Many women dread their menstrual cycle each month, whether it is because of painful cramps, bloating or even hormonal acne. But missed periods may also be a significant cause for concern, according to an expert at Baylor College of Medicine.
The most common reason for missed or irregular periods is due to a health condition called polycystic ovarian syndrome (PCOS).
“PCOS is a very common disorder caused by disrupted hormonal communication between the brain and ovaries that results in irregular periods and lack of ovulation, called anovulation, in women,” said Dr. Amy Schutt, assistant professor of obstetrics and gynecology in the division of reproductive endocrinology and infertility at Baylor. “This condition affects 10 to 15 percent of reproductive aged women and manifests differently from woman to woman.”
Different criteria are involved in identifying polycystic ovarian syndrome, Schutt said. Women with the syndrome often have many small cysts on their ovaries but there are other symptoms as well. Women who possess two out of three criteria are classically diagnosed with PCOS.
“Irregular or infrequent menstrual periods, the identification of polycystic-appearing ovaries by ultrasound and evidence of elevated male hormone levels are the diagnostic criteria for PCOS,” she said. It is also important that other causes of these symptoms be ruled out during an evaluation.
Although the very name of the disease focuses on the appearance of the ovary, Schutt stresses that this condition is a whole-body metabolic disorder.
“This is a lot more involved than just having polycystic ovaries. The classic appearance of PCOS is a woman who might be overweight, insulin resistant and who might suffer from other aspects of metabolic syndrome, including elevated cholesterol and hypertension,” she said.
Polycystic ovarian syndrome may also lead to difficulty getting pregnant, since women who do not have their period every month may not be releasing an egg.
There is no cure for PCOS; however, Schutt says that there are medications and strategies available to help treat the manifestations of the disorder that may help them get pregnant.
“We can treat the symptoms very well. Whether it’s infertility, irregular periods, bothersome hair growth, acne or oily skin, we have medications that can treat those symptoms effectively, and the outcome from both a fertility and medical perspective is very good,” she said.
For women who are not trying to get pregnant, Schutt recommends treating them with birth control pills to help control their cycle. “The birth control pill is very effective in regulating the menstrual cycle, reducing male hormone levels and improving symptoms of acne. The birth control pill essentially overrides the abnormal communication between the brain and ovary, and ultimately this protects the uterus from unopposed estrogen, which can lead to uterine cancer,” she said.
“PCOS is a very common condition. I think the name PCOS is a misnomer, focusing on the appearance of polycystic ovaries, but it’s really a symptom of a larger metabolic syndrome,” she said. “If women come to me with irregular periods or infertility we can identify those symptoms and identify their health needs to hopefully prevent the development of metabolic conditions when they are older.”