Hormones in PCOS

Many women have reached out to ask me to explain what their hormones look like if they have PCOS and this is a great follow up after looking at “normal cycles” and hormones for those on “the pill”.

PCOS is a hormonal disorder which is commonly diagnosed in young women. It was named for multiple cysts seen on the ovaries of patients diagnosed with PCOS, although this is a bit of a misnomer as patients with PCOS will not always have cystic ovaries.

Symptoms of PCOS

• Irregular periods or absence of your period
• Unusual or unwanted hair growth, for example hair growth on the chin or head hair loss
• Acne
• High blood sugar
• High blood pressure
• Weight gain or the inability to lose weight
• Inability to get pregnant
• Fatigue
• Sleep problems

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Hormones

Unlike the last two posts, it is much harder to provide a diagram of what hormones will look like in a cycle. This is because PCOS can present differently in various patients. Some people may have a 2-month cycle, some may not ovulate, and some may cycle regularly.

There are multiple female hormones that PCOS will affect like androgens, estrogen, and progesterone.

Androgens:

All females normally produce small amounts of androgens, like testosterone. In PCOS patients these androgens are usually greatly elevated.

Progesterone:

Progesterone levels are often decreased in PCOS.

LH and FSH:

LH and FSH are also hormones involved in a women’s menstrual cycle. In a “normal” female the ratio of LH to FSH is 1:1 (except right before ovulation) but in PCOS this ratio will often be abnormal.

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How is PCOS diagnosed?

Currently, the most widely accepted way is by using something called the Rotterdam criteria:

Two of three are needed to make the diagnosis:

• Oligo – and/or anovulation – which means irregular cycles, or you are not ovulating.
• Clinical and/or biochemical signs of hyperandrogenism – which means signs of high testosterone like acne or unwanted hair growth (like on the chin) OR high androgen on your labs work.
• Polycystic ovaries (by ultrasound) – exactly like it sounds, cysts are seen on your ovaries when imaging is performed.

Disclaimer: All material on this website is for informational and educational purposes only and is not a substitute for the advice provided by your healthcare professional or physician.