Bald Symptoms: Polycystic Ovarian Syndrome (PCOS)

As part of a new feature, I thought I’d track down the variety of diseases and syndromes for which alopecia can be a presenting symptom. In most cases hair loss is just good, old-fashioned hair loss; but there are times when it can be indicative of something else. Quick reminder: I’m not a doctor. If you have a specific health concern, go see a physician.

Today let’s talk about Polycystic Ovarian Syndrome (PCOS)

What is it?

PCOS (aka Stein-Leventhal syndrome), is an endocrine disorder. It affects between 5–10% of women, and occurs amongst all races and nationalities. It is the most common hormonal disorder among women of reproductive age, and is a leading cause of infertility. The causes are unknown, and the symptoms and severity of the syndrome can vary greatly.

Based on a 2003 definition, PCOS present if 2 out of 3 criteria are met:

1. oligoovulation and/or anovulation (irregular, few, or absent menstrual periods);
2. excess androgen (male hormone) activity;
3. polycystic ovaries, which cannot be explained by other causes.

What does it do?

Women with PCOS are at risk for the following:

• Endometrial hyperplasia (an enlarged uterine lining) and endometrial cancer (cancer of the uterine lining)
• Insulin resistance/Type II diabetes
• High blood pressure
• Dyslipidemia (disorders of lipid metabolism – cholesterol and triglycerides)
• Cardiovascular disease

Some data suggest that women with PCOS have a higher risk of miscarriage. Also, many women with PCOS have a difficult time conceiving because of their irregular cycles and lack of ovulation.

How is it treated?

The causes of PCOS are unknown, and there is no cure per se. Treatments usually focus on the symptoms associate risks. Hormone therapies, such as oral contraceptives, are used to regulate menstrual cycles, counteract the effects of excess androgen, and reduce the risks of ovarian cancer. Diet and exercise, sometimes coupled with insulin lowering medications, address the increased cardiovascular risks.

What are it’s symptoms?

• Oligomenorrhea, amenorrhea – irregular, few, or absent menstrual periods; cycles that do occur may comprise heavy bleeding, probably a result of there reduced frequency
• Infertility, generally resulting from the lack of regular ovulation
• Elevated blood levels of male hormones, specifically testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS). These can cause hirsutism (extra hair in traditionally male locations, e.g. the chest and abdomen) and occasionally masculinization (appearance of other traditionally male characteristics, e.g. a deeper voice)
• Central obesity – “apple-shaped” obesity centered around the lower half of the torso
• Male-pattern baldness
• Acne, oily skin, seborrhea
• Dark patches of skin (tan to dark brown or black)
• Skin tags (tiny flaps of skin)
• Prolonged periods of PMS-like symptoms (bloating, mood swings, pelvic pain, backaches)
• Sleep apnea

Additional Resources

PCOSupport.org
Wikipedia
SoulCysters: PCOS Support Group