Despite the numerous studies conducted on PCOS, it is still very much a heterogenous and not fully understood condition with no definitive cure or universally effective treatment.
The Centers for Disease Control and Prevention (CDC), reported it’s affecting up to 12% of females of child-bearing age in the United States. Yet, it’s surprising how little is widely known about it.
It’s not only people without the condition who don’t understand it. If a woman’s primary healthcare provider doesn’t recognize the signs and symptoms, how can she be expected to? According to the National Institute of Health PCOS is still underdiagonized and understudied and notes that 70 % of women with PCOS don’t know they have it. This lack of knowledge leads many women to suffer in silence, feeling misunderstood and alone, or not getting the right care.
Still, as misunderstood as it is, there are a lot of myths surrounding it. Some believe it’s a rare condition that only affects overweight women, while others think losing weight will cure it. Similarly, symptoms like unwanted hair growth and infertility vary widely, contrary to what many women think, not every woman with PCOS will experience these issues.
Given how many women are affected, you might wonder why PCOS isn’t more heavily researched. Before we dive into debunking the misconceptions, let’s take a moment to understand what PCOS actually is for those who may not be familiar.
What is PCOS?
Polycystic ovary syndrome, commonly known as PCOS, is a hormonal disorder that affects many women of reproductive age. It gets its name from the presence of multiple small cysts on the ovaries, although not all women with PCOS have these cysts. The condition is marked by an imbalance of reproductive hormones, which can lead to a variety of symptoms including irregular menstrual cycles, excess hair growth on the face and body, acne, and weight gain. The exact cause of PCOS isn’t fully understood, but it is believed to involve a combination of genetic and environmental factors. Women with PCOS often have higher levels of androgens, sometimes called “male hormones,” which can disrupt the normal function of the ovaries.
At the time of writing, there’s still no known cause of PCOS, and there is also no cure.
01
Only Overweight or Obese Women Develop PCOS
While being overweight can make PCOS worse, it can affect women of all body types. Penn Medicine notes that women of any weight range can have PCOS. A 2019 study also found that overweight and obesity occur in 38% to 88% of women with PCOS. This wide range shows that not all women with PCOS are overweight or obese, contradicting the misconception.
Interestingly, where you live can also aggravate this. A research review in Obesity Management noted that the rates of overweight and obesity in women with PCOS are much higher in the U.S. compared to other parts of the world, where the rates can be as low as 20%. The U.S. has one of the highest rates of overweight and obesity overall, which likely contributes to this disparity.
02
PCOS Always Causes Unwanted Hair Growth
PCOS can lead to higher levels of androgens, which are male hormones that can cause hair growth in areas like the face, chest, and back. But the degree of hair growth varies greatly among women with PCOS. Some may experience much hair growth, while others may have little to no change at all. Unwanted hair growth, or hirsutism, is just one possible symptom of PCOS, and it doesn’t affect every woman with the condition. In fact, some women may experience other symptoms like irregular periods, weight gain, or acne, but not hirsutism.
Although unwanted hair growth is one of the most challenging symptoms for women with PCOS, not because it causes physical pain, but due to the emotional toll it can take. Many women report feelings of shame and a loss of femininity and beauty. A study from 2014 found that women with PCOS reported often experiencing a sense of humiliation, abnormality, exhaustion, and inferiority compared to other women. These feelings are frequently tied to the unwanted hair growth associated with the condition.
On the bright side, managing unwanted hair growth from PCOS doesn’t have to be so difficult. There are a combination of treatments. Medications can help lower androgen levels and reduce hair growth, for women who are not looking to conceive yet, birth control medication can help regulate hormone levels . And spironolactone is often prescribed along with birth control for good results. Lifestyle changes such as weight management and a healthy diet can also be beneficial. Additionally, cosmetic treatments like laser hair removal or electrolysis can help manage hair growth effectively.
03
Women with Irregular Menstrual Cycle Have PCOS
Another classic misconception: if a woman has an irregular menstrual cycle, she must have PCOS.
Not true, although it’s the most common cause, having irregular periods doesn’t automatically mean a woman has PCOS, when they can also be caused by many other factors. Stress, dramatic weight changes, thyroid disorders, and other hormonal imbalances can all cause a irregular menstrual cycle.
Doctors often look for other symptoms and conduct various tests to diagnose PCOS accurately. These can include checking for elevated levels of male hormones (androgens), examining the ovaries for multiple small cysts, and assessing other symptoms like acne, weight gain, or hair growth. Without these additional signs, an irregular menstrual cycle alone is not enough to diagnose PCOS.
Additionally, throughout a woman’s life stages, including puberty, pregnancy, childbirth, breastfeeding, and menopause, hormone levels can fluctuate causing all sorts of changes in your menstrual cycle. Besides, irregular periods can be especially common as you approach menopause.
04
PCOS and Polycystic Ovaries Are the Same Thing
Many people think that polycystic ovary syndrome (PCOS) and polycystic ovaries are the same thing, but they’re not. The name PCOS is actually misleading. Just because you have PCOS doesn’t mean you have polycystic ovaries, and having polycystic ovaries doesn’t mean you have PCOS.
Polycystic ovaries have more immature follicles than usual. These follicles are small sacs in the ovaries that each hold an egg. Normally, these sacs release their eggs during the menstrual cycle, but in polycystic ovaries, this process doesn’t happen as it should.
The major difference between the two is that polycystic ovaries alone don’t usually cause health issues, while PCOS does. Women with just polycystic ovaries often have fewer fertility problems compared to those with PCOS.
Additionally, Polycystic ovary is quite common. About 30% of women of reproductive age have them, but they don’t necessarily have any other symptoms. For a diagnosis of PCOS, you need at least two out of three common symptoms: polycystic ovaries, irregular periods, or high levels of androgens (male hormones) shown in a blood test. So, you could have irregular periods and high androgens but no polycystic ovaries.
05
Lifestyle factors Can Also Causes PCOS in Women
False, lifestyle choices like diet can influence the severity of symptoms, but they are not the root cause of the condition.
Researchers are still studying the causes for PCOS, but one thing they’re aware of is that women with PCOS have a family history of the condition, suggesting that it is inherited and not simply a result of lifestyle choices.
In a 2019 study in The Application of Clinical Genetics, PCOS is said to be an extremely heterogenetic and complex disease.
Reducing PCOS to a matter of lifestyle choices oversimplifies the condition and places undue blame on those who suffer from it. Weight gain, for example, can exacerbate symptoms, but many women with PCOS struggle with weight management due to the hormonal imbalances caused by the condition itself. These imbalances affect how the body processes insulin and can lead to weight gain, creating a frustrating cycle for those affected. This means that even women who maintain a healthy lifestyle can still develop PCOS, and managing the condition often requires medical intervention alongside lifestyle changes.
06
Women with PCOS Can’t Get Pregnant
While PCOS can present challenges, it’s far from a definitive barrier to pregnancy. With the right support and treatment, many women with PCOS can and go on to have healthy pregnancies and children.
PCOS affects hormone levels and can lead to irregular or absent ovulation, which can make it harder to conceive. But this doesn’t mean pregnancy is impossible. Medical advancements and treatments have significantly improved the chances of pregnancy for women with PCOS, including fertility treatments such as in vitro fertilization (IVF), a more advanced method that may be used if necessary. And there are others such as ovulation induction and intrauterine insemination.
Lifestyle changes can reduce symptoms and ovulation problems, treatments such as medications to induce ovulation, and even fertility treatments can help address the hormonal imbalances caused by PCOS. Many women with PCOS respond well to these treatments and are able to conceive with the help of their healthcare providers. However, consulting and working closely with their doctors may be needed to explore the best options for their individual needs.
07
PCOS Can Be Cured or Reversed by Losing Weight
There’s currently no cure for PCOS at the time of writing, and it can’t be reversed either. But there are many ways to manage the condition and live a healthy life, and losing weight is just one method among many.
While not all women with PCOS are overweight, there is a connection between PCOS and being overweight or obese. For women who are carrying extra weight, losing even a small amount—about 5%—can help improve the metabolic, hormonal, and reproductive effects of PCOS. However, losing weight with PCOS can be challenging. Hormonal imbalances affect metabolism, which influences how the body converts food to energy and how it burns and stores fat. This means that women with PCOS might find it harder to lose weight compared to women without the condition. It’s not as simple as “just losing weight.” Even with changes in diet and exercise, some women with PCOS may struggle to see significant weight loss, which can be very frustrating. That’s where patience and self-care comes in. If you can afford it, getting a personal trainer, and the support of your doctor are all needed to manage PCOS effectively.
08
PCOS Always Leads to Diabetes
Over 50% of women with PCOS develop type 2 diabetes by the time they are 40 years old, according to the CDC. That’s still quite a lot of women who don’t develop diabetes.
Although PCOS can increase the risk of diabetes, due to insulin resistance, it doesn’t seal your fate. Not every woman with PCOS will get diabetes. Insulin resistance means that the body’s cells don’t respond well to insulin, causing the pancreas to produce more insulin to keep blood sugar levels stable. Over time, this can increase the risk of diabetes, but it doesn’t guarantee it will happen. In other words, if detected and treated early enough, insulin resistance can be managed so it doesn’t progress to diabetes.
In fact it’s possible for women with PCOS to manage their insulin levels and avoid developing diabetes by maintaining a healthy weight, right lifestyle changes and medical care, eating a balanced diet, and staying physically active can dramatically reduce insulin resistance. Regular check-ups and blood sugar monitoring can also help catch any early signs of diabetes, allowing for prompt management and intervention.
Each woman’s experience with PCOS is different, and not all will face the same health challenges. Awareness and proactive management are key to living a healthy life with PCOS.
