Polycystic Ovarian Syndrome – was once considered a gynecological condition.
We now know that it’s an endocrine disorder that has an underlying metabolic condition usually associated with insulin resistance that leads to hyperinsulinemia.
That means that insulin builds up in the body. This in turn leads to increased production of ovarian androgen and decreased sex hormone binding globulin.
All of that creates a situation where follicles grow in the ovary – but not to maturity, generally there is an increase of luteinizing hormone and decreased follicle stimulating hormone, excess circulating estrogen and suppressed ovulation =no period.
Symptoms
These out-of-whack hormones create a viscous cycle with continued irregular or suppressed periods, weight gain, acne, male pattern hair loss, unwanted facial hair, acne, infertility and more.
The risks associated with PCOS are substantial:
obesity, insulin resistance, infertility, dyslipidemia, sleep apnea, endometrial hyperplasia & cancer, depression/anxiety, binge eating, pregnancy complications, gestational diabetes, pregnancy induced hypertension, small birth weight for babies and more.
PCOS symptoms often appear in women when they are in their teens starting with irregular or missing periods and acne, but these symptoms are often passed off as normal for young girls and a decade can pass before they get any real help.
Side Note:
(This is different than the type of an-ovulation that we see in highly athletic young women – if they get extremely low body fat, they can stop ovulating, especially when they are in training. Generally, as soon as their training slows down and they regain a little body fat, ovulation returns.
An-ovulation can also be an issue for women with eating disorders -which also needs to be taken seriously)
Why is it so important to have a regular period?
Long term lack of ovulation- especially when follicles are still growing – puts women at risk for endometrial cancer, bone loss (even at a young age this can happen quickly), metabolic issues, cardiac issues and more.
Testing
If you suspect that you or your daughter may have PCOS ask your Dr to test Pituitary & ovarian hormone levels – LH, FSH, Estradiol, Progesterone, prolactin & of course rule out pregnancy.
It’s also important to test for free testosterone and free androgen, sex hormone binding globulin and DHEA-S. (your Dr should be familiar with these tests )
in addition a fasting glucose tolerance test, a full thyroid panel (with TPO), a lipid profile, vitamin D and HsCRP.
yes, that’s a bunch of tests – but getting a clear picture of what is happening can give you and your Dr the information you need to help.
So what can you do?
Diet is key
A diet high in healthy fats and protein and lower in carbohydrates (less than 80 gm/day) – focused on healthy carbs in fruits, veggies and whole grains has been shown to reduce and even reverse the metabolic syndrome that accompanies (and exacerbates) PCOS.
About 70% of women with PCOS are overweight and research has found that simply reducing body weight by 5-10% can reverse many of these symptoms.
The Mediterranean or modified ancestral diet have been shown to be most effective.
Supplements & herbs
There are actually several supplements and herbs that have been shown to be highly effective in helping with PCOS – here are a few:
Fish Oil – 2grams a day – this is considered a high dose but has shown to be really beneficial
Vitamin D -bringing levels up to optimum has been shown to be helpful in reducing anxiety, improving energy and reducing several other symptoms of PCOS.
Flax Seeds – 1-2 Tablespoons a day in food – making sure you have a daily bowel movement helps excrete excess toxins and hormones.
Probiotics & Prebiotics – (I know, I need to do a post on both of these!) But including a high quality probiotic in addition to probiotic foods like fermented sauerkraut, fermented pickles, kefir and yogurt can also help restore gut health and improve digestion and detox pathways.
Adaptogens – like ashwagandha, ginseng & licorice- all help the body manage the stress response and regulate cortisol levels.
No Pill without a Skill
My mentor and Teacher, Dr Aviva Romm has made this an essential part of her practice and encourages her students to do the same.
the best diet, herbs and supplements can only do so much if women aren’t taking care of their minds, bodies & souls.
Meditation
Yoga
Regular exercise (taking care not to over exercise)
Circadian rhythm reset – get up at the same time each morning and get to bed at a reasonable time each night. Use the sunrise as your guide.
These are just a few of the things that can help.
in a world where fast food, late nights and long, sedentary days are the norm – diseases like PCOS are becoming more and more prevalent.
Often the genetics that predispose women to these types of disorders are set into motion before they are even born- but with support from a healthy diet, botanicals and lifestyle changes, PCOS is not a life sentence.
If you need help navigating PCOS I’d love to help – lets schedule some time to chat. (schedule a free 15 min introductory meeting here)