PCOS doctor Perth

8 confusing PCOS Myths: Separating fact from fiction

Author: Dr Jemma Dalrymple
First published: August 13, 2024

PCOS can be a confusing condition to understand, especially with all the myths that surround it. These myths can make it harder for women to get the right information and support. In this blog, we’ll talk about some of the common myths about PCOS and share the facts to help clear things up.

PCOS myths

Myth 1: PCOS is only about cysts on the ovaries

It’s easy to think that a condition called ‘polycystic ovarian syndrome’ is just about the ovaries, but that’s not actually true. PCOS is a complex condition and the most important underlying problem is an excess of androgens (male hormones).

In fact, women with PCOS don’t even have cysts on their ovaries! What we might see on an ultrasound is a high number of follicles or fluid-filled sacs containing immature eggs which don’t develop properly.

"The name ‘polycystic ovarian syndrome’ is misleading. The International Guideline on PCOS, published in Australia in 2023, says that the name is a “distraction” and should be changed."

Understanding that PCOS is a hormonal issue can help shift the focus to managing these imbalances rather than just worrying about the presence of cysts.

Myth 2: All women with PCOS have the same symptoms

PCOS symptoms can vary greatly from one woman to another. It’s like a ‘lucky dip’ of symptoms that might include irregular periods, acne, excess hair growth, weight gain, and mental health issues. Each woman’s experience with PCOS is unique.

"PCOS is not a one-size-fits-all condition. Because it’s complicated, it’s different for everyone."

Since PCOS affects everyone differently, it’s important to get care that’s right for you.

Myth 3: Birth control pills are a “band-aid treatment” for PCOS

Many women are concerned that going on the pill for PCOS will only mask or cover up the symptoms. In fact, the pill actually helps to reduce the excess androgen levels and restore hormonal balance in women with PCOS.

It also has other helpful effects:

It regulates your menstrual cycle
It protects the lining of the uterus (the endometrium), which can become overgrown in women with PCOS, leading to a risk of cancer
It improves symptoms like acne and excess face and body hair

However, the pill isn’t for everyone and you should talk to your doctor about whether it’s a good option for you.

Myth 4: PCOS can be cured if you lose weight

Unfortunately, there is no known cure for PCOS. While lifestyle changes aimed at preventing weight gain, or losing weight, are the best and most important treatment for PCOS, they are not a cure.

Did you know? Many people believe that only overweight women suffer from PCOS. While weight gain can be a symptom, PCOS affects women of all sizes. Weight gain is just one of many symptoms, and women with a normal or low BMI can also have PCOS and these women will still have a higher risk of heart disease and diabetes than the rest of the population.

"Weight loss can improve some symptoms, but other treatments may also be necessary."

Lifestyle change alone might be enough to cause the menstrual cycle to regulate and improve skin problems. Exercise – even a stroll around the block – is also a great treatment for mental health problems and will leave you feeling great! However, PCOS is considered a lifelong diagnosis.

Myth 5: Women with PCOS can’t get pregnant

While PCOS can make it harder to conceive due to irregular ovulation, it doesn’t always lead to infertility. Many women with PCOS go on to have successful pregnancies, sometimes with the help of lifestyle changes or fertility treatments.

The good news is that lifestyle changes, and sometimes metformin (a medication which helps with glucose metabolism) are often enough to regulate the cycle leading to successful pregnancies. When these measures don’t work, there are lots of safe and effective options for fertility treatment.

"With the right approach, many women with PCOS can and do become pregnant."

Of course, it’s also important to know that if you have PCOS and you don’t want to be pregnant, you need to use effective contraception! Although you might not ovulate regularly, there’s no way of predicting when that might be…

Myth 6: If you don’t want children, PCOS isn’t a big deal

It’s hopefully clear by now that PCOS doesn’t just affect your cycle! As well as the symptoms listed above, PCOS can cause problems including:

Increased risk of diabetes,
Increased risk of heart disease,
Poor mental health (women with PCOS are significantly more likely to suffer from depression and anxiety),
Increased risk of cancer of the endometrium (the lining of the uterus)
Metabolic changes and difficulty losing weight

Managing PCOS is important regardless of whether you plan to have children. Taking a holistic approach can improve your quality of life in many ways.

Myth 7: PCOS is caused by poor diet and lack of exercise

There is no single cause for PCOS. There is definitely a genetic component but no single gene has been found. There are also environmental and lifestyle factors. While high body weight and BMI are often associated with PCOS, it can also happen in women with low BMI. What we do know is that living the healthiest lifestyle you can will improve your symptoms and reduce your risk of complications. Even small changes make a difference!

Myth 8: You can’t diagnose PCOS in adolescence

It can certainly be harder to diagnose PCOS in adolescence, because it’s normal for periods to be irregular for the first few years. In addition, the ultrasound changes we see in women with PCOS are normal for adolescent women. However we can increasingly recognise features of PCOS without needing an ultrasound (or, in some cases, any tests at all!) Where adolescent women don’t quite meet the criteria to diagnose PCOS we can recognise that they are “at-risk” and plan to follow them up in a few years, but we don’t need to wait for a definite diagnosis to start looking after their health.