everyone has both the female and male hormones in them, just at varying levels (which causes the sex differences). High levels of the male hormone are one of the ways a doctor can diagnose PCOS. Other diagnoses include a pelvic exam or an ultrasound to see how swollen or large your ovaries are.
After my doctor had told me that this was probably what I had, she wanted me to go on an oral birth control which helps to stop ovarian cysts from forming since you aren't actually ovulating every month. She also explained to me what some other symptoms of PCOS were, to see if I had them as well. As she listed them off, everything began to make sense. Since my body wasn't regulating my hormones correctly, it probably attributed to my weight gain during puberty (I was a fairly skinny kid). I'm not going to say that PCOS was the only reason my weight spiked during puberty, I am a huge fan of food and I'm a lazy person, but it didn't help me any.
PCOS also can attribute to excessive acne or oily skin (which can lead to acne). This one is a tricky symptom because every kid going through puberty gets acne. PCOS can also cause abnormal or unwanted facial hair growth. Everyone's got a little peach fuzz on their cheeks and chin, but women with PCOS tend to have darker, rougher hairs forming, especially on the upper lip and between the eyebrows. I didn't really struggle with this symptom, but afterwards I had noticed that some of my peach fuzz was a lot longer and rougher than the rest of the hairs. It's something I've become a little self-conscious of. I find myself checking for dark or long hairs when I look in the mirror now.
The most common symptom, and the one that led my doctor to PCOS, is frequent missed or irregular periods. I had thought nothing of this my whole life until I missed those three months freshmen year. My period was always regularly late. It rarely held to a 28 or 32-day cycle, but it would always come. My doctor had said that if I had said something sooner, I could've gotten on birth control earlier and maybe helped to stop some of the cysts from forming.
Birth control is probably the most common treatment for PCOS, because most women start to show symptoms early enough in life that they can start a regiment without it affecting their ability to start a family. There are other options, however, if you're someone who doesn't believe in birth control or are trying to start a family.
Like I had said in my article about SSRIs, starting birth control may not just be a once and done thing. Many women have to try out different forms of birth control until they find their right match. I was on a brand for almost a full year when my doctor took me off of it because my blood pressure had begun to spike. I went four months after that with no birth control, until I saw another doctor in June who'd put me on a lower dose birth control. That pill and I did not get along. I was nauseous all the time and it made my anxiety spike, while I was already on an SSRI. I went back to my new doctor and he and I agreed to let me try my old birth control brand again now that my blood pressure had regulated down again. It's been almost two months back on my old pill and I can say with certainty that my body is much happier with this pill. Yes, I still am having some unpleasant complications with it (some weight gain, some nausea but not to the extent of the other pill). Birth control trial and error can be literal hell for the women who aren't lucky enough to click with a brand or dose right away. Even women who want to go on birth control for preventing pregnancy or just making their periods less heavy have to go through this process of trial and error, simply because everyone's body is different. Thankfully, we live in an era where there are so many birth control options available to us.
Unfortunately, there is no cure for PCOS. Doctors aren't even sure how someone gets PCOS to begin with, but they do see a genetic pattern with mothers or sisters who also have PCOS. If left untreated, PCOS can cause a plethora of complications later on in a woman's life, including: type 2 diabetes, high blood pressure, high cholesterol, infertility, sleep apneia, and depression and anxiety. I encourage anyone who's missed their period for a couple of months (with no risk of pregnancy) or has an irregular period to talk to your doctor about PCOS, and at least rule it out. The earlier you start treatment for PCOS the less likely you are to have complications in the future.