The Beginner's Guide to Polycystic Ovary Syndrome (PCOS)



The most frequently asked question is, "What is PCOS?"

PCOS (also known as PCOD – Polycystic Ovarian Disease) is a disorder of the endocrine system, which is the glandular factory in your body that produces hormones that regulate metabolism, sexual function, sleep, mood, and, of course, reproduction. Chronic anovulation and elevated levels of androgens – a class of hormones commonly (and perhaps incorrectly) regarded as'male' hormones – characterize the disorder.


When a "healthy" woman gets her period, her ovaries release an egg into a tiny fluid-filled sac known as a "follicle." The follicle accumulates fluid as the egg grows until the egg is mature, at which point the follicle ruptures, releasing the egg. This is what ovulation is... In women with PCOS, the ovary does not get the hormone recipe correct for egg maturation, so ovulation does not occur. Consider it scones without the use of yeast or baking powder. Instead, the follicle remains inside the ovary, forming a "cyst," and the disorder gets its name from the accumulation of multiple cysts over time.


Polycystic ovary disease patients are more likely than others to have cardiovascular risk factors such as:

  • Insulin resistance and impaired glucose tolerance are symptoms of PCOS (the warm-up acts for Type II diabetes). By the age of 40, up to 40% of all women with PCOS in the United States will have Type II diabetes or impaired glucose tolerance (Dunaif 1995)
  • "Central Obesity" (a euphemism for having a fat tummy). Approximately half of all women with PCOS are overweight or obese (Norman et al. 2004)
  • Blood pressure that is abnormally high
  • Ovarian cancer
  • Infertility

If you understand the fundamental concepts of functional integrative medicine, you will realize that almost every negative "personality trait" you have been accused of having is most likely a function of your physiology. When I realized this, it lifted a weight off my shoulders, and I hope it does the same for you! Polycystic ovary disease may be the name given to a collection of biochemical reactions that are not occurring properly within you for many of you. Ladies, name-it-to-tame! PCOS may help explain a variety of issues that have been bothering you.


While scientific research has shown an association between polycystic ovarian disease and the comorbidities mentioned above, such as PCOS insulin resistance, causation does not appear to have been established. If you want to know what causes polycystic ovaries, Mr. Google will inevitably disappoint you because most medical professionals seem content to accept a starting point of "we don't know," and I'm planning on rolling with this because we have a lot more to discuss before we get hung up on things we can't control.


There are a wide range of polycystic ovaries symptoms presented by women with PCOS with archetypal patients being identified as falling into one of two distinct categories:

  • “Classical” PCOS and,
  • “Thin Type” PCOS


  • Excessive hair growth, or hair in unwanted places like the face, chest, back, stomach, thumbs, toes
  • Hair loss from the scalp; thinning of hair
  • Acne and oily skin
  • Dry skin (ironically)
  • Depression or mood swings
  • Sleep apnoea
  • Cold intolerance


Even if you have most of the symptoms of polycystic ovaries, your doctor will only diagnose you with PCOS if at least two of the following three criteria are met:

  • An ultrasound of your ovaries reveals a single ovary with 10 or more follicles.
  • Androgen levels in the blood are high, according to blood tests (testosterone).
  • Your menstrual cycles are more than 35 days apart, or they are shorter than 21 days.

Because only two of three criteria are required for a PCOS diagnosis, women who have regular periods may still have it and be unaware of it. The fact that you have your period does not imply that you are ovulating. The only way to be certain is to have your luteal progesterone levels tested on day 21 of your cycle.

pain in women with PCOS


In addition to being a major health issue and causing infertility, polycystic ovary syndrome patients experience a variety of polycystic ovary symptoms, as well as an increased risk of complications during and after pregnancy.

  • Normal pregnancy causes insulin resistance, which can result in impaired glucose tolerance or gestational diabetes (Sivan et. al 2003).
  • Women with a 25-75 percent incidence of PCOS insulin resistance appear to be at an increased risk of developing gestational diabetic complications (Legro et al 2004).
  • Researchers have also proposed that, as a result of their mother's insulin issues, the children of women with PCOS may suffer long-term health consequences as a result of the "fetal programming" their nutritional and hormone management systems receive while in the womb (Barker 2002).

If that isn't enough to make you want to spit your coffee, a HIGHLY cited study conducted by a massive international team of experts discovered the following when they analyzed the known risks of getting pregnant with PCOS, including all neonatal complications. Boomsma et al. (2006) discovered that women with PCOS had a higher risk of:

  • Diabetes during pregnancy (supporting previous research findings)
  • Pregnancy-induced hypertension, as well as
  • Preeclampsia

They also found that babies born to PCOS mothers had a higher rate of neonatal intensive care unit admission and a higher perinatal mortality rate. That's all right.

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