There’s still a lot we don’t know about it. PCOS, or polycystic ovary syndrome, basically is a metabolic disorder with hormonal imbalances. It’s actually the most common form of hormonal imbalance. We would also call this an endocrine disorder, “endocrine” just referring to hormones, so an endocrine disorder, the most common one in women of reproductive age, probably affecting somewhere between about 5 to 15 percent of women.
How is it diagnosed? There are some controversies around the diagnostic criteria. There are different ways to make the diagnosis, so I think that’s one of the reasons we don’t have a clear idea on exactly how many women this is affecting. The main hormone disruption that we’re seeing in PCOS, or polycystic ovary syndrome, is higher-than-normal levels of androgens in women. Androgens, you can think of as the “male hormones.” These are things like testosterone, DHEA, and these hormones are responsible for giving some of the male characteristics. As women we normally have these hormones, but in PCOS we tend to see higher levels of the androgens.
Initially one of the common features in polycystic ovary syndrome was an appearance of polycystic ovaries. Technically, they aren’t actually ovarian cysts, they’re actually follicles that were seen, and then they have a very classic appearance in the setting of typical PCOS. But that actually isn’t even used as diagnostic criteria, but it’s something worth mentioning because that’s where the name comes from, polycystic ovary syndrome. Your doctor generally should be looking for absent menstrual periods, maybe excess facial hair growth , or hirsutism, thinning of hair on the scalp and along the temples, maybe obesity, insulin resistance, and then should want to measure the androgen level, those sex hormone levels of testosterone, DHEA. You might have bleeding, but it’s not ovulating or producing an egg, which would allow for pregnancy, which is where we see that fertility issue coming up.
Signs and Symptoms The vast majority of women (around 70%) with PCOS suffer from insulin resistance, and therefore have difficulty losing weight. Insulin is a hormone produced by the pancreas that is released when carbohydrates (sugar) are consumed. Insulin’s job is to help bring sugar of out the blood and into the cell, but when insulin resistance is present, the cell’s receptors don’t open up efficiently to let the sugar in for absorption. This leads to both elevated glucose in the blood and elevated circulating insulin. Insulin is a “fat storage” hormone and therefore elevated circulating insulin can make it challenging to maintain a healthy weight. Because the cells are not able to utilize the glucose efficiently, this often leads to severe sugar cravings as well. Other symptoms associated with PCOS include skin problems (acne), hair loss, unwanted hair growth (hirsutism), irregular or heavy periods, and mood disturbances.
Treatment
PCOS treatment options
Hormonal birth control is often used as a treatment in traditional medicine, but this is more of a “band-aid” approach and isn’t truly getting to the root of the problem. Right when you go off birth control you will be right back where you started.
Diet and lifestyle changes can be made to improve PCOS symptoms. One recent long-term study showed that 54% of women with PCOS were able to improve their menstrual cycle via lifestyle and behavior modification changes and 43% of women were ovulating regularly post intervention.
Dietary treatment is highly individualized and we always take into account a woman’s relationship with food and readiness to change when creating treatment plans. Some general recommendations often include: – Eating a lower glycemic index diet – Being mindful of the amount of carbohydrates you consume and balancing out meals with adequate protein and fat – Including anti-inflammatory fruits and vegetables – Eating adequate healthy fat – Taking supplements proven to help with PCOS symptoms and cravings (these are discussed more in my 3-month program). Key supplements include Magnesium, Vitamin D, zinc, B Vitamins, Folate, Inositol, Berberine.
If you are feeling confused and frustrated with all of the conflicting advice about PCOS, let me walk alongside you and help you! Schedule a free 1-hour health strategy session.
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