What is PCOS?
PCOS is a disorder of the endocrine system — the system of glands that produce hormones that regulate the body’s functions. The World Health Organization estimates that PCOS affects an estimated 8% and 13% of women of childbearing age (between 15 and 44). Most women find out they have PCOS in their 20s and 30s when they see their healthcare provider about trouble getting pregnant.
Dr. Aliabadi calls PCOS the “silent epidemic” and goes on to say that it “is the leading cause of infertility, and yet patients are not being diagnosed in time.”
Living with a chronic condition like PCOS can take a toll on your life. Dr. Aliabadi is deeply passionate about helping women manage and overcome the challenges of PCOS and with her extensive expertise and compassionate approach, she has helped countless patients achieve better health and well-being.
Who is at risk of PCOS?
We don’t know what exactly causes the polycystic ovarian syndrome. While most women won’t be diagnosed with PCOS until their 20s or 30s, it can start at any age after puberty. There is no difference in risk for women of different ethnic backgrounds.
A family history of PCOS increases your own risk.
Obesity and PCOS go hand-in-hand: overweight people seem at higher risk, and obesity is a symptom of PCOS. Being overweight can also worsen PCOS symptoms.
How Does PCOS Develop?
PCOS often develops between puberty and menopause.
As we mentioned, ovaries contain many follicles, representing immature eggs. By the time a girl hits puberty, her ovaries contain about 40,000 follicles. These follicles have two main cell layers that are involved in the production of hormones, theca cells and granulosa cells.
Theca cells produce androgens in response to luteinizing hormone (LH). LH triggers the release of an egg from the ovary during the middle of the mensural cycle,
These androgens then move to the granulosa cells, where they are converted into estrogen, helping with follicle maturation and ovulation.
An enzyme called aromatase, found in the ovaries and fat cells, converts androgens into estrogen. Insulin, cortisol, and inflammatory cytokines can activate aromatase.
Unfortunately, high androgen levels promote the growth of follicles and prevent them from maturing, which leads to an excessive number of small follicles and high levels of Anti-Mullerian hormone (AMH), which indicates the number of growing follicles. AMH levels also vary with vitamin D levels, which are often low in women with PCOS. High androgens also cause symptoms like acne and unusual hair growth.
Problems in these cells are thought to be a main cause of PCOS.
How do gynecologists diagnose PCOS?
There is no single test to diagnose PCOS. To help diagnose PCOS and rule out other causes of your symptoms, Dr. Aliabadi will review your medical history and do a physical exam with tests:
- Physical exam. Your blood pressure, body mass index (BMI), and waist size will be checked. They will also look for excess hair growth on your face, chest, back, acne, or skin discoloration. Dr. A may look for thinning hair or signs of other health conditions (such as an enlarged thyroid gland).
- Pelvic exam. This may be performed for side effects of extra androgens (for example, an enlarged clitoris) and to check if your ovaries are enlarged or swollen.
- Pelvic ultrasound (sonogram). This test uses sound waves to examine your ovaries for cysts and check the endometrium (lining of the uterus).
- Blood tests. This is to check your androgen hormone levels. Doctor will also check for hormones related to other common health problems that can be mistaken for PCOS, such as thyroid disease. She may also check your cholesterol and blood glucose levels.
What are the symptoms of PCOS?
Patients with PCOS symptoms typically experience:
- Unpredictable and or irregular periods – Menstrual periods may be absent or infrequent or occur too frequently
- Several small ovarian cysts.
- Severe acne or acne that doesn’t respond to treatment.
- Oily skin.
- Acanthosis nigricans – abnormal patches of skin that appear dark and velvety.
- Skin tags – small excess flaps of skin in the armpits or neck area.
- Hirsutism – abnormal hair growth on the chest, face, upper thighs, and abdomen.
- Male-pattern hair loss or baldness.
- Severe weight gain – affects about 80% of women with PCOS.
- Infertility. PCOS also increases the risk of preterm delivery, a cesarean section delivery, and miscarriage.
If you’re experiencing these symptoms, please make an appointment with your OB/GYN. Keep notes of your symptoms, and be sure to ask any questions. Your OB-GYN will diagnose based on your symptoms, hormone levels, and ultrasound findings.
If you’re overweight and have PCOS, you’re at higher risk of obstructive sleep apnea — a condition where breathing repeatedly stops during sleep.
How does PCOS affect hormones?
Polycystic ovary syndrome causes the body to produce high levels of androgens (i.e., “male hormones”). Everyone has some androgens, but their stories tend to be lower in women.
This hormonal imbalance prevents the proper maturation of eggs. In healthy ovaries, eggs are developed and released by the follicles; the empty follicles then dissolve and are reabsorbed into the ovary. With PCOS, the immature follicles cannot dissolve and instead develop into small fluid-filled cysts.
Gynecologists like Dr. Aliabadi, specializing in reproductive endocrinology, study the connection between hormonal imbalances and fertility. PCOS is a leading cause of infertility due to these hormonal imbalances.
Long-term health risks of polycystic ovary syndrome
While we don’t know the exact cause of PCOS, we do know it is related to insulin resistance and increased levels of androgens in the bloodstream. Also, patients with PCOS often have higher LDL (bad) cholesterol and lower HDL (good) cholesterol levels.
Women with PCOS often have insulin resistance — meaning their bodies can’t lower blood sugar levels correctly. These factors contribute to your risk of serious illness and complications. Research shows that patients with PCOS have an increased risk of developing:
- Type 2 diabetes mellitus. Insulin resistance can lead to elevated blood sugar levels and, over time, increase the risk of developing Type 2 diabetes.
- Hypertension (high blood pressure)
- High cholesterol
- Cardiovascular disease (heart disease)
- Metabolic syndrome
- Endometrial cancer. Irregular or absent menstrual cycles can lead to a build-up of the uterine lining (endometrium), increasing the risk of endometrial hyperplasia and, potentially, endometrial cancer.
- Mental health issues. Women with PCOS may be at higher risk for depression, anxiety and low self-esteem. There’s no need to try and cope alone; support groups are available to help you. Click here to learn more about PCOS support groups.
Women with PCOS may also experience pregnancy complications, including gestational diabetes, preterm delivery, or pre-eclampsia.
What are some PCOS treatments?
If you are diagnosed with PCOS, Dr. Aliabadi will recommend a course of treatment based on your symptoms, your medical history, and your desire to become pregnant in the future. While PCOS cannot be cured, a mixture of medication and lifestyle changes can lessen symptoms.
With advances in fertility care, patients with PCOS can carry healthy, full-term pregnancies.
PCOS treatments may include:
Combined hormonal birth control pills
Oral contraceptive treatment can deliver estrogen and progestin to the body to regulate the menstrual cycle and reduce androgen levels. These pills can reduce menstrual irregularities and decrease unwanted body hair and acne. This treatment plan can work long-term for patients who no longer wish to become pregnant.
Weight loss
Healthy eating habits and regular physical activity can help relieve PCOS-related symptoms, but they may not be enough. While losing weight can help to lower your blood glucose levels, improve the way your body uses insulin, and regulate hormones, PCOS works against weight loss.
Insulin resistance and hormone imbalances can result in weight gain. While it may be harder to reverse PCOS-triggered weight gain, it is possible to lose weight if you have PCOS. Support groups and primary care doctors can help find what your body needs to start losing weight and improving your symptoms.
Insulin-sensitizing drugs
These drugs are normally used to treat patients with diabetes, but they can help women with PCOS by facilitating the body’s response to insulin. They can also jumpstart ovulation by reducing levels of androgens; this helps put the menstrual cycle back on track.
Appearance changes
If PCOS has given you extra unwanted hair, try facial hair removal creams, laser hair removal, or electrolysis. You can find hair removal creams and products at drugstores. A doctor must do procedures such as laser hair removal or electrolysis; your insurance may not provide coverage. These procedures can help reduce the appearance of excess hair and (potentially) slow its growth.
If you’re experiencing excessive acne due to PCOS, a dermatologist may be able to prescribe creams or treatments to reduce acne or improve its appearance.
Are there any supplements that may help PCOS sufferers?
As one of the leading medical expert in PCOS, Dr. Aliabadi set out to create a comprehensive PCOS solution. Frustrated with the roadblocks to diagnosis and quality care, Ovii was created to give women an opportunity to help take control of their health.
Dr. Aliabadi wanted more for her patients and set out to create a comprehensive solution targeting women’s health.
Ovii was formulated as a once daily nutritional supplement targeting women’s health beyond the standard.
Dr. Aliabadi created a effective way forward for women searching for a science-backed, doctor approved supplement. Ovii is an alternative that helps women manage their symptoms.
Lear more about Ovii here.
Make an appointment with Dr. Aliabadi, the best PCOS doctor near me
Don’t let PCOS define your life. Schedule a consultation with Dr. Aliabadi and receive personalized expert care. The consultation is a thorough, personalized process that involves a comprehensive review of your medical history, lifestyle, and symptoms, along with diagnostic testing. Dr. Aliabadi (also known as “Dr. A” to her patients) collaborates with you to create a customized treatment plan that addresses your unique health needs, fertility goals, and long-term wellness, ensuring ongoing support and adjustments as needed.
As one of the nation’s leading OB/GYNs, Beverly Hills’ Dr. Thaïs Aliabadi offers the very best in women’s health and well-being. With her warm, professional team, Dr. Aliabadi supports women through all phases of life. She fosters a special one-on-one relationship between patient and doctor.
Highly trained and honored by the medical community, Dr. Thais Aliabadi is certified by the American Board of Obstetrics and Gynecology and a Diplomat of the American College of Obstetrics and Gynecology. She implements the most advanced, state-of-the-art technology and treatment options.
Dr. Aliabadi specializes in up-to-date, minimally invasive surgical techniques, promising her patients shorter recovery times, reduced pain, and the least interruption to their daily lives.
We also invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700 for general inquiries.
PCOS FAQs
What does PCOS belly looks like?
People with PCOS usually gain weight in a pattern that involves more abdominal visceral fat (Visceral fat is fat that wraps around your abdominal organs deep inside your body) than any other area of the body.
What causes PCOS?
Although the underlying cause of PCOS is unknown, there are several contributing factors that have been identified, such as: insulin resistance, low-grade inflammation, hereditary, excess androgen
How to get pregnant with PCOS quickly?
If you have PCOS, your chances of becoming pregnant and having a healthy baby improve significantly when you adopt a healthy lifestyle, which includes maintaining a healthy weight, not smoking, eating a healthy diet, getting plenty of regular exercise, and getting enough sleep.
If you have irregular or sporadic periods, this may indicate that you are not ovulating and will need medical assistance to conceive. The first line of medical treatment for this is ovulation induction and you might need medication to help you ovulate or use fertility technologies such as in vitro fertilization.
How common is PCOS?
PCOS affects 6% to 12% (as many as 5 million) of US women.
Why does PCOS cause weight gain?
PCOS can cause your body to become resistant to insulin, making your pancreas produce more of the hormone. The excess insulin leads to fat storage and increased hunger, both of which can cause weight gain.
How to lose weight with PCOS?
Losing weight can be challenging for women with PCOS, but there are several strategies that can be helpful, including a healthy diet, regular exercise, and managing stress.
Some medications may be prescribed to help manage PCOS symptoms, including weight loss medications, which can help improve insulin sensitivity and promote weight loss. Learn about Trimly, Dr. Aliabadi’s personalized PCOS medical weight loss treatment at trimly.com.
What are the first signs of PCOS?
The first signs of PCOS include irregular periods, excessive hair growth, acne, weight gain, and darkening of the skin.
Is PCOS genetic?
Yes, PCOS has been found to have a genetic component, meaning that it tends to run in families. Studies have shown that women with a family history of PCOS are more likely to develop the condition.
Is PCOS an autoimmune disease?
No, PCOS is not an autoimmune disease. It is a hormonal disorder.
Does PCOS cause infertility?
PCOS can cause infertility, but not all women with PCOS will have difficulty becoming pregnant. Women with PCOS may have irregular or absent periods, which can make it more difficult to predict ovulation and conceive. Additionally, PCOS can cause hormonal imbalances that interfere with the normal process of ovulation and can make it more difficult to get pregnant. However, with appropriate treatment and management, many women with PCOS are able to conceive and have a healthy pregnancy.
Can you develop PCOS later in life?
While PCOS typically develops during adolescence or early adulthood, it is possible to develop PCOS later in life. Some women may not experience symptoms of PCOS until their 20s, 30s, or even 40s. However, it is more common for PCOS to be diagnosed earlier in life.
Can birth control cause PCOS?
No, birth control does not cause PCOS. In fact, birth control pills are often prescribed to help manage the symptoms of PCOS.
Does PCOS cause hair loss?
PCOS can cause hair loss in some women. The hormonal imbalances associated with PCOS can lead to an excess production of androgens, which can cause hair loss or thinning hair on the scalp.
What’s the link between vitamin D and PCOS?
Vitamin D plays a crucial role in reproductive health by influencing hormone receptors and promoting progesterone secretion. Women with PCOS often have a vitamin D deficiency, which affects granulosa cell function. Supplementing with vitamin D can improve insulin sensitivity and reduce androgen levels, aiding in the management of PCOS.
How does Metformin help with the PCOS symptoms?
Metformin improves insulin sensitivity, which reduces insulin levels and, in turn, lowers androgen production. This can help regulate menstrual cycles, promote ovulation, and improve fertility. Additionally, Metformin can aid in weight loss and reduce the risk of developing type 2 diabetes, which is often associated with PCOS.
What insurance plans are accepted?
Unfortunately, I cannot be a participating provider for insurance networks that don’t support the time-intensive, well-researched, integrative care that I do. My patients need more and expect more than today’s traditional care model. As do I. Read more about my insurance policy here.
What preparations are suggested for an appointment with your specialist to diagnose PCOS?
To prepare for a PCOS diagnosis appointment, gather your medical history, symptom log, family history, and a list of current medications and supplements. Additionally, prepare questions for your doctor and bring any relevant previous test results and insurance information.
What additional tests might be recommended to check for complications following a PCOS diagnosis?
After a PCOS diagnosis, extra tests may be recommended to monitor for complications such as diabetes, cardiovascular disease, endometrial hyperplasia or cancer, obstructive sleep apnea, and mental health conditions.
Are there different types of PCOS?
Yes! Polycystic Ovary Syndrome was initially identified if a patient had irregular menstrual cycles that lasted longer than 35 days (oligomenorrhea) and polycystic ovaries (PCO) with more than 12 follicles or were larger than 10mL.
Before 1980, simply having polycystic ovaries was all it took for doctors to say you had PCOS. But in the early 1980’s it was discovered that female-to-male transsexuals treated with testosterone also developed PCO. As a result of that, a new criterion based on high androgen levels was added into the mix.
From there doctors learned that many women with high androgen levels (two-thirds of whom had oligomenorrhea) had ovarian issues even without PCO. This new information led to doctors to identify four types of PCOS, and they are:
- Classic PCOS: When a patient has high androgens, oligomenorrhea or no ovulation, and PCO on ultrasound.
- Essential PCOS: When a patient has high androgens and oligomenorrhea or no ovulation at all.
- Normo-androgen PCOS: When a woman has normal levels of androgen but has PCO and oligomenorrhea or no ovulation.
- Ovulatory PCOS: When the patient has high androgens and PCO.
Although insulin resistance is not part of the diagnosis, it is known to play a key role in PCOS development.
What is the role of insulin in PCOS?
Insulin helps regulate our sex hormones. But when our cells don’t respond well to insulin, glucose transport is impaired. This the leads to high insulin levels which in turn increases the production of testosterone in the ovaries. And insulin resistance, which leads to high insulin levels, is found in between 50% and 70% of women with PCOS. And this is worsened by obesity.
Thus treatments that can bring down insulin levels, such as weight loss, can improve ovulation and hormone balance in PCOS.
Supported by her warm professional team, Dr. Aliabadi treats women through all phases of life and cherishes the special one-on-one relationship between patient and doctor.
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