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Grace Lipsinic

Prof. Riley

English Comp. 2

27 April 2021

Why is PCOS a Difficult Diagnosis for Doctors to Understand?

Throughout the entirety of the world, “1 in 5 women” suffer from PCOS (Polycystic

Ovarian Syndrome): a chronic hormonal disorder common among women in the reproductive

age (Mayo Clinic) (“Polycystic Ovary Syndrome”). Common symptoms of this diagnosis include

irregular periods, an increase in excess androgen (a male hormone), and polycystic ovaries

(Mayo Clinic). With the research and application of modern studies, the number of diagnosed-

patients is suspected to rise. Though many women(worldwide)are clinically diagnosed with

Polycystic Ovarian Syndrome, experts are still unaware of the definitive cause(s) of PCOS and it

continues to be an up-battling diagnosis without a cure. Though many doctors are aware of the

existence of PCOS and its popularity, why is its’ diagnosis still so poorly understood?

Initially, Polycystic Ovarian Syndrome was first described in 1935 by American

gynecologists, Irving F. Stein and Michael L. Leventhal, but its existence was first discovered in

1731 by an Italian scientist, Vallisneri (Dorota Szydlarska) (“History of Discovery of Polycystic

Ovary Syndrome”). He described a married, infertile woman with “shiny ovaries with a white

surface” in which the ovaries were “the size of pigeon eggs.” However, it wasn’t until the 1990s

before definitive criteria were made for PCOS by the NIH (National Institution of Health)

Vallisneri (Dorota Szydlarska). Ever since PCOS became an official diagnosis, many studies

have been done thus far, and It had been found that PCOS is most likely due to genetics(Mayo
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Clinic), but there is no definitive cause for its diagnosis. It is believed that the percentage of

PCOS-diagnosed women from decades or even centuries ago, have stayed the about same, but

with the adaption of modern technology the criteria of Polycystic Ovarian Syndrome has been

refined (Dorota Szydlarska). Doctors and gynecologists may recommend pelvic exams, blood

work, and even ultrasounds before an official diagnosis is made(Mayo Clinic). However, many

women suffer from PCOS unknowingly and are not officially diagnosed.

With the adaption of modern medicine, treatment of Polycystic Ovarian Syndrome has

improved and each will vary depending on the individual; the level of PCOS a woman could

have can differ from person to person. Gynecologists may recommend birth control pills or

progestin to regulate periods and stunt unwanted hair growth, or lifestyle changes, such as diet

and exercise, and even acne medications, like spironolactone to balance hormones (Mayo

Clinic). In essence, these medications have been proven effective, however, these medications,

like many others, come with risks and do not work for every patient. Birth control pills, for

instance, can cause sore breasts, nausea, and in some serious cases, blood clots.

Polycystic Ovarian Syndrome or PCOS is a very common disorder and it’s not new to

science. Yet, there are still some common misconceptions regarding its diagnosis. Some doctors

view that only overweight or “obese” patients are known to have PCOS, which is a common

mistake (Ally Fullmer) (“5 Myths of Polycystic Ovary Syndrome”). This stereotype is widely

known to many because PCOS patients suffer from insulin-resistance. When one’s body resists

insulin (a natural hormone), it causes the body to demand more insulin and triggers the ovaries to

produce more hormones (Medical Centric) (“Polycystic Ovarian Syndrome, Causes, Signs and

Symptoms, Diagnosis and Treatment”). This can lead to both obesity, inflammation, and higher

levels of androgen (Abraham Subeka) (“Association of Metabolic and Inflammatory Markers with
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Polycystic Ovarian Syndrome”). Doctors may recommend losing weight with diet and exercise,

but many patients who aren’t considered “obese” are known to suffer from PCOS (Ally

Fullmer). Not only that, but androgen is also not the only excess hormone that PCOS patients’

over-produce. PCOS patients, additionally, are known to produce higher amounts of estrogen (a

female hormone) (Ally Fullmer). Increases in estrogen can “lead to a build-up of lining of the

uterus which is a major risk factor for [developing] uterine cancer,” says Doctor Sloane.

Polycystic Ovarian Syndrome affects women with different potencies and with

differentiating symptoms. For instance, infertility and obesity. Though conceiving as a PCOS

patient can prove difficult (because most cannot track their ovulation) and obesity being a

common symptom, it’s important to note that a woman can still get pregnant with PCOS and that

a women’s weight has absolutely nothing to do with its diagnosis (Ally Fullmer).

Controversy concerning Polycystic Ovarian Syndrome is still ongoing and there

continues to be misconceptions regarding its diagnosis. PCOS is not a disease, but it can be a

disorder one can develop. Which is a good reason why PCOS bewilders both doctors and

gynecologists. Though its definitive cause is still unknown, there has been significant

improvements in the knowledge of PCOS. Though, PCOS is not a diagnosis one can get rid of,

with the right medications, diet and exercise, it can be managed.

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Work Cited

Abraham Gnanadass, Subeka, et al. “Association of Metabolic and Inflammatory Markers with

Polycystic Ovarian Syndrome (PCOS): And Update.” Archives of Gynecology and

Obstetrics, 2021, p. 1. EBSCOhost, doi:10.1007/s00404-020-05951-2.

Fullmer, Ally. “5 Myths About Polycystic Ovary Syndrome (PCOS).” Penn Medicine, 18 Mar.

2020, www.pennmedicine.org/updates/blogs/fertility-blog/2020/march/five-myths-about-

pcos.

“Polycystic Ovarian Syndrome (PCOS), Causes, Signs and Symptoms, Diagnosis and

Treatment.” YouTube, Medical Centric, 30 Aug. 2018, www.youtube.com/watch?

v=16LB2VRUjP0.

“Polycystic Ovary Syndrome (PCOS).” Mayo Clinic, Mayo Foundation for Medical Education

and Research, 3 Oct. 2020, www.mayoclinic.org/diseases-conditions/pcos/diagnosis-

treatment/drc-20353443.

Szydlarska, Dorota, et al. “History of Discovery of Polycystic Ovary Syndrome.” Advances in

Clinical and Experimental Medicine, 29 Feb. 2016,

www.advances.umed.wroc.pl/pdf/2017/26/3/555.pdf.