If you have PCOS, dealing with oily skin or breakouts can become a common occurrence. You might have hoped that adulthood was finally a time to wave goodbye to acne, but for women with PCOS, the condition can continue into adulthood. Up to 43% of adult women with PCOS experience acne.
People with PCOS tend to get acne on their lower face, including the jawline, chin, and upper neck. You might find it gets worse around the time of your period. This is sometimes known as “hormonal pattern” acne.
Women with PCOS experience acne due to a hormonal imbalance. PCOS leads to high levels of high levels of androgen hormones (e.g., testosterone) produced by the ovaries and adrenal glands. These hormones can increase sebum (an oily, waxy substance) and skin cell production, leading to acne.
Experiencing acne in adulthood can be tough to deal with and may affect your mood and self-confidence. However, there are plenty of treatment options available.
Changes In Hair Growth
Women with PCOS may experience excessive hair growth, thinning hair, or even hair loss.
Excessive hair growth (also known as ‘hirsutism’) often occurs in unwanted areas of the body (e.g. upper lip, chin, chest, back, abdomen, arms and thighs). Around three-quarters of people with PCOS experience this symptom. In people with PCOS, high levels of sex hormones (e.g. testosterone) send the hair follicles into overdrive, leading to excessive hair growth.
Alopecia (better known as female pattern hair loss) is another distressing symptom of PCOS. It describes progressive hair thinning or loss in women. High sex hormone levels also play a part in hair loss. In some people, the hair follicles in the scalp are over-sensitive to testosterone, leading to hair loss instead of hair growth. The reason isn’t clear, but genetics may play a role.
For many women, weight problems are a frustrating and upsetting symptom of PCOS. You might find yourself gaining weight, for no apparent reason, or struggling to lose weight. Losing weight isn’t easy at the best of times but if you have PCOS, it can be even more difficult. Yes, there really is a reason! It isn’t “just you”.
People with PCOS are more likely to be insulin resistant. When your body is resistant to the hormone insulin, it stops using it properly. This means that you end up with lots of extra unused insulin floating around your body (known as high circulating insulin levels). Insulin is a fat-storing hormone, so the more that accumulates, the harder it becomes to burn body fat. High levels of insulin can also make you feel tired, bloated and hungry.
For women with PCOS, body weight is a little more complex than we think. Weight gain can be a cause and a symptom of PCOS. High androgen levels can cause people to gain weight around their middle (known as ‘central fat’). Central fat causes (yes, you guessed it…) insulin resistance, which then causes the ovaries and adrenal glands to produce more androgens. But, remember that not everyone with PCOS will experience weight problems.
Most of us have a love/hate relationship with our periods, or menstruation. A period is part of the monthly menstrual cycle when a person bleeds from their vagina, in response to changes in hormone levels.
A menstrual cycle is considered to begin on the first day of your period. Usually, the average menstrual cycle is every 28 days with most cycles lasting between 25-30 days. The volume of blood usually lost in a period is around 30-80ml (about an eggcup full).
When it comes to periods, things don’t always go to plan, especially when you have PCOS. Rest assured, if you have PCOS and are having period problems, you’re not alone. A whopping 75-85% of women with PCOS experience period problems, including infrequent, irregular, heavy, or prolonged menstrual cycles (longer than 35 days). The most common period problems in PCOS are long cycles or a lack of periods.
Hormonal imbalances are usually the cause of period problems in PCOS. Problem periods can be more than “just an inconvenience”. Left untreated, they can make it difficult to get pregnant and can put you at higher risk of certain health conditions.
Problems getting pregnant
Sadly, women with PCOS may experience fertility issues due to irregular menstrual cycles and ovulation problems. Some people learn they have PCOS only after seeking infertility treatment.
Ovulation problems are usually the primary cause of infertility in women with PCOS. Ovulation (the release of an egg) may not occur due to hormonal imbalances or due to a problem with the cycle itself. Even if ovulation occurs, an imbalance in hormones may prevent the lining of the uterus from developing properly to allow for implantation of the mature egg.
If you’re thinking about trying to get pregnant, it’s important to address these hormone imbalances early to encourage normal ovulation and improve your fertility.
Reduced Egg Quality
If you are trying for a baby using assisted conception, (e.g. IVF), you may have been told that you have a problem with egg quality. This could mean that your eggs may fail to fertilise or develop enough for a healthy transfer and implantation.
Women with PCOS have been shown to have problems with egg quality. It’s not known for certain why this happens, but it could be linked to insulin resistance and high levels of the sex hormones known as androgens (e.g., testosterone). However, not all women with PCOS will have a problem with egg quality.
Treatments are available to improve egg quality in women undergoing assisted reproductive technology (e.g., by taking Myo-Inositol and folic acid supplements). Consult with your doctor for further support and advice.
Maintain A Healthy Pregnancy
Women with PCOS who become pregnant have a raised risk of complications during their pregnancy; including gestational diabetes, preeclampsia, high blood pressure, preterm delivery and pregnancy losses. This can be due to a number of different reasons including being overweight, hyper stimulation of the ovaries (through assisted conception), altered hormone patterns, altered cycle lengths, and insulin resistance.
Problems in pregnancy will depend on lots of factors, including your family history, ethnic background and lifestyle. To improve fertility and promote healthy pregnancy, optimising your health at preconception is of great importance. Consider seeing your doctor for further support and advice.
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What if I suspect I have PCOS?
If you haven’t yet received a diagnosis of PCOS, but you’re experiencing any of these symptoms, please make an appointment with your doctor. Your doctor will take your blood pressure and send you for blood tests to measure your hormone levels and to check for other conditions. They’re also likely to check for high cholesterol and diabetes. You may even need an ultrasound scan to see whether you have a high number of follicles in your ovaries (polycystic ovaries). Having a diagnosis means that you have ruled out other conditions and can at least move forward, work on a plan and take control of your PCOS.
What is the treatment for PCOS?
There isn’t a cure for PCOS. But it is possible to manage your symptoms positively. Management of PCOS is tailored towards the individual goals and needs of each person. Your doctor may prescribe certain medications to help with your symptoms. These may include the contraceptive pill to regulate your menstrual cycle and reduce excessive hair growth. Or topical skin treatments to address issues with acne.
Lifestyle changes will also make a difference. Following a healthy diet and an exercise programme and making sure you get enough of the right vitamins and minerals can really help restore some balance in your body. Even a modest weight loss of between 5-10% of your body weight is likely to have a positive effect on your condition.
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What are the long-term health implications?
By not addressing the symptoms of your PCOS, such as being overweight and having irregular periods, you can increase your chance of developing type 2 diabetes, high cholesterol, high blood pressure, heart disease, endometrial hyperplasia (a thickening of the wall lining of the uterus) and endometrial cancer, as well as ongoing problems with fertility. 33 If you do become pregnant, there is a greater risk of experiencing complications during your pregnancy, particularly if you’re overweight.
It’s important to take control of your condition. So, as well as taking supplements and embracing a healthy lifestyle, it’s vital to have regular checks for your weight, blood pressure and glucose levels in the blood.
Jodie Relf is a registered dietitian and qualified Pilates instructor who is passionate about empowering women to take control of their PCOS symptoms naturally. Having personally experienced the challenges of being diagnosed with PCOS in her early twenties and feeling frustrated with the lack of evidence-based advice and treatment available, Jodie made it her mission to specialize in this area.
With a deep understanding of hormonal imbalances associated with PCOS, Jodie works closely with her clients to develop personalized approaches for managing their symptoms. By addressing the underlying hormonal imbalances, she helps her clients regain confidence and adopt a positive outlook on managing their PCOS.