One of the most common questions I receive: How did you know you had PCOS?
Frankly, I didn’t. I’d never even heard of it, which I believe is fairly commonplace.
A common follow-up to that question: How do doctors reach a PCOS diagnosis?
Since there is no symptom that every single woman with PCOS has, leading doctors in the field got together in Rotterdam in 2003 to establish criteria to issue a PCOS diagnosis. A woman must have 2 out of these 3 to be diagnosed with PCOS.
- Polycystic ovaries. Enlarged ovaries that have at least 12 follicles.
- Less then 8 cycles per year OR lack of ovulation.
- Elevated male hormone. This can be evidenced by blood tests showing an excess of testosterone or testosterone-related symptoms (e.g. acne, excessive hair growth, male-pattern baldness, etc.)
For me, I had all three factors. At my first ultrasound, I had 73 cysts, I hadn’t had more than 1 period per year…ever, and while my elevated male hormone hadn’t started to manifest itself too much outwardly, my blood tests indicated I was in the high range. There was no question for me.
On a related note, while not part of an official diagnosis, I have read in several places that over 50% of women with PCOS have insulin resistance; I spoke with my doctor and he believes it is closer to 70%. Perhaps that is why the Paleo diet works so well since those with insulin resistance tend to respond positively to the diet. Thoughts?
I know very few women who suspected PCOS. I was diagnosed as a teenager after doing things that should have lead to weightloss–calorie/fat restriction, exercise, etc., and ended up gaining weight. My mom was worried I had diabetes or something else going on, as PCOS was a very new diagnosis back then. Most of the other women I know were diagnosed after spending a year trying to get pregnant.
I have suggested the possibility of PCOS to several friends who had a lot of trouble losing weight through traditional means, or other symptoms like the lack of periods or hair growth. All of them ended up being diagnosed while trying to conceive. It seems such a shame to me that their OBs or GPs didn’t catch the signs sooner, so they could correct some of the hormone and weight issues before they tried to get pregnant. I won’t put that on my friends, though, because of the embarrassing nature of the symptoms and the tendency of doctors not to believe you when you detail your unsuccessful weightloss efforts. I was lucky enough to be living at home and have my mom vouch for my efforts to the doctor.
I agree with you–PCOS just kind of sneaks up on you, even with its prevalence today. It’s not talked about much because who wants to bring up the subject: “Hey I noticed you exercise all day long and only gain weight. Plus, you’ve got a beard. What’s that all about?”
So glad your mom could vouch for you so you could sidestep some of those, “It’s all about calories in/calories out” conversations.