Polycystic Ovarian Syndrome (PCOS) is a very serious genetic endocrine disorder that affects women and girls. It affects your hormones, metabolism, and reproductive organs. PCOS is the leading cause of female infertility as well as a precursor to many other serious medical conditions such as obesity, type 2 diabetes, heart disease, and endometrial cancer.
The exact cause of PCOS is unknown, but it is closely linked to high levels of hormones like testosterone and insulin. It also tends to run in families, which is why it is believed there is a genetic component to this condition. Often women with PCOS go undiagnosed for years because they don’t realize that their irregular periods, acne, skin tags, and unwanted facial hair are all related and they just try to deal with each symptom separately. While there is no cure for PCOS, there are treatments that can help to minimize some symptoms, and even simply understanding that you have an underlying endocrine disorder can help decrease some of the stress that these symptoms can cause.
Women are typically diagnosed with PCOS when they have at least 2 of the following three symptoms:
Based on these criteria, women can be diagnosed with PCOS even if they have regular periods or normal androgen levels. Women with PCOS can experience very different types of symptoms and have very different body types. Often a dermatologist may be the first type of medical provider to clue you in on your diagnosis.
There are many different dermatologic conditions that can be caused by PCOS. Each of these conditions can be seen in other syndromes, or even by themselves, but if you have a few of the following, then you may have PCOS to blame.
In general, diet and exercise and, in the case of obese patients, weight loss can help PCOS patients to decrease their insulin resistance and help lower their testosterone levels. Sometimes the weight loss can also help to regulate your menstrual cycle. Not all PCOS patients are obese however, so weight loss is not recommended for patients who are not overweight or obese.
Medications like Metformin can also help to decrease insulin resistance and sometimes normalize ovulation. It is also very important to stop smoking in order to reduce the risk of smoking-related complications such as blood clots- this can be a problem for obese sedentary women in general, and especially if they are taking oral contraceptives to try to help treat their PCOS.
Antiandrogenic oral contraceptives not only help to treat menstrual irregularities, but they can also help to treat acne and hirsutism by trying to regulate estrogen and progesterone in the body, helping to check the abundance of testosterone usually seen in PCOS. Spironolactone is a powerful antiandrogen that has also been used in treating acne and hair loss. Isotretinoin can be used to help for severe cases of acne, but women with PCOS must be aware that they have a higher risk of acne recurrence when they are done their course of treatment.
We can treat and manage most of these dermatologic issues here at NOVA Plastic Surgery and Dermatology using a combination of prescriptions and procedures. It is important to have someone recognize that you have underlying PCOS that is causing these conditions because simply treating your acne or your excess body hair and ignoring the underlying cause will not completely solve your issues.