Understanding PCOS: Symptoms, Causes, and Treatment Options

Managing Symptoms of Polycystic Ovarian Syndrome (PCOS) with Pelvic Floor Therapy

Polycystic Ovarian Syndrome (PCOS) is the most common hormonal disorder affecting females of reproductive age, with an estimated prevalence of 6.5-8%.¹ Although there is a familial connection, there is currently no identified gene responsible for the inheritance of PCOS.¹ It is important to understand that PCOS is a complex endocrine disorder that can result as a combination of many factors, some of which include²:

Insulin resistance
Ovarian abnormalities
Chronic inflammation
Diet and lifestyle
Nervous system dysregulation
Excessive male sex hormones

Diagnosing PCOS

According to the Rotterdam Criteria, a formal diagnosis of PCOS requires the presence of at least two of the following key symptoms: irregular menstruation, increased male sex hormones, or polycystic ovaries. However, diagnostic imaging of the ovaries is no longer mandatory for a PCOS diagnosis.² It is also essential to rule out other conditions that can mimic PCOS, such as hyperprolactinemia and hypothyroidism. Hormonal blood tests are typically administered to assess male sex hormone levels, female sex hormone levels, as well as thyroid stimulating hormones, prolactin, and adrenal hormones for differential diagnosis.²,³

It is important to advocate for diagnostic testing if you believe you may have PCOS, as proper medical management is essential to improving your quality of life and reducing complications related to a PCOS diagnosis.

Understanding the Disease Process of PCOS

At the core of PCOS is the failure of the ovary to release an egg, leading to a cascade of hormonal imbalances. The result is an increase in male sex hormones being produced by the ovaries and adrenal cortex, which stimulates luteinizing hormone (LH) production. The overproduction of LH is what’s responsible for the development of cysts that rest on the outside border of the ovaries.³

In addition to polycystic ovaries, PCOS may also lead to a range of symptoms and secondary complications, including³:

Acne
Male pattern of hair growth
Irregular menstrual cycles
Lack of ovulation
Infertility
Obesity and insulin resistance
Increased risk for cardiovascular disease
Thyroid diseases
Non-alcoholic fatty liver disease (NAFLD)
Sleep apnea

Although there is currently no cure for PCOS, healthcare providers (including pelvic health therapists) can help manage symptoms through lifestyle modifications.

How Pelvic Floor Therapy Helps Manage PCOS Symptoms

Women with PCOS often experience musculoskeletal issues such as low back pain, tailbone discomfort, abdominal cramping, and chronic inflammation. Physical activity is crucial in alleviating these symptoms by improving metabolic-related symptoms, range of motion, reducing pain, and increasing muscle strength…

…this is where pelvic floor therapy comes into play! Pelvic floor therapy not only supports hormone regulation through physical activity but also aids in relaxation and restoration of the pelvic floor muscles. Additionally, pelvic health therapists address pelvic pain, urinary/bowel dysfunction, sexual health, weight management, as well as mental well-being to improve your quality of life. By targeting both surrounding musculoskeletal and pelvic health, pelvic floor therapy can help alleviate some of the discomforts associated with PCOS, promoting overall well-being!

Goodarzi MO, Azziz R. Diagnosis, epidemiology, and genetics of the polycystic ovary syndrome. Best Pract Res Clin Endocrinol Metab. 2006;20(2):193-205. doi:10.1016/j.beem.2006.02.005
Abraham Y. PCOS: demystifying the hormonal web. Presented as part of Pelvicon; September 27, 2024; Atlanta, GA.
Polycystic ovarian syndrome. Physiopedia. August 31, 2023. Accessed October 1, 2024. https://www.physio-pedia.com/index.php?title=Polycystic_Ovarian_Syndrome&oldid=340780.