"Could It Be Me?" Women Struggling with Irregular Periods

[Financial News] The belief that 'polycystic ovary syndrome means infertility' is a misconception. Although PCOS is a common cause of infertility, women can become pregnant with an accurate diagnosis and ovulation-induction treatment. It is also not a condition that requires lifelong medication. However, because it can affect metabolic and mental health in addition to menstruation and pregnancy, early diagnosis and ongoing management are important.
Lee Je-yeon, a professor of obstetrics and gynecology at Ewha Womans University Mokdong Hospital, said, "Ovulatory dysfunction caused by PCOS is a common cause of infertility," while adding, "Having the condition does not make pregnancy impossible; successful pregnancy is possible with an accurate diagnosis and effective ovulation-induction treatment."

Polycystic Ovary Syndrome (PCOS) is a reproductive endocrine disorder affecting women of reproductive age. It occurs when ovulation does not take place properly or androgen secretion increases relative to female hormones, causing irregular menstruation. Symptoms related to elevated androgen levels, such as hirsutism on the chin or upper lip, acne, and female-pattern hair loss, may appear. Metabolic abnormalities, including insulin resistance, impaired blood sugar regulation, elevated blood pressure, and abdominal obesity, may also accompany the condition.
PCOS is also closely associated with sleep problems such as snoring and sleep apnea, as well as mental-health issues including depression and anxiety. For this reason, it is important to take a comprehensive look not only at menstruation and pregnancy, but also at metabolic health, including blood sugar, cholesterol, and obesity.

Lee emphasized, "PCOS is neither permanent infertility that cannot be treated nor a condition requiring lifelong medication. The key is to identify the problem through an accurate diagnosis and provide lifelong management tailored to the patient's condition."
The most common sign is irregular menstruation. Lee explained, "Irregular menstruation is a hallmark symptom of PCOS. Because regular ovulation does not occur, menstrual cycles often become longer or periods are skipped," adding, "However, irregular menstruation can have various causes besides PCOS, including severe weight loss, thyroid disease, and hyperprolactinemia, so the exact cause must be identified."

The symptoms of PCOS vary by age. Lee advised, "PCOS can delay menarche. If menarche has not begun at all or irregular menstruation continues three years after menarche, patients should visit an adolescent gynecology clinic."
However, a cautious approach is needed for teenagers. Their reproductive hormone systems are still immature, so irregular periods or acne may be normal changes of puberty. For about eight years after menarche, many small follicles may also be seen in the ovaries during normal puberty. Therefore, teenagers should not be hastily diagnosed simply because their ovaries appear 'polycystic' on an ultrasound.
Symptoms also tend to ease with age. Lee added, "Even among women diagnosed with PCOS, menstrual cycles often become regular around age 42. Hirsutism and acne also decrease in their 40s, while the polycystic appearance of the ovaries on ultrasound gradually diminishes. Menopause occurs about two to three years later than in other women."
Genetic factors cannot be overlooked. Although genetic factors are known to influence PCOS, it should be viewed as a complex disorder that acts together with environmental factors. A mother having PCOS does not necessarily mean her daughter will develop it, but if a biological sister has been diagnosed, women should carefully watch for possible symptoms.
Lee emphasized, "Because accurate diagnosis and identification of the problem are needed, along with lifelong management suited to the patient's condition, I recommend that anyone with symptoms seek care and consultation from an obstetrics and gynecology specialist."


[email protected] Jung Myung-jin, medical correspondent Reporter