What is PCOS? Could I have it?
“So, like, you never get a period?”
I shake my head.
“Wow” my seventeen-year old mentee wistfully responds.
We had met so that I could quickly glance at her resume and give her a few tips. Somehow, the conversation had shifted to my new position at Glow and then, naturally, to menstrual cycles.
“Well, it’s unpredictable” I clarify. “Some cycles average 45 to 60 days. Other times, I will go months without one. There was a stretch in my 20s that lasted close to three years.”
“That sounds so awesome! I wish that I never got my period…”
My reaction is immediate: “Uhm. No. You do not wish that. Never wish that. That is a terrible thing to wish for…”
She stares at me, head cocked, clearly curious.
I can’t help but explain:
I rarely get my period because I have something called PCOS: Polycystic Ovarian Syndrome. It is a horrific hodgepodge of symptoms that vary in severity from woman to woman. But here is what a majority of us have in common:
Amenorrhea. Not having your period does not just mean you just buy fewer tampons. It means that you rarely ovulate. If you do not ovulate, you cannot become pregnant. Women who do not ovulate regularly also are at a greater risk for miscarriage. Also if your amenorrhea is caused by low estrogen levels, you are at risk of osteoporosis — a weakening of your bones.
I can tell that my mentee is not moved. These things are a long way off for her. What does a seventeen-year-old care about bone loss? I decide to shift tactics.
Hair, hair everywhere (except the top of your head).If you have PCOS, chances are good that you also have androgen excess. And that can cause a whole bevy of issues: acne, excessive facial and body hair, and male-pattern baldness. How bad does it get? Well, imagine if the receptionist of your waxing salon knew you simply by the sound of your voice? Imagine never being able to wear your hair down or blown-out because any such effort meant that your naked scalp would be clearly visible. Imagine spending years going from dermatologist to dermatologist trying to find that one magic pill that might finally work on your 37-going-on-13-with-acne skin?
Now she looks suitably aghast. “Really?” she asks. In answer, I pull off the band holding up my ponytail and bend my head down for her inspection. Her sharp intake of breath is all the response I need. I move on.
Obesity that you cannot escape. More than six out of every ten women who have PCOS are also overweight. And losing that weight can seem like a constant struggle. PCOS makes it more difficult for the body to use the hormone insulin, which normally helps convert sugars and starches from foods into energy. This condition - called insulin resistance - can cause insulin and sugar to build up in the bloodstream. High insulin levels can make gaining weight extremely easy. And taking it off, impossibly difficult. The most maddening part of the weight gain is its cyclical nature: The more weight you gain, the greater your insulin resistance, the more weight you gain.
I tell my mentee that I used to weigh a very healthy 110 lbs at her age.
“That’s close to what I weigh now…” she trails off. And I can distinctly see her thought process because she has started looking at me like I’m carrying the Ebola virus.
“So how can I prevent it? How do I make sure I do not get this PCOS?”
You cannot. No one can. There is currently no way to prevent polycystic ovarian syndrome. But early identification or treatment are essential to minimizing some of the risks associated with PCOS. If you avoid smoking, exercise frequently, and maintain a healthy diet under constant vigilance from an early age, then perhaps your symptoms will be more manageable. The key word being: perhaps.
Here is how you know you should speak to your doctor about PCOS:
Your menstrual periods are infrequent, irregular, or absent.
You have hair growth on your chin, upper lip, sideburns, chest, in the area around nipples, or the lower abdomen along the midline.
You are overweight but eat less that many of your peers.
I tell her that this is by no means a complete list – but a good start. My mentee leaves soon after, clutching a marked-up resume and absent-mindedly running her fingers through her long hair.
I feel a small sense of satisfaction at her edification.
They say that up to 10% of women have PCOS. Tragically, many people view PCOS as a cosmetic problem. They do not realize that PCOS has potentially devastating consequences. But the fact of the matter is – every woman should know about PCOS and the havocs it can wreak on the female body. And the earlier you know, the better.
Well, one down.
What has your experience been with PCOS? Do you have it? What is your worst, most annoying symptom? And has anything worked in terms of diminshing your symptoms? Please let us know.