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What is PCOS?
Polycystic Ovarian Syndrome — PCOS is a hormonal imbalance that affects women during their childbearing years (ages 15 to 44). Between 2.2 and 26.7 percent of women in this age group have PCOS. Many women have PCOS but don’t know it. The cause of PCOS is a combination of genetic and environmental factors including lifestyle and nutrition.
What are the defining symptoms?
Irregular menstrual cycles (typically longer, though not always)
The above causes one or more of:
How is PCOS diagnosed?
It’s important to note, as a Nutritionist it is out of my scope of practice to diagnose PCOS or any other condition. If I suspect one of my clients has PCOS, I refer them to a GP or if I suspect PCOS has been incorrectly diagnosed then I do ask that they seek a second opinion.
Currently The Rotterdam Criteria (below), is used to diagnose PCOS:
In order to get a diagnosis of PCOS you need to meet 2 out of 3 of the criteria.
This is confusing because you can have ‘polycystic ovaries’ and NOT have PCOS and you can have PCOS and NOT have polycystic ovaries.
What’s referred to as ‘cysts’ on the ovaries are immature ovarian follicles, which any women can have. Prior to ovulation or in an attempt to reach ovulation, many follicles will attempt to become the dominant follicle, which would then go on to ovulate — this is normal, and this is what is being seen as ‘cysts’ on the ovaries. The key takeaway here is that PCOS cannot be diagnosed with ultra-sound alone, and perhaps this shouldn’t be included at all in the criteria — and on this note, the name needs changing too.
A better definition, I believe now being used by PCOS researchers is — “High androgens when all other possible causes of high androgens have been ruled out.”
What else could cause symptoms that look like PCOS?
What causes PCOS?
The most common:
Other possible causes:
If you suspect PCOS, I suggest asking for these tests:
*Hormones: testosterone, DHEA-s, LH, FSH, prolactin, estrogen, progesterone.
*Insulin Resistance: insulin assay – if this is not available fasting insulin but this isn’t as sensitive.
*Thyroid Markers: TSH, T4, T3, RT3, TG Ab, TPO Ab.
*Inflammatory Markers: CRP, homocysteine (this is basic).
*Micronutrients: Vitamin D, B12, folate, iron, zinc.
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