Providing good care to a patient with Polycystic Ovary Syndrome (PCOS) is a challenge that many healthcare providers face. Women suffering from PCOS often have many nonspecific symptoms that may be blamed on a variety of other problems. Empathy, patience, active listening, and a willingness to investigate symptoms are all vital in the diagnosis and treatment of patients with PCOS.
What is PCOS?
PCOS is primarily a problem with a woman’s hormone balance. Often, the patient does not produce enough hormones to maintain a regular menstrual cycle. This may prevent ovulation, or the release of an egg, from occurring. In many cases, this leads to small cysts forming on the ovaries, which is where the name polycystic ovary comes from.
Often, the cysts that develop on the ovaries produce higher than normal amounts of androgens, or male sex hormones. Some symptoms of PCOS appear because of excess androgens. While many patients with PCOS do develop cysts, many do not. The presence or absence of cysts on the ovaries does not confirm or exclude a PCOS diagnosis.
Other symptoms that patients with PCOS may develop include:
- Missed periods
- Irregular periods
- Very light periods
- Excess body hair over the chest, stomach, and back
- Weight gain
- Acne or oily skin
- Male-pattern baldness
- Thinning hair
- Fertility problems
- Skin tags on the neck or armpits
- Dark patches of skin
- Thickening patches of skin
- Pelvic pain
- Severe menstrual cramps
During pregnancy, patients with PCOS have a higher risk of:
- Miscarriage
- Hypertension
- Gestational diabetes
- Preterm delivery
- C-section
Nursing care of a patient with PCOS
Patients who present with symptoms of PCOS should receive a thorough assessment and complete a detailed health history report. Since PCOS symptoms can also be caused by other hormone imbalances, poor diet, genetic disorders, or illnesses, it is important to get as much information as possible.
Patients with PCOS may struggle with pain control during their period, self-esteem issues due to hair loss or skin problems, and the devastation that comes with fertility problems. It is important for caregivers to address these problems. Take care not to dismiss the patient’s concerns over painful periods or cosmetic issues.
Treatment for PCOS may include:
- Hormonal birth control
- Androgen antagonists
- Surgical removal of cysts
- Insulin
- Diet and lifestyle modifications
Since women with PCOS often experience fertility problems, they may need fertility treatments such as IVF or medications to induce ovulation.
PCOS, reproductive healthcare, and the law
Varying abortion laws throughout the United States often makes it difficult or scary for women to seek reproductive healthcare. This is especially true for women with PCOS and other reproductive disorders with a higher risk of complications like miscarriage or ectopic pregnancy.
Treatment for spontaneous miscarriage and ectopic pregnancy is legal in all 50 states, even those with the strictest abortion laws. Reproductive healthcare providers should help their patients understand the laws in their state regarding birth control, abortion, and other laws surrounding women’s healthcare.
Related: Women’s Reproductive Health Issues in the Face of Changing Legislation
Reproductive health statistics in the United States
PCOS is a relatively common problem in the United States, affecting up to 13% of reproductive-age women. Unfortunately, around 70% of PCOS cases remain undiagnosed worldwide. In addition, 5-15% of women experience period pain that is so severe, it affects their ability to perform activities of daily living. There is a high probability that many of these women are suffering from undiagnosed PCOS.
PCOS is also the most common cause of infertility in women ages 20-35.
Misinformation surrounding PCOS
Nurses and other caregivers must be aware of misinformation to better educate their own patients and remain unbiased. There are several common misconceptions about PCOS that should be cleared up for both providers and their patients.
- “It’s the patient’s fault that they have PCOS.” While patients who are overweight or struggling with uncontrolled diabetes have a higher risk of developing PCOS, they do not deserve to be treated than a patient with any other type of disease. In addition, many patients without a history of diabetes or weight problems develop PCOS.
- “PCOS will go away with weight loss.” Many symptoms of PCOS will improve if an overweight patient returns to a healthy weight. However, there is no complete cure for PCOS.
- “PCOS is rare.” Unfortunately, many providers dismiss complaints of acne and painful menstruation, thinking that these symptoms are normal for all women of childbearing age. Severe pain, irregular periods, skin problems, and fertility problems should all be investigated. Since PCOS affects more than 10% of the population, it is worth investigating symptoms to find out whether they are being caused by PCOS.
- “Pregnancy is impossible with PCOS.” Patients who are diagnosed with PCOS should talk to a specialist if they hope to become pregnant. While it can be more difficult, many women with PCOS experience healthy pregnancies and deliveries. On the other hand, patients who are not ready for or do not want to become pregnant need to use a reliable form of birth control. Having PCOS does not mean that a couple is safe from an unexpected pregnancy.
