Polycystic Ovary Syndrome (PCOS) is a condition in which certain hormones are out of balance. These imbalances typically show up as irregular menstrual cycles, a higher level of androgens (a type of hormone including testosterone) in the body, and small cysts in the ovaries. PCOS can cause symptoms including excess facial and body hair, mood changes, and acne. It can also make it difficult to become pregnant, and may significantly harm a person’s overall health if left untreated.
PCOS can look and feel different for everyone. Some of the most common PCOS symptoms are:
PCOS symptoms may start around the same time as a person’s first period. This can lead people to think their cycles or symptoms are normal when they might not be. If symptoms appear around the same time as a first period, or if periods are consistently irregular 2–3 years after starting, it’s a good idea to talk to a healthcare provider.
PCOS sounds like it’s exclusively a disease of the ovaries, but it’s not. While PCOS does affect the ovaries and ovulation, it’s actually a full-body endocrine and metabolic disorder that is closely tied to insulin resistance.
The Four Different Types of PCOS
According to Lara Briden, a Naturopathic doctor and insightful women’s health expert, there are 4 different types of PCOS. Below we will discuss what those are and how they can impact your health.
Insulin Resistant PCOS
For some people with PCOS, hormonal imbalances are likely caused by insulin excess. Insulin, the hormone important for processing sugar/glucose, also acts as a signal to the ovaries to produce testosterone. When someone is insulin resistant--when they have a lower sensitivity to insulin for processing glucose--their body adjusts by making more insulin. This leads to higher levels of testosterone, which can slow or stop the growth and release of eggs from the ovary, and suppress the production of hormones like estrogen and progesterone that go along with a functioning menstrual cycle. About a half to two-thirds of people with PCOS have been found to be insulin resistant--a group which may also tend to experience more symptoms and health complications of the disorder over time.
If your menstrual cycles were regular before taking birth control, then it could be a temporary situation of "post-pill" PCOS. There is some evidence that stopping oral contraceptives can cause a short-term delay of fertility, but there has not yet been research into the possible condition of "post-pill" PCOS. Typically this is seen in women who started certain types of oral contraceptives while still young, and then experience both a delay in re-establishing regular ovulation and a temporary surge in androgens and androgen-excess symptoms, such as acne.
The theory of women with PCOS having more inflammation than normal is due to higher androgens which in turn stimulate more insulin production. Higher insulin levels contribute to weight gain which only causes more inflammation. Thus a vicious cycle ensues for women with PCOS.
Inflammation can also be caused by diet, which can induce oxidative stress to stimulate an inflammatory response (even without weight gain). A diet high in carbohydrates is associated with a pro-inflammatory response. Eating an anti-inflammatory diet may counteract some of the inflammation in women with PCOS and help improve both metabolic and reproductive aspects.
When hormones are elevated--as is pervasive in PCOS--symptoms of androgen excess begin to manifest. For some women, this affects their menstrual function and fertility. For others, they continue to menstruate but struggle with physical changes like unwanted hair growth, weight gain, and acne.
This means that a woman with PCOS symptoms could have normally functioning ovaries with no cysts and no insulin resistance, yet still fit the symptomatic profile of the syndrome.
There is some controversy over whether elevated androgens cause insulin resistance or if insulin resistance happens first. The most likely answer is “it depends.” Some women likely develop insulin resistance first, while others develop elevated androgens first.
There is still a lot to learn and research when it comes to PCOS but one thing is clear; it can affect your skin and your health. We hope this post will help you be more aware of different aspects of your health that can also have an impact on your skin.
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