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Four Ways that Polycystic Ovary Syndrome (PCOS) Can Take a Toll On Your Femininity (And What You Can Do To Feel Like a Woman Again)

Polycystic Ovary Syndrome is an endocrine disorder that affects up to 10% of women and is the main cause of female infertility. But if you’re here, reading this post, maybe you already know that! Although there have been significant gains in public awareness and strides toward a deeper understanding of the syndrome, PCOS is still a relatively obscure condition with no known cure and no definitive causes. What is known, however, is that it can prove to be incredibly challenging, frustrating, and agonizing for women who experience it.

I certainly support continued medical research on this disorder. However, I’d like to approach this discussion in a way that includes not only the physical impact that PCOS has on a woman, but the emotional impact as well. Because the nature of PCOS is that it affects a woman’s hormones (specifically and most notably, her ability to reproduce), it makes sense that it has the ability to wreak havoc on her sense of womanhood in general. Although we thankfully live in an age and culture in which a woman can define herself in almost any way she chooses, there are still certain aspects of womanhood that seem universal. Here are some ways that PCOS can take a toll on femininity:

Infertility

This is one of the most well known symptoms of PCOS.  An overproduction/imbalance of androgens causes women with PCOS to ovulate irregularly or not at all. This can lead to inconsistent menstrual periods and difficulty in becoming pregnant. To say this can lead to tremendous distress for women who want children is an understatement. Infertility contributes to body shame, questioning your worth as a person, and exacerbation of  the emotional anguish of a woman or couple thwarted in their desire to create or expand their family. Eighty-one percent of women ultimately become mothers; it can be heartbreaking to miss out on that for reasons beyond your control.

Weight Gain

Ah, the dreaded weight gain. I’ve got it, and so do two-thirds of other women with PCOS. Many people struggle with occasional weight issues, but the weight gain experienced by those with PCOS is something more drastic than just a natural slowdown of the metabolism, or a side effect of over-indulgence. There are close ties between PCOS and Type 2 diabetes, with the commonality being insulin resistance. Women with PCOS are more likely to develop diabetes, and did you know that having diabetes may be a precursor to developing PCOS? Significant weight gain is usually a factor in both conditions. A resistance to insulin means that starches and sugars aren’t properly digested and can accumulate in the bloodstream, ultimately leading to accumulating pounds and inches, among other issues. And while many women struggle with letting go of their pre-baby body or the physique they once enjoyed, the often large and sudden weight gain experienced by those with PCOS can be all the more devastating, particularly if you are not able to have children. Not everyone wants to be rail thin, but gaining a substantial amount of weight can cause a woman to feel unfeminine, unattractive, and undesirable. And there’s that nagging issue of all the health problems associated with excess weight to top it off.  A collective cultural abhorrence of fat, coupled with acceptance of fat-shaming behavior and comments, adds to the mental distress.

Hair Problems

For centuries, body hair has played an important role in cultural ideals concerning gender. For women, it seems that we want hair where we want it, and we don’t where we don’t! Polycystic Ovary Syndrome often includes the symptom of hirsutism, or excessive female body hair, particularly in places where it does not typically grow. You may be disgusted to find dark hair growing on your face, arms, chest, abdomen, or back. This is once again due to the surplus of androgen hormones. Additionally, some women with PCOS experience the opposite of too much hair: hair loss (like male pattern baldness). Emotionally, it can be devastating to discover patches of hair missing from your head, and there can be a lot of fear and anxiety when you see clumps of hair going down the drain or loading up your brush. Hair is supposed to be our “crowning glory,” and it’s hard to feel like a princess when you’ve got bald spots.

Low Sex Drive

What woman doesn’t want to enjoy a healthy and satisfying sexual relationship? However, even being adored or desired by your partner isn’t necessarily enough. Unfortunately, the hormonal imbalance caused by PCOS can make you feel less than fully eager. Women usually feel sexiest right around the time of ovulation, and if ovulation isn’t happening, your sex life might not be happening either. Low libido may also be attributed to PCOS affecting your body in other ways. You may not feel sexually confident because of feelings of depression, excess weight, increased body hair, etc.

Not to be a downer, but PCOS can really do a number for your self-confidence as a woman (as if we don’t already have enough to worry about!). So what can be done? Are we supposed to just hang our heads and cry, resigned to a life of misery? In a word, no. Tears may be part of the grief process for sure, but take it from someone who knows: you do not have to be miserable, and you do not have to let PCOS rob you of your joy. There’s no magic solution for making yourself feel better, and your heartbreak certainly won’t be solved overnight from something you gleaned from a single blog post. But allowing yourself to feel what you feel, reading and educating yourself about your condition, and finding a community of support are great ways to start.

One of the things that many women who learn to effectively manage PCOS must learn is how to readjust their expectations. Nutrition can play a huge part in helping with weight control, and different types of hormone therapy and lifestyle changes can help with fertility and hair growth. For example, if you’ve done some research and decide that you want to go ahead and give waxing a try to tame your lady beard, go for it, but please don’t think that a single beauty procedure is going to make you happy. It may give you a little boost, but remember that true joy comes from the inside (which is precisely the reason that I’ve chosen to focus on the mental health aspect of living with PCOS).

Keep learning, keep reading, and keep moving forward with hope. I am here for you.

Getting Started with Getting Healthy

Polycystic Ovary Syndrome (PCOS) is a complicated, often frustrating condition that affects many women who are experiencing infertility, or may even be a primary cause of infertility.  Symptoms typically include recurrent ovarian cysts, excess hair growth (or hair loss similar to male pattern baldness), acne, skin darkening, difficulty losing weight, and, of course, trouble getting pregnant.  Often, the condition is not accurately diagnosed until failure to get pregnant results in referral to a reproductive endocrinologist, who has specialized training in PCOS and other endocrine disorders. Any of these conditions taken singly are difficult to deal with – but the combination is often overwhelming for patients who have been diagnosed with PCOS.  PCOS is particularly difficult because it’s under-diagnosed, so you may have years of vaguely troubling symptoms before the diagnosis is made and treatment begins.  The physical side effects are unattractive and visible to the world – “I’m fat, pimply, and hairy,” as one of my clients stated tearfully.  Friends and relatives may assume that you’re lazy or eat too much, and that’s why you aren’t losing weight.  As a result, depression and low self-esteem are very common among women with PCOS. I was diagnosed with PCOS in my early twenties, and, as both a patient and a professional, I have learned that there are many things you can do to improve the quality of your life and your health with PCOS.  You can take control of your health and mood now by doing the following:

Get educated:  Do some research on the web, ask your doctor a lot of questions, join a support group and use it, read the RESOLVE newsletter for help regarding infertility, and stay on top of developments in treatment.

Obtain skilled medical help:  Although an internist or general practitioner may diagnose PCOS, it is more likely that a gynecologist, endocrinologist, or reproductive endocrinologist will do so.  If you have PCOS, you will most likely want to have an endocrinologist who will prescribe appropriate medications, monitor you for the potential development  of Type 2 diabetes, and coordinate with your reproductive endocrinologist while you are trying to get pregnant.  Because it is common to experience higher rates of thyroid disorder and heart disease when you have PCOS, it is a good idea to have frequent monitoring. Your physician can also:

• help you lose weight with the assistance of certain medications, and/or referral to a skilled dietician, who can teach you how to eat in a way that contributes to balancing your hormones and managing your symptoms;

• refer you to a good dermatologist, who can help to control or eliminate skin conditions related to PCOS, such as skin darkening and acne, and even help with treatments for hair loss; and

• suggest a therapist or support group to help you cope with the stress of infertility, symptoms of depression, and frustration of dealing with a chronic disease.

Exercise:  Yoga will resynchronize your brain, produce deep relaxation, reduce stress, and enhance your acceptance of your body, just as it is in the moment.  The cross-lateral motion of walking is also highly effective in regulating PCOS-related insulin resistance, controlling weight – and, surprise! – resynchronizing your brain waves.

Look better so you feel better:  In addition to seeking the help of a dermatologist for skin and hair conditions, you might want to actively manage excess hair growth cosmetically.  There are many ways to do this, but electrolysis is the only method that has been proven permanent.  A licensed electrologist will have a great deal of experience with PCOS patients.  Your dermatologist can provide you with a reliable referral. Although weight gain around the middle is frustrating and hard to overcome when you have PCOS, you can learn how to dress well, no matter your size or shape – and you deserve to do so!  Seek out current fashions that are figure-friendly, and get help when you need it – if you’re just not good at putting outfits together, ask a friend who is good at it to go shopping with you, use the free services of a department store personal shopper, or spring for a stylist who will help you figure out what works on you.

Don’t forget your brain:  Education is only one element of what your mind needs to effectively cope with the stress of PCOS.  Sometimes friends, partners, and physicians aren’t quite enough to help you work through your anger, frustration, irritability, and sadness about having PCOS, not being able to get pregnant, or the difficulty you experience losing weight in spite eating well and exercising regularly.  A licensed psychologist can help you decrease stress, develop personalized coping methods, enhance your support group, and identify additional resources.   Look for a health psychologist who utilizes mind/body methods that include meditation, guided visualization, mindfulness, and other ways of supplementing your good health practices. By actively taking care of your physical and mental health and appearance, you can learn to feel better by knowing that you are doing the best you can with a challenging condition.