1 in 10 women have PCOS—but many of them don't even realize it. Here's what you need to know about this endocrine disorder.

Though it was first described in 1935, Polycystic ovary syndrome (PCOS) remains a misunderstood and under-diagnosed endocrine disorder—and a very common one, affecting one in ten women. But experts say about half the women and girls who have PCOS don't know it, which is a huge problem when you consider the health implications of leaving the disorder untreated. (Think diabetes, cardiovascular disease, depression and more.) That's why, for PCOS Awareness Month, people have been taking part in the Lemon Face Challenge (#lemonfacechallenge), which helps put a (sour) face to this cause. Wondering if you might have PCOS? Read on for more info about risk factors, how to spot the symptoms and how it can impact your fertility.

What is PCOS?

Polycystic ovary syndrome (PCOS) is the most common hormonal endocrine disorder in females, affecting 10-15% of teenage girls and women. “It’s a complex condition that affects many systems in the body, including metabolism, hormones, fertility, and the brain and immune system. It has genetic origins, and certain environmental and dietary factors can make it worse. The name PCOS is somewhat misleading as cysts aren’t present in many women—which is why experts are considering a name change to reflect the overall nature of its far-reaching and lifelong effects,” says Dr. Fiona McCulloch, author of 8 Steps To Reverse Your PCOS.

Who is at risk?

“It affects an estimated 2 million women in Canada and an estimated 50% don't know they have it. Women with a family history of diabetes, or who have relatives with PCOS can be at risk,” says Dr. McCulloch.

What are the symptoms?

The biggest indicator is an irregular menstrual cycle; it might be super-short (meaning, you get your period several times a month) or stretched out (not getting it for three months) and the flow can range from very light to very heavy. Other symptoms include excess body hair on the face, chest, back, hands and around the nipples, thinning hair on scalp, weight gain—particularly around the waist due to insulin resistance, fertility complications and skin issues, including persistent acne and dark patches of skin on the neck, armpits or between the breasts.

How is it diagnosed?

Dr. McCulloch says, PCOS is typically diagnosed when a woman has two of the three following signs:

1. Anovulation (the failure to either produce an egg or discharge it from an ovary) or delayed ovulation (cycles that are typically 35 days or longer).
2. High levels of hormones such as testosterone or clinical signs of high androgens like hirsutism (facial hair growth), acne or alopecia.
3. Polycystic ovaries detected via an ultrasound.

Does PCOS affect women trying to get pregnant?

It's the leading cause of female infertility. It impacts a woman's ovulation and egg quality, and is also associated with miscarriages, says Dr. McCulloch.

What other health complications can women with PCOS experience?

It can have serious health consequences. Women with PCOS are at risk for type 2 diabetes, cardiovascular disease, obesity, Hashimoto's thyroiditis and hypothyroidism, depression and anxiety.  

What are the treatment options?

There is no cure for PCOS. The most important intervention that can make a difference is proper nutrition. “Following a low-glycemic or insulin-index diet can help to manage insulin resistance, which is central to the condition," says Dr. McCulloch. One study found that a low-starch, low-dairy diet benefitted weight loss, reduced testosterone and improved the markers of insulin-resistance in women with PCOS.

Exercise has also been found to improve PCOS—even a modest 5 percent reduction in weight can drastically improve symptoms.

“When it comes to conventional medical care, the most common intervention is the oral contraceptive pill to regulate menses, metformin to manage insulin resistance, and anti-androgen medications like Spironolactone to reduce the effects of testosterone,” says Dr. McCulloch.