What is PCOS and How Did I Even Get it?
In This Article
What is PCOS?
The name Polycystic Ovary Syndrome implies there is a problem with your ovaries, but really it’s a whole body disorder that affects ovulation and causes your body to produce too many androgens (masculine hormones like testosterone).
This causes symptoms like irregular or missing periods, acne, facial hair growth, thinning hair on your scalp, and weight gain.
There has been much debate about the name PCOS as it doesn’t accurately describe what’s going on in your body.
For starters, the name was coined due to the “cyst-like appearance” of follicles seen on ultrasound scans.
Researchers noticed women with PCOS often had ovaries that looked like a string of pearls – with lots of tiny, under-developed follicles.
These “cysts” aren’t really cysts at all, but multiple “baby eggs” that attempted to grow but never made it to full size.
It’s common for baby eggs to begin developing but become stalled due to the hormonal imbalances associated with PCOS.
Once the egg becomes stalled, your body decides to discard that baby egg and try again with a new one.
It often takes several tries before your body is able to grow a full-sized egg and release this at ovulation.
Once you have finally ovulated, this is followed by a period around two weeks later. This is why very long cycles or missing periods are a common feature of PCOS.
Does PCOS mean you have cysts on your ovaries?
Interestingly, not all women with PCOS have polycystic ovaries.
You can still meet the criteria for diagnosis based on other signs and symptoms including irregular cycles (more than 35 days between periods) and hyperandrogenism (high testosterone on blood tests and/or physical signs like acne and hirsutism).
In young women in particular, ultra-sounds are an unreliable means of diagnosis as up to 70% of healthy women under 21 have polycystic ovaries.2
Since PCOS doesn’t involve true cysts on your ovaries, and some women have normal ovaries on ultrasound, researchers have proposed several different names to more accurately describe what is going on in your body.
Some of my personal favorites include “Metabolic Reproductive Syndrome” and “Metabolic Hyperandrogenic Syndrome.”3
For now, we’ll stick to the name PCOS, but watch this space for updates!
Is PCOS a disease?
PCOS is a syndrome not a singular disease.
It is a group of symptoms related to too many androgens.
Other syndromes you might have heard of include irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS).
What’s common between these syndromes is that they describe a group of symptoms, which can have multiple root causes.
Let’s think about an IBS scenario for a minute.
Sarah developed IBS because she caught a stomach bug whilst on holiday in Thailand and ended up with a parasite infection.
Tara has IBS because she works a highly stressful job and drinks lots of coffee on an empty stomach to keep up with the workload.
Both Sarah and Tara experience painful bloating, alternating diarrhea and constipation, and stomach cramps.
However, the treatment that will help resolve their symptoms is likely completely different.
Sarah might benefit from a course of antibiotics to kill the parasite, while Tara might benefit from learning stress management techniques and swapping coffee for green tea.
Syndromes don’t have one simple test that can be used to diagnose them.
Similarly, syndromes don’t have one singular medication or procedure that will work for everyone because the root cause is different in each case.
If you have been officially diagnosed with PCOS, this is because you met a specific criteria of symptoms. To understand what is causing these symptoms, we need to look deeper.
You might be experiencing your PCOS symptoms because of your body’s sensitivity to stress hormones.
It could be a combination of your genetics making your insulin function less efficiently as well as eating a diet that doesn’t support your blood sugar levels.
You might have increased levels of inflammation in your body due to an underlying food sensitivity that has gone unaddressed.
Or you might have recently stopped taking the birth control pill, causing a temporary overproduction of androgens in your ovaries.
This is why a very low carb or ketogenic diet worked for a PCOS influencer you saw on Instagram, but you felt worse when you tried it.
Or why your friend with PCOS feels amazing after an early morning HIIT class, but your energy is tanked for the rest of the day.
In the same way that we need to know why someone is experiencing IBS in order to prescribe the right treatment, to truly heal your PCOS, we first need to understand your root cause.
What are the PCOS "Types" or "Root Causes"
- Insulin resistance
- Adrenal (stress-based)
- Inflammatory
- Post-birth control.
For a Cyster with insulin-resistant PCOS and no issues with her adrenal glands or stress hormones, a very low carb diet and high intensity exercise plan could be incredibly helpful in reversing her symptoms.
For another Cyster with adrenal PCOS, the same plan could leave her feeling moody, stressed, hungry, and with no improvement in her symptoms.
Over the next few chapters, you’ll discover exactly which one (or combination) of these four root causes is driving your symptoms.
We will then create an individualized, step-by-step plan to reverse your PCOS type.
We’ll identify the most important food, movement, mindset, and supplement changes to address your unique root cause and reverse your symptoms for good, so you can start thriving with PCOS
How did I get PCOS?
Research in this area is still developing, however at this point in time, there seem to be three key influences that increase your risk of developing PCOS: genetics, endocrine development, and environmental exposure.
When researchers examined families of women with PCOS, they found that both male and female relatives were much more likely to have metabolic syndrome, insulin resistance, high blood pressure, and high cholesterol.
This suggests that there may be a familial genetic link involved with the development of PCOS.
Research has also shown that early exposure to endocrine disrupting chemicals like pesticides, phthalates and Bisphenol A (BPA) as a fetus or in early childhood may impact the development of your hypothalamus pituitary-ovarian axis (the way your brain talks to your ovaries).
This can lead to issues with ovulation and increased production of androgens, causing the symptoms of PCOS.
Increased stress hormones and chronic dieting in the years before and during puberty have also been linked with an increased risk of developing PCOS later in life.
Finally, there are several environmental triggers that have been shown to accelerate or “switch on” your development of PCOS. These include insulin resistance, inflammation, and stress hormones.
In some women, taking the oral contraceptive pill can also temporarily trigger the symptoms of PCOS due to a surge in androgens.
Think about it like this: You are born with an increased likelihood of developing PCOS, and then certain triggers in your environment and your lifestyle cause that gene to be switched on, leading to the symptoms of PCOS.
While we can’t change your genetics or what happened in your early life, we can change your current environment to minimize the expression of your PCOS and eventually reverse your symptoms.
How does my root cause create my PCOS symptoms?
The factors that triggered our PCOS are likely different from those of another Cyster, which is why every case of PCOS is unique.
At the heart of it, your unique root cause stimulates your body to produce too much testosterone or other androgens.
Can the pill regulate my cycle or fix my PCOS symptoms?
What will happen if I don’t address my root cause?
If you don’t address why your body is producing too many androgens and having issues with ovulation, your symptoms probably won’t improve and will likely get worse over time.
You may also increase your risk of developing more severe conditions over time.
Let’s look at some issues that can happen with each root cause if it goes unaddressed for a long time. I’ve provided these points to keep you informed and to motivate you – not to scare you.
It’s important to understand what putting the work in now can mean for your future.
Just because these risks are listed for your root cause does not mean you are destined to experience them.
If you take action now to take charge of your PCOS, you can dramatically reduce your risk of the conditions mentioned below.
Insulin resistance in PCOS
High stress hormones in PCOS
Inflammation in PCOS
About The Author - Tamika Woods
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List Of References For This Article
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Phase of Premenopausal Women Differs between Ovulatory and Anovulatory
Cycles. Geburtshilfe Frauenheilkd. 2015;75(12):1250-1257.
10. Fica S, Albu A, Constantin M, Dobri GA. Insulin resistance and fertility in
polycystic ovary syndrome. J Med Life. 2008///Oct-Dec;1(4):415-422.