Polycystic ovary syndrome (PCOS) is a complex condition that affects millions of women, and it disproportionately impacts Black women. 1 in 10 women of childbearing age are diagnosed with PCOS, according to the Office on Women’s Health. An article in Capital B last year reported that there is little research as to why we are disproportionately affected by the condition and up to 75% with the condition remain underdiagnosed. We need to lead conversations about PCOS and what it means for our community regarding symptoms, treatment, and well-being.
PCOS Explained
Polycystic ovary syndrome (PCOS)is a hormonal condition, it consists of an imbalance that occurs when the ovaries produce excessive androgens, these are sex hormones that contribute to puberty, reproductive health, and body development according to The Cleveland Clinic. Although males produce more androgens, they are produced by both males and females. This excessive production can lead to imbalanced reproductive hormones.
What are the Symptoms?
The Mayo Clinic has provided insight into the symptoms of PCOS, if you are experiencing any of the following symptoms, you should visit your healthcare provider. PCOS symptoms include the following:
- Irregular periods, having few menstrual periods or having periods that are not regular are common signs of PCOS.
- Excessively lengthy periods, having periods that last for many days or longer than is typical for a period can be a cause for concern.
- Fertility issues.
- Too much androgen, elevated levels of the hormone androgen may result in excess facial and body hair, this is called hirsutism. High androgen levels can contribute to male-pattern baldness and severe acne as well.
- Polycystic ovaries, the ovaries might become bigger, and many follicles containing immature eggs may develop around the edge of the ovaries. This can contribute to cysts and difficulties with the function of the ovaries.
Additionally, PCOS can be a risk factor for other complications in a woman’s life. The Mayo Clinic has created a list of complications that can occur for women diagnosed with PCOS, the list includes:
- Infertility.
- Gestational diabetes or pregnancy-induced high blood pressure.
- Nonalcoholic steatohepatitis, this is a severe liver inflammation caused by fat buildup in the liver.
- Miscarriage or premature birth.
- Type 2 diabetes or prediabetes.
- Sleep apnea
- Metabolic syndrome, this is a cluster of conditions including high blood pressure, high blood sugar, and unhealthy cholesterol or triglyceride levels that significantly increase one’s risk of heart and blood vessel (cardiovascular) disease.
- Depression, anxiety, and eating disorders.
- Endometrial cancer, this is cancer of the uterine lining.
Hirsutism
According to the Resilient Sisterhood Project, Black women with PCOS are shown to have higher rates of hirsutism, insulin resistance, obesity, high blood pressure, abnormal cholesterol, high blood sugar and a higher risk or cardiovascular disease or metabolic syndrome. People with PCOS hirsutism typically have course, visible, dark hairs growing in these parts of the body. These hairs are commonly called androgenic. Many women select from the following methods to manage their hair growth:
Manual removal, such as shaving, plucking, or waxing.
* Depilatory agents, such as topical gels, lotions, or hair removal creams.
* Hormonal medications, such as birth control pills that boost estrogen levels and anti-androgen drugs that can decrease testosterone levels.
* Electrolysis, this technique kills the growth center of a hair with electricity.
* Laser hair reduction, this kills hair with a laser, it has been proven to work best on fair-skinned people with very dark hair. (Editor’s note To avoid an adverse reaction you must go to a board-certified dermatologist experienced with dark skin that has a laser designed for use for dark skin).
If you are experiencing signs of hirsutism , this is not enough to equate to a direct PCOS diagnosis, we urge you to visit your healthcare providers to get a thorough understanding of your symptoms, this can aid in proper diagnoses regarding PCOS or other conditions.
Treating Your PCOS
Since PCOS does not have a cure, treatment focuses on managing the symptoms and complications that concern patients, these focal points can be different for every individual. This could include infertility, hirsutism, acne, or obesity, according to the Mayo Clinic. Lifestyle changes and medication may be suggested for patients to achieve their health goals. To regulate periods and ovulation, healthcare providers may recommend some of the following options:
- A combination of birth control pills, that contain both estrogen and progestin decrease androgen production and regulate estrogen. Regulating these hormones can lower the risk of endometrial cancer and lessen symptoms associated with PCOS.
- Progestin therapy, taking progestin for 10 to 14 days every 1 to 2 months can regulate periods and protect women against endometrial cancer.
- Clomiphene, this oral anti-estrogen medication is taken during the first part of a woman’s menstrual cycle, it can help with ovulation and the process of getting pregnant.
- Letrozole (Femara), this breast cancer treatment can work to stimulate the ovaries.
- Metformin, this medicine for type 2 diabetes that can be taken orally improves insulin resistance and lowers insulin levels.
- Patients can also discuss topical gels, creams, and medications to reduce the speed of excessive hair growth and the effects that high androgen levels can have on the skin.
Navigating life with PCOS can certainly be tough and many women suffer mentally as they struggle to find support in an experience that can be very isolating. Here at BHM, we want to remind you that you are not alone, and we urge you to find support whether it be from healthcare providers, friends, family, therapists, other women living with this condition, or a combination of all these things.The Resilient Sisterhood Project has reported the experiences of many black women with PCOS who have felt invisible and invalidated when seeking help from medical practitioners. Others have had their symptoms dismissed. been bullied about their weight instead of the root cause of their issues.
It is imperative that Black woman try their absolute best to research their doctors, read patient reviews, and remain confident in their knowledge of their experiences and the questions that they are seeking answers for. We don’t deserve to be profiled or dismissed when we are trying to take care of our health, advocating for ourselves is one of the keys to attaining proper healthcare and holding our healthcare providers accountable
If you happen to have PCOS, your story and experiences are valuable. Remember to always advocate for yourself and your health and have compassion for yourself as you go through this journey.
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