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Could your irregular periods be caused by PCOS? We take a look at the symptoms of PCOS, the menstrual irregularities women with Polycystic Ovary Syndrome may experience, and at the treatment options.

Do you often miss periods despite not being pregnant, are your cycles abnormally long, or have you stopped menstruating altogether? Polycystic Ovary Syndrome is one of the most common causes of irregular periods during which you do not ovulate. Could your irregular menstruation be caused by Polycystic Ovary Syndrome (PCOS?) How can you tell, and what can you do about it? Let's investigate that!

How Do I Know If I Have Polycystic Ovary Syndrome?

It is important to keep in mind that Polycystic Ovary Syndrome is, well, a syndrome — a medical condition characterized by a myriad of different symptoms that occur simultaneously.

If your doctor suspects you might be suffering from PCOS, they are most likely to look for the presence of the Rotterdam diagnostic criteria:

  • A lack of ovulation or irregular ovulation
  • A polycystic appearance of the ovaries, as determined by an ultrasound scan
  • Hyperandrogenism, or elevated levels of androgens [1]

You need two out of these three basic characteristics to be diagnosed with Polycystic Ovary Syndrome, and they are not difficult for your doctor to assess. You, the patient, are a different story, however — if you're not sure whether you have PCOS, you only have the resulting symptoms to go on.

Since up to 70 percent of women with Polycystic Ovary Syndrome are estimated to remain undiagnosed [2, 1], in part due to the debate over the diagnostic criteria of the syndrome, it is especially important to be aware of the most common symptoms of PCOS. PCOS is associated with an increased risk of cardiovascular disease, metabolic syndrome, diabetes, infertility, depression and anxiety, and is, as such, something you want to know about if you have it. [3]

You should strongly consider asking your doctor to assess you for Polycystic Ovary Syndrome if a lot of these symptoms are familiar to you:

  • Irregular menstrual cycles. 
  • Unexplained weight gain or difficulty losing weight. 
  • Hirsutism — being very hairy in a lot of places where men, but not women, typically have more hair: the chin, upper lip, chest, lower abdomen, and back, for instance. Excess hair growth caused by Polycystic Ovary Syndrome is very common. 
  • Androgenic alopecia, or hair loss resembling male pattern baldness.
  • Acne on the face, shoulders, back, and chest. 
  • Darkened skin where you have skin creases. 
  • Skin tags
  • Infertility. [4]

What Are Your Menstrual Cycles Likely To Be Like When You Have Polycystic Ovary Syndrome?

Problems with ovulation are so common in PCOS patients that more than nine in 10 women with the syndrome are believed to suffer from some form of anovulation [5]. Unless you have been trying to conceive and use ovulation tests, you will not necessarily know whether or not you ovulate during your menstrual cycles. You will, however, be able to recognize that you are dealing with irregular periods.

The characteristic features of the menstrual cycles of women with PCOS might include:

  • Oligomenorrhea, or infrequent menstrual periods in laypeople's terms. If your menstrual cycles are typically longer than 35 days, and you have eight or fewer menstrual periods per year, you may have oligomenorrhea. 
  • Amenorrhea, or the lack of menstrual periods. You may be diagnosed with amenorrhea if you have gone at least three months without having a period. [6]
  • These conditions, in conjunction with PCOS, usually don't mean you will never ovulate — research indicates that you are likely to ovulate during just under a third of your menstrual cycles. [7
  • You may have started menstruating a little later than your peers, or your periods may have started off being regular only to become irregular when you gained weight, as many women with PCOS do. [8]

What Can I Do About PCOS-Related Irregular Periods?

Women who are trying to get pregnant with PCOS and those who suspect they could have Polycystic Ovary Syndrome and would like to add to their family at some point will primarily want to aim for more regular menstrual periods. Since irregular periods are simply a manifestation of a wider syndrome with associated health problems we have already discussed, even PCOS patients who are not planning on getting pregnant will want to attempt to tackle this symptom (and its underlying causes). 

Weight loss is one of the primary ways to encourage more regular menstrual cycles among the large portion of women with Polycystic Ovary Syndrome who are struggling with obesity [9]. Research suggests that losing just 10 percent of your total body weight will make your menstrual cycles more regular, and thus increase your chances of getting pregnant [10, 4]. Weight loss may be harder to accomplish for women with PCOS, but studies do show that your best bet for losing weight with PCOS is a low glycemic index diet

If you aren't trying to get pregnant right now, combined oral contraceptives are an excellent way to achieve more regular menstrual cycles. The birth control pill won't only give you artificially regular periods, but also decreases your adrenal androgen production. [11]

Metformin, a drug used in the treatment of type 2 diabetes, was also shown to have the ability to make the menstrual cycles of women with PCOS more regular [12]. Additionally, you can use Metformin for losing weight with PCOS

The Bottom Line

Irregular periods can be caused by a lot of different factors, ranging from thyroid problems to excessive exercise, and from stress to the (premature) menopause. Every woman who has irregular periods without knowing why is more than justified in seeking medical attention. Should you recognize a lot of the symptoms of Polycystic Ovary Syndrome besides irregular periods, you could, however, speed up your diagnosis by asking your doctor whether you could have PCOS. 

The same measures that regulate the periods of women who have PCOS also increase their general health, and more regular periods will increase your chances of getting pregnant. Weight loss and following a PCOS diet plan are particularly important in improving your health outcome. 

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