PCOS with Regular Periods
According to a study by Goldzieher et al. (1963), approximately 12% of women with PCOS had regular menstrual cycles. More recent research confirms this proportion, with rates ranging from 15% to 25%. While polycystic ovary syndrome (PCOS) is often associated with irregular periods, it is possible to have PCOS with regular menstrual cycles. This complex endocrine disorder, affecting a significant percentage of women of childbearing age, remains largely underdiagnosed due to its diverse manifestations. At Imane Harmonie, we often say, "One woman, one PCOS," and every hormonal profile is different.
What is PCOS?
Polycystic ovary syndrome is a common hormonal disorder and a major cause of infertility in women. It is characterized by excessive production of androgens (male hormones) and the formation of multiple small follicles on the ovaries. Symptoms can vary widely from one woman to another, making diagnosis sometimes challenging, especially in the presence of regular menstrual cycles.
Can You Have PCOS with Regular Periods?
The answer is yes. It is entirely possible to have PCOS even with regular menstrual cycles. This can occur when the ovaries produce abnormally high levels of androgens and present a high number of follicles, despite having a regular menstrual cycle. Typical symptoms include acne, facial hair growth, obesity, and difficulty conceiving. However, it is important to understand that having regular periods does not necessarily mean that you are ovulating every month. You may indeed have your period without ovulating.
Having Regular Periods but No Ovulation
When a woman does not release an egg (anovulation), the endometrium (uterine lining) can continue to thicken under the influence of estrogen. However, without ovulation, the production of progesterone necessary to stabilize this endometrium does not occur. This hormonal instability can lead to "withdrawal bleeding," which resembles a period but is not true menstruation resulting from a complete ovulatory cycle.
PCOS can cause hormonal imbalances that prevent ovulation but still allow the endometrium to develop under estrogen influence. The endometrium can then shed irregularly, causing bleeding that may be mistaken for a period.
Why is PCOS Often Undiagnosed?
PCOS is extremely heterogeneous, and its manifestations can be subtle, especially with regular cycles. According to the World Health Organization, about 70% of PCOS cases remain undiagnosed globally. The lack of symptom recognition by patients and sometimes even by healthcare professionals contributes to this underdiagnosis.
How to Diagnose PCOS with Regular Periods?
To diagnose PCOS in women with regular cycles, it is essential to conduct hormonal evaluations and ovarian ultrasounds. A blood test may reveal elevated androgen levels. An ultrasound may show enlarged ovaries with many follicles. It is also crucial to consider other symptoms such as fertility issues, acne, excessive hair growth, and weight gain.
Long-term Health Implications of PCOS
PCOS is not limited to fertility issues. It is associated with an increased risk of developing serious conditions such as type 2 diabetes, heart disease, and hypertension. Managing PCOS often involves lifestyle changes, such as weight loss and increased physical activity, as well as medical treatments to regulate hormones.
PCOS with Regular Cycles
Case Study: Prevalence of PCOS in Hyperandrogenic Women with Regular Cycles
Having regular cycles does not necessarily mean you are ovulating. In a prospective observational study, fifty-eight women with PCOS and regular cycles were evaluated. The results revealed that:
- 20.7% were anovulatory and met the diagnostic criteria for PCOS.
- 53.4% of ovulatory patients had polycystic ovaries or an increased 17-OHP response, suggesting PCOS despite ovulation.
Other Symptoms of PCOS
In addition to menstrual irregularities, PCOS presents other symptoms such as:
- Acne and oily skin
- Male-pattern hair loss
- Excessive hair growth (chin, upper lip, arms, chest, back, abdomen, thighs, buttocks)
- Weight gain
- Difficulty conceiving
These symptoms indicate high levels of androgens. Diagnosis can be confirmed through blood tests and ultrasounds.
Managing PCOS with Regular Cycles
You will find here all the natural treatments that can be implemented in managing PCOS.
Even with regular cycles, managing PCOS is crucial. Hormonal contraceptives can help regulate hormone levels and reduce symptoms. For those wishing to conceive, specific treatments such as metformin and ovulation stimulants may be necessary. Regular consultation with a specialist is essential to monitor the condition's progression and adjust treatments accordingly.
Conclusion
PCOS with regular periods is a complex and often misunderstood reality. By being better informed and regularly consulting healthcare professionals, women can obtain an accurate diagnosis and effective management of this condition. If you experience PCOS symptoms, even with regular cycles, it is crucial to consult a doctor for appropriate testing and regular follow-up. Knowledge and vigilance are key to effectively managing PCOS and preventing long-term complications.
And before you go, feel free to read our article on PCOS and OPK: The Differences to confirm that there is no confusion between the two concepts.
