Diagnosing PCOS can be a complex process – especially since many of the symptoms of PCOS can go overlooked for years. Usually the symptoms like weight gain, acne or irregular periods are nonspecific and can occur in many other conditions. That is why it is important to rule out other conditions before making a diagnosis for PCOS.
So if you suspect having PCOS, don’t delay your diagnosis, speak to a doctor. Depending on your initial assessment, your doctor may recommend certain test for PCOS that can help confirm diagnosis and also rule out other conditions.
These tests usually include a combination of scans and blood tests – assessing only based on the physical symptoms is not enough. Test for PCOS includes:
- Ultrasonography (USG)
- Testosterone and Free Androgen Index
- Insulin test
- Thyroid stimulating hormone test
- Prolactin test
- Reproductive hormones like LH, FSH
If diagnosed with PCOS, your doctor will assess your reports to understand the root cause of your PCOS. Since symptoms and root cause will be different for each woman, your treatment needs to be personalised for you. Usually a combination of lifestyle modifications and medications are prescribed.
Making lifestyle changes has been proven to be the most effective approach in treating PCOS and reducing the severity of the symptoms. By lifestyle changes we mean, eating a balanced diet that is rich in nutrients and helps you manage hormonal imbalance, exercising regularly, managing your stress and getting good sleep each night. However, you can’t benefit from following a generic diet or exercise plan that you found online for PCOS. Your diet, exercise needs to be personalised to your symptoms and that addresses your root cause. You don’t have to follow a diet plan forever, which makes building sustainable habits an important part of your PCOS journey. Nearly 80% of your diet is about your diet that can help balance your hormones. This means eating complex carbs, including sufficient amounts of protein, healthy fats and dietary fibre from whole foods. Limit on processed or packaged foods. If you are in the overweight or obese category, losing even 5% to 10% of your bodyweight can help improve many symptoms of PCOS.
Although not all women need medications, some women may require medications in addition to making lifestyle changes. These medications help improve many symptoms of PCOS such as irregular periods, insulin resistance, acne and excess facial or body hair. Birth control or oral contraceptive pill (OCPs) is a commonly prescribed medication for PCOS. When your body’s hormonal balance is disturbed and your ovaries aren’t functioning properly such as producing excess of male hormones — the best way to restore this balance is by giving hormones from outside and that’s what OCPs do. In addition to OCPs, metformin which is a drug prescribed for type 2 diabetes patients is also useful for PCOS women to reduce insulin resistance. Reducing insulin resistance helps with weight loss, cravings, fatigue and also helps reduce the levels of male hormones (androgen). There are also many anti-androgen drugs to reduce the level of androgens that can ultimately help reduce excess facial/body hair, acne and scalp hair loss. However, anti-androgen drugs have some side effects and are often prescribed after OCPs haven’t worked. For women who are planning on conceiving, there are many ovulation induction medications such as Letrozole or Clomid that help stimulate ovulation and improve your chances of conceiving. All these medications need to be taken under the guidance of a medical professional.
Taking care of your mental health is as important as your physical health. PCOS can affect your mental health in many subtle ways and can show up as mood swings, anxiety and depression. Although treating your physical symptoms are important, also taking care of your mental health is important to your overall treatment journey. Take time out for yourself and do the things that help you unwind or relax. This could mean going for a walk, meeting your friend, watching your favourite movie or taking a nap. It is helpful to have a friend/partner or a family member with whom you can share your feelings and talk it out on days you don’t feel too well. Some women may also benefit from on-going counselling or therapy sessions. Remember to seek professional help when required and to prioritise your mental health always.