Dr. Joy Cooper Answers Your Questions About Polycystic Ovary Syndrome (PCOS)

September is Polycystic Ovary Syndrome Awareness Month. This condition affects 1 in 10 women and causes insulin resistance, which can contribute to infertility and lead to type 2 diabetes. We sat down with OBGYN, Dr. Joy Cooper, MD, MSc to ask questions gathered from our community about Polycystic Ovary Syndrome (PCOS).

PCOS affects millions of women worldwide, which is just one of the reasons the condition has its own month dedicated to spreading awareness. Although there is currently no cure, women affected can manage their symptoms through diet and, if necessary, medication. Here, Dr. Joy Cooper uses her expertise as an OBGYN to answer some of your questions. 

  • What is PCOS?

Polycystic Ovarian Syndrome is a condition with infrequent menstrual cycles along with key features on a pelvic ultrasound or elevated levels of testosterone and excessive body hair. The major issue with PCOS is that having rare or infrequent cycles means that you are not ovulating regularly, which can impact fertility. 

  • Is PCOS common?

According to the criteria that the National Institute of Health uses, 7% of the reproductive aged-women have PCOS. However, when discussing women who have irregular cycles, PCOS is about 55-90% of that population. Basically, the majority of women who do not bleed every month have PCOS.

  • What are the causes and early symptoms of PCOS?

PCOS is thought to be caused by insulin resistance. Insulin is a hormone and a shift in any hormone in the body can have an impact on other hormones. The menstrual cycle, which is run by hormones from the brain and reproductive system, can easily be impacted by insulin resistance. PCOS is one of the manifestations of this impact. 

The major symptom of PCOS is not having a period every month. Some people skip one month, some skip several. Before perimenopause, your cycle should come every month to shed the lining of your uterine cavity. Some people have irregular hair growth in places that do not typically grow hair. You can even test if your hair growth is abnormal. Google “Ferriman-Gallwey score” and mentally circle the hair growth that is representative of your body. If your score is greater than 8, then you have hirsutism or extra hair growth, a common feature of PCOS.

  • What deficiencies are related to PCOS?

PCOS has been noted to be affected by Vitamin D deficiency. Supplementation in patients who are deficient in Vitamin D has yielded better improvement in their insulin resistance and elevated levels of testosterone. Vitamin D deficiency can also impact a PCOS patient’s ability to ovulate and respond to fertility treatments. 

  • How does blood sugar affect PCOS?

PCOS patients are less able to decrease their blood sugar because their body does not respond as well to the insulin that their pancreas produces. Having persistently higher blood sugars can make one more and more resistant to insulin. That may impact your PCOS by making your ovulate less, which essentially makes you less fertile.

  • How is PCOS related to diabetes?

Diabetes and PCOS have a lot of overlap because they are caused by the same thing. Yes, you guessed it, insulin resistance. For this reason, a lot of PCOS patients are prediabetic or actual diabetics. Some studies have noted a two to fivefold increased risk of diabetes in PCOS patients. You should be screened regularly by your doctor for diabetes if you have PCOS.

  • Can Sugarbreak products help with PCOS? 

Yes. Sugarbreak helps reduce your sugar intake, which can help the insulin resistance associated with PCOS. Patients who lose weight or limit their sugar intake can have more regular cycles, and it can also decrease the amount of testosterone in their body.

  • What is the recommended diet for a woman with PCOS?

There is no recommended diet specific to PCOS patients, just limiting daily calories will yield the best results. 

  • Is PCOS a life-long problem?

While the insulin resistance will always have an ability to turn into diabetes, the major

symptom of irregular periods will come to an end with menopause. Fertility is usually the biggest challenge with PCOS, but PCOS patients tend to respond to a variety of medications to stimulate pregnancy that can be prescribed or administered by a fertility doctor. 

  • What are the best tips for managing and living with PCOS?

The most important thing to know about PCOS is that you are at increased risk of endometrial cancer. Going more than six months without a period can be dangerous if you are not on medications to prevent you from having a period. The tissue that should be shed starts to build up and can start rapidly dividing into precancerous or cancerous cells. Your doctor can put you on birth control to regulate your cycle or give you medications to take periodically to induce a period and prevent you from developing cancer. 

Joy A. Cooper, MD MSc is Co-Founder of telemedicine startup Culture Care. She also practices as an Obstetrician-Gynecologist at Highland Hospital in Oakland, California. She completed residency at the Hospital of the University of Pennsylvania. She earned her MD from Howard University, completed a Master's in Sexually Transmitted Infections & HIV at University College of London/London School of Hygiene & Tropical Medicine and earned an A.B. in African and African-American Studies at Harvard College.