Doctors don’t know what causes it
According to the American College of Gynecologists and Obstetricians (ACOG), the cause of polycystic ovary syndrome is not known, but it may be related to many different factors working together. In addition to an irregular menstrual cycle and increased levels of androgens that interfere with ovulation, another factor may be insulin resistance. Up to 80 percent of women with the syndrome are obese, and insulin resistance (a problem with how food is converted to energy) is also common in people with obesity. Insulin resistance may increase androgens; but, it’s still unclear exactly how all the factors are connected. “There is a lot we still need to learn about PCOS,” Dr. Shahine says. Find out the silent signs you could have insulin resistance.
You can be thin and still have it
You might already know that polycystic ovary syndrome is more common in women who are overweight or obese—but that doesn’t mean thin women can’t have it too. “Some women are thin with no insulin resistance or acne but they have irregular menses, which is sometimes the only symptom.” Because of this, it’s very unclear how exactly women develop the syndrome. There is a familial link—according to the U.S. Department of Health and Human Services, you are more likely to have it if your mother, sister, or aunt did. “We know it runs in families but we have not found a specific genetic mutation yet,” Dr. Shahine says. New research from Northwestern University is looking at DNA, and has gotten closer to identifying genes associated with polycystic ovary syndrome—but they haven’t yet been found. “We still do not really know why some people get it and some people do not,” she says.
The pill can mask symptoms
Another factor that can make diagnosing polycystic ovary syndrome so difficult is that many women who aren’t trying to get pregnant are on birth control pills. “The most common warning sign is irregular menstrual cycles, so if someone is taking birth control pills—which regulate the menstrual cycle—then that warning sign can be masked,” Dr. Shahine says. So, a woman could have the syndrome throughout her 20s, but not find out until she goes off the pill in her 30s to try to get pregnant. This just puts off the diagnosing process—which means not only will it take her longer to get pregnant, but she may be at risk for other associated health issues. However, the pill is actually also the PCOS treatment for symptoms in women who are not actively trying to get pregnant. What else should you know before you go off the birth control pill?
It is linked to heart disease
One of the most dangerous health problems associated with polycystic ovary syndrome is cardiovascular disease, including high blood pressure and high cholesterol. A recent study from Europe found that women with the condition were two to five times more likely to develop metabolic syndrome than those without. Although this doesn’t mean that polycystic ovary syndrome causes the increased risk, it is a concerning correlation. “Indirectly, women with PCOS often have trouble controlling their weight, which is a part of the syndrome,” says Brent J. Gray, MD, and OBGYN at PIH Health. “It is the excess weight that contributes to heart attack, high blood pressure, and high cholesterol. There are no direct connections.” Although it’s not the hormone problems themselves that cause the problem—in the study both women with and without excess androgens exhibited an increased risk—weight is definitely a factor. Here’s how to have your most heart-healthy day.