What PCOS Really Means & How to Get Accurate TestingFeb 03, 2020
If you were told that you have PCOS based off an ultrasound you may have been misdiagnosed.
PCOS is being over-diagnosed and causing a lot of women unnecessary worry.
Polycystic ovarian syndrome affects 1 in 10 women between ages 15-44 but despite its high prevalence, it's still a very misunderstood condition.
In this Article
You'll learn what PCOS actually is and the role that polycystic ovaries really have with this condition - it's not what you think!
We'll discuss what causes it and what the symptoms are.
Then we'll look at what kind of testing is the most accurate to determine if you really have PCOS and I'll show you where to get this testing if you're doctor won't refer you.
Let's dig in!
What is PCOS?
Polycystic Ovarian Syndrome, or PCOS, is a hormonal related condition that affects 1 in 10 women between ages 15-44.
Despite the name, it’s not an ovarian disease.
PCOS is a heterogeneous disorder, which means that it’s a group of symptoms that can result from several different underlying causes.
Polycystic ovaries are actually just one of the symptoms of the condition, they aren't the cause as commonly thought.
In fact, you can be diagnosed with PCOS and not even have polycystic ovaries!
It's more accurate to look at PCOS as androgen excess which interferes with or stops ovulation from occurring.
How is PCOS diagnosed?
As mentioned, PCOS is a set of symptoms and it's really important to have the right PCOS testing to rule out other possibilities.
The criteria for diagnosing PCOS has changed over the years and not everyone agrees on one set criteria so let's look at the two most common criteria:
According to the Rotterdam criteria, if you meet 2 of these 3 symptoms then you will be diagnosed:
- Irregular or absent ovulation
- Elevated androgens (with the exclusion of other medical conditions that might cause this)
- Polycystic ovaries
According to the Androgen Excess & PCOS Society criteria, all of the following 3 criteria need to be met:
- Irregular or absent ovulation
- Elevated androgens
- Other reasons for high androgens have been ruled out
The new International PCOS guidelines state that ultrasound is not a recommended tool for diagnosing PCOS in women whose first occurrence of menstruation was less than 8 years ago.
Why? Because multi-follicular ovaries are a normal occurrence in younger women! And this is one of the reasons I much prefer the AE&PCOS Society criteria.
In general, polycystic ovaries alone are not a good indication of PCOS because:
- Healthy women with regular cycles and no other signs of hormonal imbalance can have polycystic ovaries. This doesn’t mean they have PCOS. And;
- It’s possible for women to show normal, healthy ovaries via ultrasound with no cysts present and still have PCOS.
Polycystic ovaries are a stand-alone symptom.
What's the best way to get PCOS testing?
Blood tests are the most accurate way to confirm if you have PCOS.
If you've already had an ultrasound that showed polycystic ovaries or multiple cysts and you want to really understand what that means, this article explains.
If you were told you have PCOS but didn't have any blood tests, ask your doctor to test your sex hormones, insulin (not glucose), your thyroid as well as both your ovarian and adrenal androgens.
To understand why these are the recommended tests, read about the 4 types of PCOS by clicking the image below.
Ordering your own tests
If you aren't able to work with a doctor for whatever reason, you can access your own hormone testing here.
I do advise working with a doctor but ordering your own testing is an option if you know something isn't right in your body and you want to take control of your own health.
The PCOS Check will measure your sex hormones, your insulin, your thyroid and both your ovarian and adrenal androgens so that you'll really know what's going on.
If you don't have a practitioner to work with you can schedule a call with me here if you'd like to go over your results and work out the next step.
What actually causes PCOS?
It can actually be caused by a number of different things and if you catch them early, they can usually be undone.
Back in July 2016 it was proposed that PCOS be renamed to Metabolic reproductive syndrome. The reason behind this suggested change is to do with what actually causes PCOS.
The most common causes:
By far the most common cause is insulin resistance. High levels of insulin can delay or prevent ovulation and it also boosts testosterone production in the ovaries.
Next in line is chronic inflammation. Typically, this is due to diet and lifestyle factors such as environmental toxins, high-stress lives, leaky gut and a high inflammatory diet.
When your immune system is chronically activated, it can suppress or stop ovulation, cause hormonal imbalances and stimulate your adrenals to produce androgens.
Another cause (although not agreed upon by all experts) is hormonal birth control. Hormonal birth control suppresses ovulation and while many women return to normal ovulation after a short amount of time, some women who quit the pill will suffer from suppressed ovulation for months or years.
Click here to read more about the different types of PCOS and their causes.
The good news about PCOS is that once the underlying problem is eliminated, you period could return within 3-4 months.
What are the symptoms of PCOS?
Because this is a syndrome, the symptoms can vary widely from woman to woman depending on her specific hormonal imbalances. Typically, you will have multiple of the following:
- Insulin resistance
- Menstrual irregularities
- No period
- Hirsutism (excessive body hair)
- Hair loss from the scalp
- Weight gain or obesity (particularly around the waist)
- Heavy bleeding during your period
- Abnormal mid-cycle bleeding or spotting
- Acne and oily skin (particularly on your check and back)
- Polycystic ovaries
- Fertility issues
- Anovulatory cycles (when the ovary doesn’t release an egg)
- Estrogen excess
What about period pain?
If you have strong period pain this indicates that something else is going on, because pain is not a symptom of PCOS.
Click here to read about the 2 most common causes of period pain.
"I definitely have PCOS so what can I do?"
The first place to start is by working out which type of PCOS you have because this will allow you to really address the underlying cause of your condition. Find out here.
Diet and lifestyle are the best approaches to truly fixing your PCOS and/or managing its symptoms.
If you'd like personal help, you can read about working with me here.
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