PCOS MYTHS - busted!
The Inside Track on all Those Rumours....
Here’s the real truth behind a lot of the most common rumours we hear about PCOS – straight from the experts.
TRUTH OR MYTH?
If I don’t have cysts on my ovaries, I can’t have PCOS
Professor Helen Mason, Formerly Professor in Reproductive Endocrinology, St. George’s, University of London, says:
‘First of all, the cysts are inside the ovary, not on the outside. The diagnostic criteria for PCOS which were agreed a few years ago state that to have PCOS you have to have 2 out of 3 of the following: increased numbers of cysts/follicles on the ovaries, irregular or absent menstrual cycles and raised androgen or a clinical sign of this, such as hirsutism or acne. So the answer is that you can have PCOS without seeing cysts on the scan. The problem with scanning is that it really is an art and not a hard science and cysts can be missed. Plus, the appearance of the ovary can change. If you have irregular cycles and acne/hirsutism , however, the chances are very good that you have PCOS.’
TRUTH OR MYTH?
I’m at an increased risk of heart disease if I have PCOS
Professor Stephen Atkin says:
‘This is an area of uncertainty and so there is very active research. Studies have suggested that if you have PCOS then there are increases in the markers that are associated with heart disease, but there are no studies that have been performed to confirm that if you have PCOS then you are more likely to have heart problems. However, if you have PCOS then you are at increased risk of developing diabetes and that is associated with an increased risk of heart disease. It therefore makes sense (especially if you have a family history of diabetes, and up to 70% of patients may have) to keep your weight down, be active and do all of the general things recommended to reduce heart disease risk – such as not smoking and eating a healthy diet packed with fruits, vegetables, and wholegrain.
TRUTH OR MYTH?
If I go on a diet everything will be ok
Samantha Bailey, Registered Dietitian with a special interest in PCOS, says:
‘Diet and lifestyle is an important element to managing the symptoms of PCOS but there may also be other treatment options to consider such as cosmetic measures and medication. It is true to say that many women who choose to follow a healthy diet do start to feel better and may see improvements in their symptoms, especially if they achieve a healthier body weight. However, it is often more useful to make lifestyle changes that you can stick to long term rather than considering yourself on a ‘diet’. Going on a ‘diet’ does not address some of the emotional aspects associated with PCOS and can sometimes put more pressure on the individual. The role of regular exercise should not be underestimated too- the benefits of exercise are well recognised for both body, mind and stress levels! Instead of thinking ‘I need to go on a diet’ try to think ‘ how can I eat a healthier diet and do more exercise?’.’
TRUTH OR MYTH?
PCOS is a rare condition
Professor Stephen Atkin, Head of Academic Endocrinology, Diabetes and Metabolism at Hull York Medical School, says:
‘Actually PCOS is the most common endocrine condition. Depending on the literature, estimates of up to 20% of premenopausal women are cited, but more reliable estimates put it between 6-9% for example the Caucasian population.’
TRUTH OR MUTH?
PCOS can be cured
Professor Stephen Atkin says:
‘I am afraid that PCOS cannot be cured, but it can be managed. In those patients who are overweight we have shown that even a small amount of weight loss (about 5%) can have a major beneficial effect on testosterone levels (that contribute to excess hair growth) and on helping periods to be more regular.’
TRUTH OR MYTH?
PCOS makes me have mood swings
Professor Helen Mason says:
‘I’m afraid it’s impossible to say. Lots of women with normal ovaries have mood swings too and many women with PCOS do not have them!’
TRUTH OR MYTH?
I can’t lose weight because of PCOS
Samantha Bailey says:
‘Many women with PCOS do find it difficult to lose weight as the associated hormone disturbance can encourage weight gain. However, there are lots of women who have PCOS and are a healthy body weight. So be reassured that it is possible to limit weight gain and that having PCOS is not an automatic life sentence of being overweight.’
TRUTH OR MYTH?
PCOS makes it difficult to have children
Dr Helen Mason says:
‘It can make things harder but there are lots of treatments now and we are very good at getting women to ovulate who do not do so. The main problem is again weight. The heavier you are the less likely you are to ovulate and the harder it will be to stimulate the ovaries. But more women with PCOS manage to have children than not.’
TRUTH OR MYTH?
I can’t have fertility drugs because they’ll make me have too many embryos
Professor Stephen Atkin says:
‘One of the most common reasons for fertility treatment is PCOS, when a woman has ovulation problems. But overstimulation of the ovaries can occur more frequently compared to women without PCOS. However, IVF units are aware of this and take all possible precautions to try and avoid this occurring.’
TRUTH OR MYTH?
I will give PCOS to my daughter
Professor Helen Mason says:
‘This is not guaranteed, but research shows there is about a 50:50 chance of that happening.’
TRUTH OR MYTH?
PCOS will go away at menopause
Professor Helen Mason says:
‘Using current diagnostic guidelines, you couldn’t diagnose PCOS once periods stop, and the cysts on the ovaries will disappear. But from research so far, it seems that the metabolic and insulin-related side of the syndrome gets going after menopause, even if some of the other symptoms such as irregular periods, disappear.’
TRUTH OR MYTH?
Weight loss drugs are the answer
Samantha Bailey says:
‘There is no one answer to weight loss with PCOS, and different approaches work for different people. The prescribable weight loss drug Orlistat (Xenical), which is also available over the counter (Alli), does really work for some individuals but it needs to be combined with a healthy, low fat diet to avoid symptoms of diarrhoea. People who have not been able to make the right dietary changes often stop the medication or miss doses which reduces its effectiveness. Finding the right plan for you can be difficult and getting some guidance and support from a qualified dietitian can make a big difference. Your GP can refer you to an NHS dietitian or you may find a local freelance registered dietitian using www.freelancedietitian.org'
TRUTH OR MYTH?
Women with PCOS are always overweight
Professor Stephen Atkin says:
‘No, that is not true. There appears to be a spectrum from slim to overweight. Many patients are overweight and we often see women who do put on weight then develop features of PCOS as a consequence.’
TRUTH OR MYTH?
If I lose weight my symptoms will disappear
Professor Stephen Atkin says:
‘By losing weight then some women do have an improvement in their symptoms with an improvement in excess hair growth and acne. Or the weight loss can help medication to work in this situation. Weight loss can also improve the regularity of periods. But this does not work for all women with PCOS, especially if they do not have much weight to lose.’
TRUTH OR MYTH?
If I have my ovaries removed I won’t have PCOS
Professor Helen Mason says:
‘As the source of the excess androgen is primarily the ovary, removing this will cause the androgen to drop and should therefore reduce the symptoms such as hirsutism and acne. Of course the cycles will stop too, so a diagnosis can’t be made. We don’t know what happens to the other problems such as insulin resistance, if the ovaries are removed.’
TRUTH OR MYTH?
I am at greater risk of cancers due to PCOS
Professor Helen Mason says:
‘There’s no real evidence for this other than cancer of the lining of the womb, the endometrium. This is because in women who do not have regular cycles the endometrium grows but is not shed regularly with periods. All of that cell growth increases the chance of the cells growing out of control: a condition known as hyperplasia. In some cases this will become cancer. The way to stop this is to make sure you have a bleed every few months, especially if you have heavy periods when you do bleed.’
Here’s the real truth behind a lot of the most common rumours we hear about PCOS – straight from the experts.
TRUTH OR MYTH?
If I don’t have cysts on my ovaries, I can’t have PCOS
Professor Helen Mason, Formerly Professor in Reproductive Endocrinology, St. George’s, University of London, says:
‘First of all, the cysts are inside the ovary, not on the outside. The diagnostic criteria for PCOS which were agreed a few years ago state that to have PCOS you have to have 2 out of 3 of the following: increased numbers of cysts/follicles on the ovaries, irregular or absent menstrual cycles and raised androgen or a clinical sign of this, such as hirsutism or acne. So the answer is that you can have PCOS without seeing cysts on the scan. The problem with scanning is that it really is an art and not a hard science and cysts can be missed. Plus, the appearance of the ovary can change. If you have irregular cycles and acne/hirsutism , however, the chances are very good that you have PCOS.’
TRUTH OR MYTH?
I’m at an increased risk of heart disease if I have PCOS
Professor Stephen Atkin says:
‘This is an area of uncertainty and so there is very active research. Studies have suggested that if you have PCOS then there are increases in the markers that are associated with heart disease, but there are no studies that have been performed to confirm that if you have PCOS then you are more likely to have heart problems. However, if you have PCOS then you are at increased risk of developing diabetes and that is associated with an increased risk of heart disease. It therefore makes sense (especially if you have a family history of diabetes, and up to 70% of patients may have) to keep your weight down, be active and do all of the general things recommended to reduce heart disease risk – such as not smoking and eating a healthy diet packed with fruits, vegetables, and wholegrain.
TRUTH OR MYTH?
If I go on a diet everything will be ok
Samantha Bailey, Registered Dietitian with a special interest in PCOS, says:
‘Diet and lifestyle is an important element to managing the symptoms of PCOS but there may also be other treatment options to consider such as cosmetic measures and medication. It is true to say that many women who choose to follow a healthy diet do start to feel better and may see improvements in their symptoms, especially if they achieve a healthier body weight. However, it is often more useful to make lifestyle changes that you can stick to long term rather than considering yourself on a ‘diet’. Going on a ‘diet’ does not address some of the emotional aspects associated with PCOS and can sometimes put more pressure on the individual. The role of regular exercise should not be underestimated too- the benefits of exercise are well recognised for both body, mind and stress levels! Instead of thinking ‘I need to go on a diet’ try to think ‘ how can I eat a healthier diet and do more exercise?’.’
TRUTH OR MYTH?
PCOS is a rare condition
Professor Stephen Atkin, Head of Academic Endocrinology, Diabetes and Metabolism at Hull York Medical School, says:
‘Actually PCOS is the most common endocrine condition. Depending on the literature, estimates of up to 20% of premenopausal women are cited, but more reliable estimates put it between 6-9% for example the Caucasian population.’
TRUTH OR MUTH?
PCOS can be cured
Professor Stephen Atkin says:
‘I am afraid that PCOS cannot be cured, but it can be managed. In those patients who are overweight we have shown that even a small amount of weight loss (about 5%) can have a major beneficial effect on testosterone levels (that contribute to excess hair growth) and on helping periods to be more regular.’
TRUTH OR MYTH?
PCOS makes me have mood swings
Professor Helen Mason says:
‘I’m afraid it’s impossible to say. Lots of women with normal ovaries have mood swings too and many women with PCOS do not have them!’
TRUTH OR MYTH?
I can’t lose weight because of PCOS
Samantha Bailey says:
‘Many women with PCOS do find it difficult to lose weight as the associated hormone disturbance can encourage weight gain. However, there are lots of women who have PCOS and are a healthy body weight. So be reassured that it is possible to limit weight gain and that having PCOS is not an automatic life sentence of being overweight.’
TRUTH OR MYTH?
PCOS makes it difficult to have children
Dr Helen Mason says:
‘It can make things harder but there are lots of treatments now and we are very good at getting women to ovulate who do not do so. The main problem is again weight. The heavier you are the less likely you are to ovulate and the harder it will be to stimulate the ovaries. But more women with PCOS manage to have children than not.’
TRUTH OR MYTH?
I can’t have fertility drugs because they’ll make me have too many embryos
Professor Stephen Atkin says:
‘One of the most common reasons for fertility treatment is PCOS, when a woman has ovulation problems. But overstimulation of the ovaries can occur more frequently compared to women without PCOS. However, IVF units are aware of this and take all possible precautions to try and avoid this occurring.’
TRUTH OR MYTH?
I will give PCOS to my daughter
Professor Helen Mason says:
‘This is not guaranteed, but research shows there is about a 50:50 chance of that happening.’
TRUTH OR MYTH?
PCOS will go away at menopause
Professor Helen Mason says:
‘Using current diagnostic guidelines, you couldn’t diagnose PCOS once periods stop, and the cysts on the ovaries will disappear. But from research so far, it seems that the metabolic and insulin-related side of the syndrome gets going after menopause, even if some of the other symptoms such as irregular periods, disappear.’
TRUTH OR MYTH?
Weight loss drugs are the answer
Samantha Bailey says:
‘There is no one answer to weight loss with PCOS, and different approaches work for different people. The prescribable weight loss drug Orlistat (Xenical), which is also available over the counter (Alli), does really work for some individuals but it needs to be combined with a healthy, low fat diet to avoid symptoms of diarrhoea. People who have not been able to make the right dietary changes often stop the medication or miss doses which reduces its effectiveness. Finding the right plan for you can be difficult and getting some guidance and support from a qualified dietitian can make a big difference. Your GP can refer you to an NHS dietitian or you may find a local freelance registered dietitian using www.freelancedietitian.org'
TRUTH OR MYTH?
Women with PCOS are always overweight
Professor Stephen Atkin says:
‘No, that is not true. There appears to be a spectrum from slim to overweight. Many patients are overweight and we often see women who do put on weight then develop features of PCOS as a consequence.’
TRUTH OR MYTH?
If I lose weight my symptoms will disappear
Professor Stephen Atkin says:
‘By losing weight then some women do have an improvement in their symptoms with an improvement in excess hair growth and acne. Or the weight loss can help medication to work in this situation. Weight loss can also improve the regularity of periods. But this does not work for all women with PCOS, especially if they do not have much weight to lose.’
TRUTH OR MYTH?
If I have my ovaries removed I won’t have PCOS
Professor Helen Mason says:
‘As the source of the excess androgen is primarily the ovary, removing this will cause the androgen to drop and should therefore reduce the symptoms such as hirsutism and acne. Of course the cycles will stop too, so a diagnosis can’t be made. We don’t know what happens to the other problems such as insulin resistance, if the ovaries are removed.’
TRUTH OR MYTH?
I am at greater risk of cancers due to PCOS
Professor Helen Mason says:
‘There’s no real evidence for this other than cancer of the lining of the womb, the endometrium. This is because in women who do not have regular cycles the endometrium grows but is not shed regularly with periods. All of that cell growth increases the chance of the cells growing out of control: a condition known as hyperplasia. In some cases this will become cancer. The way to stop this is to make sure you have a bleed every few months, especially if you have heavy periods when you do bleed.’