‘Many women find another vocation of sorts for their “second act”. With children out of the house or getting older, they can spend time on themselves, go back to school and take a class in a subject they have always dreamt about. Some pick up a paint brush for the first time, try a musical instrument or write a best-seller. Others have relationships, get married for the first time or again, start a business or travel the world. Of course these aren’t snap decisions and take months if not years of meditation and consultation with family and friends. But the possibilities are endless.’
CHAPTER 4 WHAT AM I DEALING WITH?
Below you’ll find a list of the key short- and long-term symptoms that women with PCOS are likely to have. We stress likely, as your symptoms will be unique to you and different from those of another woman with the syndrome. There’s a wide menu of PCOS symptoms out there, and you can get any combination to any degree of severity, which is why it’s important to find the solutions that work for you.
The most important thing to note is that PCOS is a combination of day-to-day symptoms and longer-term health effects. Even if your day-to-day symptoms aren’t bothering you so much, don’t ignore the self-help plans that come later in the book – the long-term health risks of PCOS mean you need to take action now.
‘The thing that got me started on a self-help plan was worrying about diabetes, but actually I lost some weight and got less spotty just from eating better and getting fitter, and I feel great!’
Amy-Jay, 29
EARLY SIGNS
Many symptoms of polycystic ovary syndrome (PCOS) start gradually, and you may think they’re related to some other medical problem.
IRREGULAR PERIODS
Nine or fewer menstrual cycles per year, or no menstrual cycles at all, may be one of the most common signs of PCOS. When periods do occur, they may be heavier, longer and more painful than normal. These conditions are caused by a hormone imbalance. Almost 50 per cent of women with PCOS don’t ovulate every month.
EXCESS HAIR
Sometimes called ‘hirsutism’, this can be a difficult symptom if you have it. For most women with PCOS, hair in the moustache and beard areas becomes heavier and darker. Masculine hair on the arms and legs, and excess hair in the pubic region, abdomen, chest or back, or on your thumbs or toes, is also possible. This symptom is caused by high levels of male hormones (androgens), as are thinning hair and acne. Up to 70 per cent of women with PCOS complain of excess hair growth.
‘One of the things that bugs me most is the hairs around my nipples.’
Harriet, 42
SKIN PROBLEMS
Skin problems such as acne, oily skin or dandruff can also crop up, due to excess testosterone. The acne is usually found around the face (especially along the jaw line), chest and back. Also, dark skin patches (acanthosis nigricans) on the neck, groin, underarms, or in skin folds, or skin tags (acrochordons) in the armpits or neck area can also bother women with PCOS. These are related to insulin resistance and diabetes.
‘I can’t believe I still have spots at the age of 30!’
Karen
GRADUALLY DEVELOPING SYMPTOMS
MOOD SWINGS
These may be caused by the emotional problems or body image insecurities related to, and triggered by the physical symptoms of PCOS, but they can also be a result of hormonal imbalance – if you’ve ever experienced PMS you’ll know how hormones can affect your feelings.
WEIGHT GAIN
‘Apple-shape’ weight gain, or upper-body obesity (more abdominal fat than hip fat) is also known as android obesity and is associated with increased testosterone levels. Many women with PCOS gain weight around their middle, and this type of weight gain can increase your risk of insulin resistance and diabetes.
Yes, it’s official. If you’ve got PCOS you’re not only more likely to be overweight but more likely to find it hard to lose weight. Research1 shows that obesity is four times more likely in women with PCOS and irregular periods than those without. And the tendency2 is to put on weight around the waist rather than the hips. Researchers think they’ve discovered the reason for this. Studies3 show that women with PCOS actually store fat more efficiently and burn calories more slowly than women without PCOS, even when they are on a diet.
In Part 2 we’ll explain in more detail what research has uncovered and, more importantly what you can do to kick-start weight loss, but for now if you’re struggling with your weight just bear in mind that you’re not alone and there are things you can do about it. If you’re struggling, we have an action plan in Chapter 11.
FERTILITY PROBLEMS
If you don’t have regular menstrual cycles, you may have problems getting pregnant. This isn’t the same as infertility, though – with help, most women with PCOS can get pregnant.
INSULIN RESISTANCE
For women with PCOS, insulin resistance increases the risk of developing diabetes. You may also develop diabetes at a younger age because of PCOS. About 30 per cent of women with PCOS have impaired glucose functioning, and 7 to 10 per cent have Type 2 diabetes. Some symptoms associated with insulin resistance include skin changes, such as skin tags or dark skin patches and upper-body weight gain.
MALE PATTERN BALDNESS
Just as heavier hair growth on your face and body is possible, thinning hair (alopecia) is also a symptom of PCOS. This is caused by higher levels of androgens.
SLEEP APNOEA
This has been reported to occur in up to 30 per cent of women with PCOS who are overweight. It’s a disorder characterized by excessive snoring at night with brief spells where breathing stops completely. Patients with this problem experience fatigue and daytime sleepiness. It can be diagnosed by a sleep study, and there are a variety of treatments available.
THE LONG-TERM HEALTH RISKS
Some conditions related to PCOS may not be obvious but are potentially dangerous. The long-term health risks4 include:
Diabetes – about 30 per cent of women with PCOS have a problem processing blood sugar (glucose intolerance). This is a major risk factor for adult-onset diabetes.
High blood pressure – if you’ve got PCOS, research5 shows that your risk of hypertension is higher than normal. This is because weight gain, high cholesterol levels and insulin resistance are known risk factors for high blood pressure.
Heart and blood vessel disease – people with high insulin levels, as in PCOS, often have low levels of so-called good cholesterol (HDL