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Part I: Understanding PCOS and getting a diagnosis

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By Mary Sabo, L.Ac DACM

Polycystic Ovarian Syndrome or PCOS is the most common endocrine disorder among women of reproductive age. Many of our patients are concerned that their longstanding use of hormonal therapies to prevent pregnancy (like the pill or hormonal IUD) may have caused their PCOS, but this is not the case. It is more likely that these interventions just mask the dysfunction that is occurring over time. It is not fully understood why so many women are being diagnosed with PCOS, but diet and genetic factors are likely part of it.  Since PCOS can present in many different ways, let’s take a closer look at this ovarian disorder.

PCOS is associated with an increased number or congestion of follicles in the ovary that can lead to some or all of the following:

  1. anovolution (absence of ovulation)

  2. increased levels of androgen hormones like testosterone or DHEA

  3. long cycles

  4. amenorrhea (absence of a period)

  5. thinning hair on their head and increased body hair growth in places such as around the nipples, on the chest or abdomen, and on the face

  6. acne

  7. digestive problems

  8. insulin resistance

Occasionally, the only sign or symptom is irregular periods or anovulation (which may or may not be obvious as some women continue having regular periods) and the diagnosis is made just through transvaginal ultrasound.  This is referred to as simply polycystic ovaries (PCO) without the “syndrome” involving elevated testosterone levels and insulin resistance.  Some women don't realize they have PCO or PCOS because they still get periods and some may even ovulate some or all cycles. Women on hormonal birth control typically have no symptoms and it is not until they discontinue use that they begin noticing symptoms or simply do not get periods.

The diagnosis of PCOS is made through a blood test looking for increased testosterone and DHEA levels along with a transvaginal ultrasound to look at the number of follicles in the ovary. Some doctors may also measure hemoglobin A1C or insulin and blood glucose levels, all of which can reflect the presence of insulin resistance. Blood tests may also reveal elevated Luteinizing Hormone (LH) and lowered Follicle Stimulating Hormone (FSH) from the pituitary gland and high Antimüllerian Hormone (AMH). Some of the Reproductive Endocrinologists I frequently share patients with consider an ovary containing more than 15 visible antral follicles on an ultrasound polycystic, even in cases where androgens are not elevated, but symptoms are present.  

If you have a diagnosis of PCOS or PCO or suspect you might be at risk, there are lots of options to help you!  See PCOS PART II of this blog for treatment options and tips on naturally supporting your ovarian function. If you are in the NYC area and need support for your hormone health or fertility, contact us or schedule a session online and we will work with you to form a customized plan to help you manage your symptoms and meet your goals.


Testimonials

“Mary Sabo is my miracle worker! It’s really incredible to think that I get to see my eastern doctor every week and have her really listen and do things that help. She is so warm and I feel like because of her, I can achieve my goals. I am not sure if this is the case for others, but my cycles have since gone from 60+ days to 35 days the first month, 30 the second and we’re on track for a 28 day cycle!!”

— T.S

I adore Mary. I have been seeing her for 4 years through a tough miscarriage, a roller coaster pregnancy, and every issue and ailment (fertility and other) along the way. She is so knowledgeable in both eastern and western medicine. I always leave her office feeling amazing, both physically and emotionally. She is kind, caring, patient, and seems to know everything about everything. Her skill in acupuncture is unparalleled - this is evident not only through my own experience, but also the doctors who work with her, the panels she's so often asked to speak on, and the incredibly successful business she so quickly grew. My visits with Mary are the highlight of my week. I cannot recommend her enough.

— M.J.

“Jessica immediately made me feel seen, respected, heard and cared for through active listening, asking varied questions, getting my pronouns correct immediately after my first request, sending email follow-ups to keep the healing going, and her clearly in-depth understanding of Traditional Chinese Medicine. As someone with chronic mental and physical pain who has dealt with my fair share sub-par bedside manner, I’m incredibly grateful to have Jessica on my team.”

— Ray