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What is PCOS (Polycystic Ovary Syndrome?)

Hi friends! In honor of Polycystic Ovary Syndrome (PCOS) Awareness Month, this week we’re going to talk about PCOS, how it impacts the pelvic floor, and what we can do about it.


PCOS is an endocrine (hormonal) disorder that affects many different functions of the body. To diagnose PCOS, your provider will look for at least two of the following symptoms:(Mayo Clinic, 2020)

  • Irregular periods (more than 35 days between cycles or less than 9 periods per year) that are often accompanied by abnormally heavy flow

  • Excess androgen (male) hormones—our bodies naturally have a small amount of testosterone and male hormones, but with PCOS the amount of these hormones is higher and can cause physical signs like excess facial and body hair, severe acne, or male-pattern baldness

  • Polycystic ovaries—your provider will look for cysts on your ovaries with ultrasound imaging

Hormones are chemicals that circulate through the body. Since PCOS is a hormonal disorder, it affects areas of the body outside of the ovaries. 3 out of 4 individuals with POC have insulin resistance which increases the risk of heart disease and type 2 diabetes (Peipei, 2017). PCOS has also been associated with infertility, liver disease, high blood pressure, high cholesterol, sleep apnea, depression and anxiety, and endometrial cancer (Mayo Clinic, 2020).


Many different diseases, like PCOS, can impact the pelvic floor and increase the risk of pelvic floor dysfunctions like incontinence and prolapse (Naz, 2020). PCOS can contribute to pelvic floor dysfunction because the pelvic floor muscles react to different hormones in the body. Not only can diseases themselves affect the way the pelvic floor works, but so can treatments, like medications and surgeries.


If you have pelvic floor dysfunction, you may have difficulty with peeing or pooping, pelvic pain, pain with sex, pelvic organ prolapse, and more. Seeing a pelvic floor physical therapist is the best resource for helping you to deal with these problems. Watch the video below to learn more about how the pelvic floor muscles work.



How is PCOS treated? The first recommended treatment for PCOS is lifestyle modification. This includes: Dietary changes—seeing a registered dietitian is a great resource

  • Exercise—the American College of Sports Medicine recommends 150 minutes per week of moderate level activity

  • Quitting smoking and drinking alcohol


These lifestyle changes have been shown to help improve insulin resistance and free testosterone levels, improve periods, and reduce excess hair growth and acne (Peipei, 2017).


Your provider may also recommend certain medications and supplements to help address any hormonal changes and other symptoms that may come along with PCOS. These medications may address issues like high blood sugar or other symptoms to help regulate your periods and decrease excess hair growth. Birth control is commonly prescribed for individuals with PCOS, but it is important to talk with your provider to determine what is best for you.

Often times it takes a while for individuals to be officially diagnosed with PCOS, and once they are it can seem overwhelming. Finding providers who listen to you can give you hope!


Here are some great resources to help you learn more about your PFM:

For providers, check our online courses to help your clients train their PFM. Consider joining our Ambassador Program and most of our courses are included with your membership!


Written by Emily Reul, PT, DPT


References

1. Peipei J, Yongyong X. Treatment strategies for women with polycystic ovary syndrome. Gynecol Endocrinol. 2017;34(4):272-277.

2. Polycystic ovary syndrome (PCOS). Mayo Clinic. October 3, 2020. Accessed September 29, 2021. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439

3. Naz MSG et al. Polycystic ovary syndrome and pelvic floor dysfunction: a narrative review. Res Rep Urol. 2020;12:179-1865


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