If you’ve been dealing with any sort of period problems, you may have come across the condition PCOS. PCOS stands for polycystic ovarian syndrome and is one of the most common endocrine disorders in women of reproductive age. However, PCOS goes beyond just menstrual irregularities and is considered a multisystem hormonal and metabolic condition.
PCOS is an anovulatory condition, meaning you do not ovulate normally. With anovulation comes irregular menses and androgen excess, or an increase in male hormones such as testosterone.
What is happening during ovulation?
Normal ovaries contain multiples follicles and every month one follicle is chosen to become the dominant one. This follicle is then allowed to grow while suppressing the growth of all the other follicles. Influenced by the Luteinizing Hormone (LH), once the dominant follicle has reached its peak, it bursts and an egg is released. If ovulation is not reached, a dominant follicle is not formed, thus all follicles are allowed to grow a little and the result is multiple cysts on the ovaries.
So does this mean you have PCOS? No. It is a common misconception that in order to be diagnosed with PCOS you need to have multiple cysts on your ovaries, like the name suggests. This can only be seen via ultrasound. However, the presence of ovaries doesn’t always mean you have PCOS as ovarian health varies from month to month thus just because you have cysts one month does not mean you will have them the next month. In fact, it is normal for some healthy women to have polycystic ovaries; they are common during puberty.
PCOS can be broken down into 4 main types, with insulin resistant PCOS being the most common.
1. Insulin Resistant PCOS
2. Post-pill (birth control) PCOS,
3. Inflammatory PCOS and
4. Adrenal PCOS
How does insulin influence PCOS?
Insulin resistance can be caused by a variety of factors including high sugar and carb intake, stress, smoking, birth control, alcohol and lack of sleep, to name a few. Insulin resistance leads to higher levels of insulin in the blood which impairs normal ovulation and causes an increase in the production of testosterone. High levels of insulin also increases SHBG levels (sex hormone binding globulin) which is a protein that binds to sex hormones (such as testosterone) and keeps hormones inactive. When SHBG levels are low, free testosterone increases, meaning active testosterone is free to act on different organs in the body.
What tests should be done and what does PCOS look like?
Blood work and physical presentation are the best way to diagnose PCOS
– Fasting insulin
– 2-hour insulin glucose challenge test
– Free testosterone
Further blood testing to assess thyroid and adrenal functions may be needed.
Signs and Symptoms
As mentioned, anovulation presents as irregular menses and androgen excess. These are two of the tell tale signs of PCOS and are required for the diagnosis of PCOS.
• Irregular menses – this can present as longer periods or later periods
• Androgen excess
⁃ Excess hair growth on chin, cheeks, belly, around nipples
⁃ Hair loss
⁃ Weight gain
Due to the complexity of PCOS, treatment focuses on a whole-body approach and addressing the multiple causes that lead to insulin resistance and the results of prolonged insulin resistance. A variety of herbs and supplements, along with diet and lifestyle changes can be implemented to help treat PCOS.
Treating Androgen Access
– Paeonia lactiflora
– Glycyrrhiza glabra
– Natural progesterone
– Ganoderma lucidum
– Saw palmetto
– Vitex agnus-castus
Treating insulin resistance
• Eliminate sugar and reduce carbs
• Exercise – weight training
• Eliminating birth control
If you are interested in speaking more about this to Dr. Tejinder Ghag, Naturopathic Physician please consider booking a Naturopath appointment in the clinic.
Enjoy your day,