Polycystic Ovary Syndrome: Symptoms and Management Tips

Some issues related to polycystic ovary syndrome (PCOS)?

First, I would like to describe my physical condition: I have always experienced menstrual pain and premenstrual syndrome (PMS) issues.
Since my first period, I have been dealing with acne, and my PMS has become so severe that I feel extremely sleepy and mentally drained a week before my period, often sleeping throughout the day at school and unable to attend classes (I am certain this is not just typical sleep deprivation; I genuinely feel unwell all day).
I worry about how I will manage in the workforce later on...
No one will understand if I am in poor condition for an entire week.

Initially, my menstrual pain required me to lie down in the health room for a class on the first day, but it has progressively worsened since my second year of high school, now requiring me to lie down for half a day, with lower back pain accompanying the abdominal pain (which was previously only in my lower abdomen).
In high school, I also started experiencing brown discharge a week before my period, which was heavy enough to require wearing sanitary pads, though not to the extent of needing frequent changes.

I have consulted both traditional Chinese medicine and Western medicine, but there has been little improvement.
The traditional Chinese medicine practitioner prescribed herbal remedies, while the Western doctor advised me to exercise more and prescribed painkillers.
Last summer, after missing my period for a month, I visited a different gynecologist.
After an ultrasound, the doctor diagnosed me with polycystic ovary syndrome (PCOS) and prescribed Diane-35.
After starting the medication, my menstrual pain improved, and my skin condition also got better with fewer breakouts.
The doctor mentioned that I could stop the medication after a few months and observe the results.
However, during the first month off the medication, my menstrual pain returned severely, and I even woke up from the pain on the first day of my period.

I learned that I needed to return for a follow-up two weeks before my next period, and the doctor prescribed another three months of medication.
Additionally, I was advised to start losing weight after my college entrance exams in July (I have gained 3 kg in the past six months, going from 154 cm and 54 kg to 57 kg).
I am unsure if this weight gain is due to the medication or because I have been eating more late-night snacks while preparing for exams (I have always gained about a kilogram each year).

I have read all the articles related to PCOS and discovered that the diagnosis is not solely based on ultrasound.
However, I do meet several criteria: hirsutism (I have excessive body hair, with long and thick hair on my arms and legs, and noticeable hair on my chest and abdomen), oily acne-prone skin, and being overweight (the doctor said I need to reduce my weight to at least 50 kg).

Aside from continuing my medication, do I need to take any additional steps? For example, should I undergo more detailed examinations? I still feel quite confused about these symptoms and do not want to scare myself by searching for information online.
The doctor I saw advised me to reduce my carbohydrate intake and go to bed earlier (I usually sleep around 1 or 2 AM, which makes it difficult to sleep early).

Thank you for taking the time to read my lengthy description, and I appreciate your response!

Mo Dai Zhi Kao Sheng, 10~19 year old female. Ask Date: 2021/04/05

Dr. Cao Guotao reply Obstetrics and Gynecology

The diagnosis of multiple cysts can also consider blood tests, which are unrelated to dysmenorrhea.
You may also consider taking birth control pills to regulate your menstrual cycle.
At 57 kilograms, you might be slightly overweight, so weight loss could be considered.
You can discuss treatment options with your regular obstetrician-gynecologist.
Wishing you good health.

Reply Date: 2021/04/05

More Info

Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder that affects many women of reproductive age. It is characterized by a variety of symptoms, including irregular menstrual cycles, excessive hair growth (hirsutism), acne, weight gain, and fertility issues. Understanding how to manage PCOS effectively is crucial for improving quality of life and reducing long-term health risks.

Symptoms of PCOS
1. Irregular Menstrual Cycles: Women with PCOS often experience irregular or absent menstrual periods. This can lead to complications such as endometrial hyperplasia and increased risk of endometrial cancer.

2. Hirsutism: Many women with PCOS have elevated levels of androgens (male hormones), which can lead to excessive hair growth on the face, chest, and back.

3. Acne and Oily Skin: Hormonal imbalances can cause skin issues, including acne and oily skin, which can be distressing for many women.

4. Weight Gain: Many women with PCOS struggle with weight gain or obesity, which can exacerbate other symptoms and lead to insulin resistance.

5. Fatigue and Mood Changes: Symptoms like fatigue, mood swings, and sleep disturbances are common and can significantly impact daily life.

Self-Management Strategies
1. Dietary Changes: A balanced diet that is low in refined carbohydrates and sugars can help manage insulin levels and weight. Focus on whole foods, including fruits, vegetables, lean proteins, and healthy fats. Reducing intake of processed foods and sugary snacks is also beneficial.

2. Regular Exercise: Engaging in regular physical activity can help manage weight, improve insulin sensitivity, and reduce symptoms of PCOS. Aim for at least 150 minutes of moderate-intensity exercise each week, incorporating both aerobic and strength-training activities.

3. Weight Management: If overweight, even a modest weight loss of 5-10% can help regulate menstrual cycles and improve symptoms. This can also reduce the risk of developing type 2 diabetes and cardiovascular disease.

4. Stress Management: High stress levels can exacerbate symptoms of PCOS. Techniques such as yoga, meditation, and mindfulness can help manage stress and improve overall well-being.

5. Sleep Hygiene: Prioritizing good sleep habits is essential. Aim for 7-9 hours of quality sleep each night. Establish a regular sleep schedule and create a restful environment to improve sleep quality.

6. Medical Management: Continue to follow up with your healthcare provider regarding medication options. Hormonal contraceptives can help regulate menstrual cycles and reduce symptoms like acne and hirsutism. Metformin, a medication commonly used for type 2 diabetes, can also be effective in managing insulin resistance associated with PCOS.

7. Regular Monitoring: Keep track of your menstrual cycles, symptoms, and any changes in your body. This information can be valuable for your healthcare provider in adjusting treatment plans.

8. Consider Nutritional Supplements: Some studies suggest that supplements like inositol may help improve insulin sensitivity and ovarian function in women with PCOS. However, consult with your healthcare provider before starting any new supplements.

When to Seek Further Evaluation
If your symptoms persist or worsen despite lifestyle changes and medication, it may be necessary to undergo further evaluation. This could include blood tests to check hormone levels, an ultrasound to assess ovarian health, or consultations with specialists such as an endocrinologist or a reproductive health expert.

Conclusion
Managing PCOS is a multifaceted approach that involves lifestyle modifications, medical treatment, and regular monitoring. By adopting healthy habits and working closely with healthcare providers, you can effectively manage your symptoms and improve your overall health. Remember, you are not alone in this journey, and seeking support from healthcare professionals and support groups can provide additional resources and encouragement.

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