Five Signs you Might Have Polycystic Ovarian Syndrome (PCOS)
I got my period for the first time when I was in 6th grade. A gloriously confusing experience that I was sort-of prepared for. You can read about it here. Now, I was told, I could expect my period every *28 days. So, when 28 days came and went, I was more than a little perturbed. Maybe I didn't get my period at all, I wondered. Maybe it was a false alarm? But alas, it was not. I had, indeed gotten my period, I just didn't get the next one "on time."
Suffice it to say, I grew up with irregular cycles. I would go months without a period. My doctor often reassured me that wild swings in cycle length are “normal” for a newly menstruating girl, which is true. It can take your body up to two years to fully regulate your menstrual cycle. But what I wish she would have told me is that if it continued past those first couple of years, there might be something amiss. Instead, I just accepted my cycle irregularity and moved on with my life. It was my "normal." It wasn’t until I came across Taking Charge of Your Fertility by Toni Weschler when I was 25 that I realized something might actually be wrong.
After a few months of charting my cycles, I began to notice that the patterns of my body did not align with the patterns I learned about in the book. And late one night while trying to decipher yet another confusing chart, I finally read the chapter I had been ignoring: “Troubleshooting Your Cycle.” What I discovered is the symptoms I had been ignoring for so long were signs of a deeper, much more complicated issue. I made the first available appointment with my gynecologist and she confirmed what I had feared — I have Polycystic Ovarian Syndrome.
According to womenshealth.gov, 1 in 10 women are living with PCOS and define it as:
Polycystic ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a common health problem caused by an imbalance of reproductive hormones. The hormonal imbalance creates problems in the ovaries. The ovaries make the egg that is released each month as part of a healthy menstrual cycle. With PCOS, the egg may not develop as it should or it may not be released during ovulation as it should be.
PCOS can cause missed or irregular menstrual periods. Irregular periods can lead to:
- Infertility (inability to get pregnant). In fact, PCOS is one of the most common causes of female infertility.
- Development of cysts (small fluid-filled sacs) in the ovaries
I was stunned and saddened by the news but my feelings quickly turned to anger. How could I be 25 years old and just now be learning about this?! With all the doctors I had seen, all the routine pap smears and physicals, all the times I discussed my irregular cycles with medical professionals and tried to be a whistleblower for my body, no one, not one single person said the phrase “Polycystic Ovarian Syndrome." Not one. To this day I am so thankful to have come across Toni Weschler’s book. I shudder to think how long it would have taken me to get a proper diagnosis had I not gone to the doctor with my charts in hand and newly gained knowledge about my reproductive body.
In an effort to help shed light on a syndrome that has become an epidemic in reproductive aged women, I want to share the **five symptoms of PCOS I lived with for years before receiving a diagnosis:
As I mentioned above, my cycle lengths would swing wildly from month to month. I would go from a 25 day cycle to a 43 day cycle to a 19 day cycle and so on. If you have been menstruating for at least two years and experience irregular cycles consistently and consecutively, I highly recommend charting your basal body temperature (BBT). Tracking your BBT can help pinpoint if/when you ovulate and are a great visual to help your care provider in making an accurate diagnosis of cause. Although irregular cycles are not exclusively indicative of PCOS, they are a tell-tale sign of a hormonal imbalance.
Now, I don’t mean cramps. I mean ovarian pain. Pain that resides under or near your hip bones. It is sharp, sometimes severe. The pain shoots like a lightning storm and can be crippling. This pain is most likely associated with cysts or inflamed ovaries and can happen any time during your cycle. If you experience severe ovarian pain that is accompanied by nausea, vomiting, fever, dizziness or fainting go to the emergency room immediately, you could have a ruptured cyst or ovarian torsion. If not treated right away you are at risk of losing your ovary.
Inability to Lose Weight
PCOS makes it nearly impossible to lose weight. This is because, for some reason, your hormonal imbalance makes your cells less receptive to insulin - this is known as insulin resistance and can turn into Type II Diabetes if left untreated. When your cells don’t absorb the food you eat as energy, your body will store it as fat and, in turn, slow your metabolism. It's a bit of a double-edged sword. So if you find yourself eating a healthy diet and exercising regularly but the number on the scale doesn’t budge, PCOS may be the culprit.
I experienced long cycles mostly when I was young but even now I have an odd cycle that lasts for 70+ days. Barring pregnancy, these long cycles occur because you are not releasing an egg, meaning, you're not ovulating. When you do not ovulate there is nothing to trigger the production of progesterone that is dominant in the 2nd half of your cycle and your body sits in a sort of hormonal limbo. Your ovaries may try again and again to release an egg, but if they fail, it just prolongs your cycle until your uterus eventually sheds its lining. This type of bleeding is called anovulatory bleeding and is not actually a period. Anovulatory bleeding occurs because the endometrial lining grew too thick and is literally falling off from the weight.
Indiscernible Cervical Fluid
This sign is subtle, but very telling. During a balanced menstrual cycle your cervical fluid will go through four stages as you approach ovulation: dry, sticky, creamy and slippery (then back to dry). When I was tracking my fluids I would notice I often had an abundance of fluid at times that didn’t make sense, like just before or after my period, for example, when my fluid should have been dry. I also noticed that my fluid never quite got to that slippery phase — slippery cervical fluid is a sign of impending ovulation. If you don’t ovulate, your cervical fluid, much like your hormones, gets stuck in limbo. Consistently creamy or cloudy cervical fluid should inspire a call to your doctor or a trusted medical professional.
Now, mind you, these are not the only symptoms of PCOS, nor are they confirmation you have it. However, as a woman who has been formally diagnosed and treated for PCOS, these were the symptoms most often overlooked during appointments with medical professionals before I knew what was going on. Also, because ovarian cysts are not always present in women with PCOS, tracking these symptoms can help you receive a proper diagnosis much more quickly.
*A healthy cycle can be anywhere from 21-35 days long
**If you are on hormonal birth control, you may not experience irregular symptoms - and that's normal. Many women use the Pill for the express purpose of artificially regulating their cycles.
***A version of this article was originally published on Cycledork.com